Scaling Up—From Vision to Large-scale Changecquin.icap.columbia.edu/wp-content/uploads/2018/07/...Scaling-up Reproductive Health Service Innovations: A Conceptual Framework. Paper

Scaling Up—From Visionto Large-scale Change

A Management Frameworkfor Practitioners

March 2006

Management Systems International600 Water Street, SWWashington, DC 20024Tel. 202-484-7170 Fax. 202-488-0754www.msiworldwide.com

Funded in part by the John D. and Catherine T. MacArthur Foundation

Scaling Up—From Vision to Large-scale ChangeA Management Framework for Practitioners

March 2006

Authored by Larry Cooley and Richard Kohl Edited by Rachel GlassDesign by Kris Humbert and Pamela Guandique

From Vision to Large-Scale Change—A Management Framework for Practitioners i

EEXXEECCUUTTIIVVEE SSUUMMMMAARRYY .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..11

SSCCAALLIINNGG UUPP BBEEGGIINNSS WWIITTHH AA PPLLAANN .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..33

SStteepp 11:: DDeevveelloopp aa SSccaalliinngg--uupp PPllaann .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..55

TASK 1: CREATE A VISION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

TASK 2: ASSESS SCALABILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

TASK 3: FILL INFORMATION GAPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23

TASK 4: PREPARE A SCALING-UP PLAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

EESSTTAABBLLIISSHH PPRREECCOONNDDIITTIIOONNSS AANNDD IIMMPPLLEEMMEENNTT AA SSCCAALLIINNGG--UUPP PPRROOCCEESSSS .. .. .. .. .. ..2277SStteepp 22:: EEssttaabblliisshh tthhee PPrreeccoonnddiittiioonnss ffoorr SSccaalliinngg UUpp .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..2299

TASK 5: LEGITIMIZE CHANGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

TASK 6: BUILD A CONSTITUENCY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

TASK 7: REALIGN AND MOBILIZE RESOURCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35SStteepp 33:: IImmpplleemmeenntt tthhee SSccaalliinngg--uupp PPrroocceessss .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..3388

TASK 8: MODIFY AND STRENGTHEN ORGANIZATIONS . . . . . . . . . . . . . . . . . . . . . . . .38

TASK 9: COORDINATE ACTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

TASK 10: TRACK PERFORMANCE AND MAINTAIN MOMENTUM . . . . . . . . . . . . . . . . . .43

CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44

AANNNNEEXX 11::SSUUMMMMAARRYY OOFF FFIIEELLDD TTRRIIAALL EEXXPPEERRIIEENNCCEE IINN MMEEXXIICCOO AANNDD NNIIGGEERRIIAA .. .. .. .. .. ..4455

MEXICO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45

NIGERIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48

AANNNNEEXX 22::SSTTEEPPSS,, TTAASSKKSS,, AANNDD QQUUEESSTTIIOONNSS FFOORR DDEEVVEELLOOPPIINNGG AANNDD

IIMMPPLLEEMMEENNTTIINNGG AA DDEETTAAIILLEEDD SSCCAALLIINNGG--UUPP PPLLAANN .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..5511

STEP 1: DEVELOP A SCALING-UP PLAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

STEP 2: ESTABLISH THE PRECONDITIONS FOR SCALING UP . . . . . . . . . . . . . . . . . . . . .52

STEP 3: IMPLEMENTING THE SCALING-UP PROCESS . . . . . . . . . . . . . . . . . . . . . . . . . . .53

AANNNNEEXX 33:: UUSSEEFFUULL TTOOOOLLSS FFOORR PPLLAANNNNIINNGG AANNDD IIMMPPLLEEMMEENNTTIINNGG AA

SSCCAALLIINNGG--UUPP SSTTRRAATTEEGGYY .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..5544

SSOOUURRCCEESS CCIITTEEDD .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..5566

Table of Contents

iiFrom Vision to Large-scale Change—A Management Framework for Practitioners

Table of Contents

Boxes

Step 1: Developing a Scaling-up Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6Categories of “Best Practice” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9Step 2: Establish the Pre-Conditions for Scaling Up . . . . . . . . . . . . . . . . . . . . . . . . .29Step 3: Implement the Scaling-up Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38

Figures

Figure 1. Summary Overview of Issues for Analyzing Scaling Up . . . . . . . . . . . .10Figure 2. Organizational Roles in Scaling Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16Figure 3. An Overview of the Scaling-up Process . . . . . . . . . . . . . . . . . . . . . . . . . . .28Figure 4. Policy Network Map—Health Sector of Boliguay . . . . . . . . . . . . . . . . . . .33Figure 5. Advocacy Network Training Manual Table of Contents . . . . . . . . . . . . .37

Tables

Table 1. Types and Methods of Scaling Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11Table 2. Choosing a Scaling-up Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14Table 3. Scalability Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

1From Vision to Large-Scale Change—A Management Framework for Practitioners

The concept of “scaling up” hasbecome increasingly popular asdonors have acknowledged with

concern the relatively poor record ofinnovative pilot projects in extendingtheir reach to large populations.Recognizing this, in October 2003, theJohn D. and Catherine T. MacArthurFoundation awarded a grant toManagement Systems International (MSI)to develop a field-tested framework andset of guidelines for improvedmanagement of the scaling-up process.This framework was intended to be ofdirect and immediate use to thoseplanning, implementing, and fundingpilot projects and to those hoping to takethe results of such projects to scale.

An earlier draft of the Scaling UpManagement (SUM) Framework wasused in field tests with reproductivehealth non-governmental organizations(NGOs) in Nigeria and Mexico and as abasis for initial dissemination efforts. Thisrevised version of the framework reflectsthat experience and incorporates thefeedback from initial dissemination.

One significant finding emerged fromthis research: Few so-called “pilotprojects” take the steps needed tomaximize their prospects for scaling up.The framework and guidelines presentedin this document seek to improve thistrack record by offering practical adviceon a three-step process to carry out eachof ten key tasks needed for effectivescaling up. These tasks include:

SStteepp 11:: DDeevveelloopp aa SSccaalliinngg--uupp PPllaann

Task 1: Create a Vision

1A. The Model: What Is Being Scaled Up?

1B. The Methods: How Will Scaling UpBe Accomplished?

1C. Organizational Roles: Who Performsthe Key Functions?

1D. Dimensions of Scaling Up: WhereDoes the Scaling Up Occur?

Task 2: Assess Scalability

2A. Determining the Viability of theModel for Scaling Up

2B. Analyzing the Organizational andSocial Context

Task 3: Fill Information Gaps

Task 4: Prepare a Scaling-up Plan

SStteepp 22:: EEssttaabblliisshh tthhee PPrree--ccoonnddiittiioonnss ffoorrSSccaalliinngg UUpp

Task 5: Legitimize Change

Task 6: Build a Constituency

Task 7: Realign and MobilizeResources

Executive Summary

This field-tested framework and set of

guidelines offer practical advice on how

to carry out each of ten key tasks needed

for effective scaling up.

SStteepp 33:: IImmpplleemmeenntt tthhee SSccaalliinngg--uuppPPrroocceessss

Task 8: Modify OrganizationalStructures

Task 9: Coordinate Action

Task 10: Track Performance andMaintain Momentum

For each Task, the document suggestsactions that need to be taken, presentsalternative tactics that can be used, and

references tools and outside resourcesthat can be of help. Annexes to thedocument summarize the field workconducted by MSI in Mexico andNigeria (Annex 1); present a sequencedlist of questions to guide the scaling-upprocess (Annex 2); and provide aconsolidated list of some of the toolsmost useful for each phase of thescaling-up effort (Annex 3).

2From Vision to Large-scale Change—A Management Framework for Practitioners

Scaling Up Begins with a Plan



The persistence of poverty andpreventable illness in low-incomecountries after 30 years of

development efforts has drawn attentionto the relatively poor record of pilot anddemonstration projects in successfullystimulating systemic change and reachinglarge populations. In rich and poorcountries alike, service providers andfunders find themselves under pressureto reduce costs, improve social outcomes,and explain why it has proven so difficultto accelerate the spread of best practices.

Recognizing this, in October 2003, theMacArthur Foundation awarded a grantto Management Systems International(MSI) to study the scaling up of smallpilot and demonstration projects and tofield test methods for improving thescaling-up process. The grant called forfive activities:

To develop a framework thatsynthesized the existing state ofknowledge on scaling up;

To conduct field trials, using theframework as a general guideline;

To assess the experience of the fieldtrials;

To revise the framework based onthe experience of the field trials; and

To disseminate these findings, withparticular emphasis on thepopulation and reproductive healthcommunities.

The initial version of the Scaling UpManagement (SUM) Frameworkdeveloped under this grant built on 11years of applied research carried out byMSI under the USAID-fundedImplementing Policy Change Program.1

It also drew heavily from the existingliterature on scaling up, strategicplanning, and organizationaldevelopment. This framework was usedin field tests with reproductive healthnon-governmental organizations (NGOs)

1 See www.msiworldwide.com/ipc

The persistence of poverty and

preventable illness in low-income countries

after 30 years of development efforts has

drawn attention to the relatively poor record

of pilot and demonstration projects in

successfully stimulating systemic change

and reaching large populations.

in Nigeria and Mexico and as a basis forinitial dissemination efforts withacademics and practitioners. The currentversion of the framework has beenrevised to reflect the lessons from thatexperience and to incorporate feedbackfrom initial dissemination.2 It isdeliberately operational and is directedprimarily to those involved in fundingand implementing pilot projects and to

those wanting to extend these projects tolarger audiences. As such, it focuses onthe practical steps and concrete tasksinvolved in managing the scaling-upprocess.

The remainder of this paper is organizedaround the 3 Steps and 10 Tasks featuredin the SUM Framework.



2 See Annex 1 for a summary of actions taken in Mexico and Nigeria. An extensive bibliography, PowerPoint presentation, anddetailed case study on the CLP Project in Nigeria are available on request from Richard Kohl ([email protected]).

Step 1: Develop a Scaling-up Plan



A lack of agreement on basic definitionsand a shortage of well-documented case

studies makes scaling up more difficult.3

The term “scaling up,” for example, is

Successful scaling up begins withgood planning. Ideally, thatplanning starts during pilot project

design and should take place long beforeimplementation is completed. Thissection of the Framework providesguidelines for SStteepp 11 of the scaling-upprocess, DDeevveelloopp aa SSccaalliinngg--uupp PPllaann. Thisfirst step includes four distinct tasks,namely:

Task 1: Create a Vision;

Task 2: Assess Scalability;

Task 3: Fill Information Gaps; and


Concrete results achieved during Step 1include a realistic assessment of theprospects and parameters for scaling upand a road map for getting to scale. ThisStep also includes developing thedocumentation and beginning to buildthe support that will be needed later inthe scaling-up process.

Successful scaling up begins with good

planning. Ideally, that planning starts

during pilot project design.


3 Notable exceptions include: Expand Net Scaling Up Health Interventions http://www.expandnet.net/; Simmons, Ruth and Jeremy Shiffman. Scaling-up Reproductive Health Service Innovations: A Conceptual Framework. Paper prepared

for the Bellagio Conference: From Pilot Projects to Policies and Programs, March 21–April 5, 2003; November 15, 2002, andupdated February 2, 2005.

Shiffman, Jeremy. Generating political will for safe motherhood in Indonesia. Social Science and Medicine 56. 2003.Shiffman, Jeremy, Cynthia Stanton and Patricia Salazar. The emergence of political priority for safe motherhood in

Honduras. Health Policy and Planning 19 (6). 2004.Uvin, Peter, Pankaj S. Jain, and L. David Brown. Think Large and Act Small: Towards a New Paradigm for NGO Scaling Up.

World Development 28 (8). 2000. Navrongo Health Research Center. What Works, What Fails (Vols. 1 and 2). Ghana Ministry of Health (www.navrongo.org).Goff, B. Mastering the Craft of Scaling Up in Colombia. Grassroots Development 14 (1). 1990.Haaga, John G. and Rushikesh Maru. The effects of operations research on program changes in Bangladesh. Studies in Family

Planning 27 (2). 1996.DeJong, Jocelyn. NGO Experiences of Scaling Up HIV/AIDS Programs. Presentation at World Bank Workshop on Orphans and

Vulnerable Children. May 2003.Ford Foundation. Asset Building for Social Change: Pathways to Large Scale Impact.Levine, Ruth. Millions Saved: Proven Successes in Global Health. Washington, DC. Center for Global Development. November

2004.World Bank. Scaling-up the Impact of Good Practices in Rural Development: A Working Paper to Support Implementation of the World

Bank’s Rural Development Strategy. Report Number 26031. Agriculture and Rural Development Department. June 2003.

applied to several distinct strategiesincluding: the dissemination of a newtechnique, prototype product, or processinnovation; “growing” an organization toa new level; and translating a small-scaleinitiative into a government policy. Toorganize these issues and differentiateamong strategies, Task 1 of the SUMFramework focuses on creating a concretevision of what scaling up would look likeif it were successful. This vision becomesthe yardstick for judging scalability (Task2) and for deciding what more needs tobe done before embarking on the scaling-up process. Task 1 includes the followingfour elements:

Clarify the model, innovation orproject to be scaled up—wwhhaatt isbeing scaled up;

Identify the methods of going toscale—the hhooww of scaling up;

Determine the organizational rolesinvolved in scaling up—the wwhhoo ofscaling up;

Establish the expected scope ofthe scaling-up effort and thedimension(s) along whichscaling up will occur—looselyspeaking, the wwhheerree of scalingup.

The following questions should beaddressed when beginning Task 1:

What organizational, process, andtechnical factors were critical tosuccess on a pilot scale?

Can the model be simplified withoutundermining its effectiveness? Is itabsolutely necessary to replicate allelements of the model on a largescale?

Does the organization that carriedout the pilot project have the desireand organizational capacity toexpand its operations and deliverservices on a substantially largerscale?

If not, which organization(s) are bestsuited and motivated to implementthe model on a scaled up basis or toserve as partners in implementingthe model?

Should the scaling-up effort includepolicy change by the government orrely exclusively on voluntaryadoption by private and non-governmental organizations (NGOs)?

Is there a need for one or moreintermediary organizations tosupport the scaling-up process? If so,what help is needed and whichorganizations are best suited toperforming these roles?



Task 1 focuses on creating a concrete

vision of what scaling up would look like

if it were successful.





Step 1: Developing a Scaling-up Plan

Along what dimension(s) shouldscaling up take place?

What would scaling up look like if itwere successful?

The following paragraphs explore thesequestions and more. They are organizedaround the elements of what, how, whoand where the scaling-up effort will takeplace.

1A. THE MODEL:WHAT IS BEING SCALED UP?

Scaling up should begin by clarifyingexactly what is to be scaled up. In thediscussion that follows, we refer to thisas the “model.” This model is normallyembedded, at least initially, in a projectand can include tteecchhnniiccaall,, pprroocceessss,, andoorrggaanniizzaattiioonnaall ccoommppoonneennttss.. We refer tountested models or individualcomponents of models as “innovations.”4

In thinking about scaling up, it is usefulto distinguish five different types ofprojects5—pilot (or research anddevelopment [R&D]), demonstration,capacity building (or infrastructure),policy, and service delivery.

PPiilloott pprroojjeeccttss,, upon which this papermainly focuses, have as their primary

purpose finding and testing newsolutions to a particular problem. Bydefinition, they include at least onetechnical, process, or organizationalinnovation. Examples of each would be: anew technology (technical innovation); anovel service delivery approach (processinnovation); or creative use of apublic/private/NGO partnership(organizational innovation). A pilotproject can also take a model that hasworked successfully in one context or forone problem and apply it to a newcontext or problem.6

DDeemmoonnssttrraattiioonn pprroojjeeccttss take an existingmodel and raise awareness about itsusefulness. The intention is to makeexisting solutions better known and morewidely accepted by decision makers andpotential users.

CCaappaacciittyy--bbuuiillddiinngg pprroojjeeccttss are intendedto create the institutions, skills, physicalinfrastructure or systems needed to make



4 The nascent scaling up literature borrows heavily from social science literature on the diffusion and adoption of technologicalinnovations. While in some sections of this paper we find the “innovation” to be useful, many small-scale pilot projects discussedin the literature do not contain an obvious technical, process, or organizational innovation. We therefore prefer to use the term“model” rather than “innovation” to refer to what is being scaled up.5 Taken from Cooley, Larry. Uses and Limitations of Projects as Instruments of Change. Unpublished: Management Systems International,1992. 6 The case studies cited above include numerous examples of each of these types of innovation.

Scaling up should begin by clarifying

exactly what is to be scaled up.

Task 1: Create a Vision11AA.. TThhee MMooddeell:: WWhhaatt

IIss BBeeiinngg SSccaalleedd UUpp??1B. The Methods: How Will

Scaling Up BeAccomplished?

1C. Organizational Roles:Who Performs the KeyFunctions?

1D. Dimensions of ScalingUp: Where Does theScaling Up Occur?

permanent changes in the level or qualityof service delivery. These projectsimplicitly assume that the other elementsnecessary for going to scale already existor are being provided elsewhere.

PPoolliiccyy pprroojjeeccttss emphasize advocacy andresearch and focus explicitly on bringingabout changes in public policy. Theseprojects target policymakers as theirintended audience and do not typicallyinclude direct provision of services to theaffected public.

SSeerrvviiccee--ddeelliivveerryy pprroojjeeccttss attempt to“projectize” service delivery on theassumption that the benefits or servicesprovided are needed urgently and are notbeing provided by existing programs andinstitutions. National immunizationcampaigns offer an obvious case in point.These projects may or may not containinnovations.

Each of these five types of projects—pilot,demonstration, capacity building, policy,and service delivery—has an internallogic with respect to scaling up. Pilotprojects approach scaling up in twostages—the initial project is intended to

find a new and better solution to aproblem on the assumption that, ifsuccessful, these innovative and novelfeatures can and will be adopted byothers. Using terminology discussed laterin this chapter, most pilot projects focuson “effectiveness” with the implicitassumption that “efficiency” and“expansion” will be addressed at somelater date. Demonstration projects,capacity-building projects, and policyprojects implicitly take a first step inscaling up by seeking to accomplish oneor more of the tasks necessary tooperating on a larger scale: creatinglegitimacy and awareness, increasingcapacity, and mobilizing resources,respectively. Service-delivery projectsnormally act as an alternative togovernment-provided services, dealingdirectly with the issue of scale byreaching as many people as resourcesallow. In none of these cases does theproject design typically include acomplete strategy for reaching scale on asustainable basis.

Many of the projects funded byfoundations and other donors describethemselves as pilot projects, as do most ofthe examples cited in the scaling-upliterature. It is important to note,however, that relatively few of theseprojects contain an obvious innovation ora research component, and most includemany elements that need not—orcannot—be reproduced on a large scale.The majority of these projects are betterseen as service-delivery projects than astrue pilot projects.



Each of these five types of projects—pilot,

demonstration, capacity building, policy,

and service delivery—has an internal logic

with respect to scaling up.

Any serious effort to scale up a modelor pilot project should be preceded bytesting, clarifying, refining, andsimplifying the model to emphasizethose elements essential to itssuccess.7 This process can take manyyears. In reviewing a number of casesin the field of rural development, theWorld Bank recently observed thatsuccessful cases “generally startedwith 10- to 15-year lead-up times,during which locally effective andappropriate technologies andprocesses were refined, often withsubsidized donor support.”8 Thissame evidence suggests, however,that many social entrepreneurs arereluctant to consider simplificationsto their initial models or prototypes,despite the fact that evidence from avariety of sources indicates that thefactors relevant to the success ofscaling-up efforts include determinedefforts at simplification.9

While most models proposed forscaling up are described by proponentsas “best practices,” few would meetthis standard. To this end, the WorldBank publication cited aboveintroduces a useful set of categoriesoriginally developed by the U.S.Center for Drug Abuse Preventionand drawn from the language ofscientific discourse. These distinguishbetween “an innovation (minimal

objective evidence), a promisingpractice (anecdotal reports andtestimonials); a model (positiveevidence in a few cases); a goodpractice (clear evidence from severalsettings/ evaluations); best practices(evidence of impact from multiplesettings, meta-analyses, expertreviews); or apolicy principle(proven inmultiple settings;considered widelyapplicable ‘truism’essential forsuccess).”10

This first elementof Task 1 shouldresult in a clearspecification of therationale for, andsubstance of, whatis to be scaled up.



Any serious effort to scale up a model or

pilot project should be preceded by testing,

clarifying, refining, and simplifying the

model to emphasize those elements

essential to its success.

7 Simplification also implies an effort to identify in an objective way those elements of an intervention that are essential and cost-effective for producing the desired results. In this regard, the randomized trials pioneered by the Poverty Action Lab areinstructive (see www.povertyactionlab.org).8 World Bank, op. cit., p. 24.9 World Bank, op. cit., p. xiv.10 World Bank; June, 2003; p. xi.

Categories of “Best Practice”

Innovation—minimal objective evidencePromising practice—anecdotal reports and

testimonials Model—positive evidence in a few casesGood practice—clear evidence from several

settings/evaluations Best practices—evidence of impact from

multiple settings, meta-analyses, expertreviews

Policy principle—proven in multiplesettings; considered widely applicable“truism” essential for success

1B. THE METHODS: HOW WILL

SCALING UP BE ACCOMPLISHED?

The second element in Task 1 involvesarticulating a strategy for how the modelcan best be extended to large numbers ofpeople. A good starting point is DavidKorten’s classic depiction of the scaling-up process as three successive stages—effectiveness (developing a solution thatworks), efficiency (finding a way todeliver the solution at an affordable cost),

and expansion (developing a way toprovide the solution on a larger scale).11

Figure 1 illustrates this progression.12

Scaling up focuses principally on thethird stage—expansion—and assumesthat workable solutions have been foundfor the issues implied by the first andsecond stages. However, literature andexperience both suggest that, within thisthird stage, it is useful to distinguishbetween several distinct approaches or

methods of achievingscale (see Table 1).13

Thus, the SUMFramework groupsthird-stage “expansion”methods into threecategories—eexxppaannssiioonn,,rreepplliiccaattiioonn,, andccoollllaabboorraattiioonn—distinguished from oneanother by the degreeto which theoriginatingorganization (i.e., theorganization thatmanaged the initialproject) continues tocontrol implementationas the model goes toscale.14



11 Korten, F. F. and R. Y. Siy, Jr. (eds.). “Sharing Experiences—Examples of Participatory Approaches in Philippines CommunalIrrigation Projects.” In Transforming Bureaucracy: the Experience of the Philippine National Irrigation Administration. West Hartford, CT:Kumarian Press, 1988. http://www.worldbank.org/wbi/sourcebook/sb0215.htm 12 World Bank, op. cit., p. 14.13 The following discussion parallels and integrates the distinctions outlined in a recent publication between “expansion ofexperience” and “transfer of experience” each of which can be pursued through either organizational growth (“horizontal”) orinstitutional and policy change (“vertical”) approaches, and each of which can engage the organization doing the scaling up on a“direct” or “indirect” basis. (World Bank, op. cit., p. x)14 Among other useful frameworks for distinguishing alternative methods of scaling up is the following taxonomy: developingpublic policies, fostering communities of practice, influencing market forces, changing power relationships, and promoting sociallearning. For a full discussion of this framework, see Ford Foundation. Asset Building for Social Change: Pathways to Large-ScaleImpact, 2004.

Figure 1. Summary Overview of Issuesfor Analyzing Scaling Up

Source: Jim Hancock, World Bank Consultant

SSttaattee ooff pprraaccttiiccee::

evidence and applicability

SSccaallee::numbers, area

Context for innovation

source of idea,IInnnnoovvaattiioonnss

TTrraannssffeerr ooff EExxppeerriieennccee::applying information in a

new setting

EExxppaannddiinngg eexxppeerriieennccee::

Internal Learning

FFaaccttoorrss ffoorr EEffffeeccttiivvee-

nneessssContextual

Local impactEEffffeeccttiivveenneessss

Internal

FFaaccttoorrss ffoorr EEffffiicciieennccyy

Contextual

Better use of resourcesEEffffiicciieennccyy

Internal

FFaaccttoorrss ffoorr SSccaalliinngg UUpp

Contextual

Replicating, spreading out institutionalizing for

wider impactEExxppaannssiioonn

Internal

SSttaattee ooff pprraaccttiiccee::

evidence and applicability

SSccaallee::numbers, area





TTrraannssffeerr ooff EExxppeerriieennccee::applying information in a

new setting

EExxppaannddiinngg eexxppeerriieennccee::

Internal Learning


nneessssContextual


Internal


nneessssContextual


Internal


Contextual


Internal


Contextual


Internal


Contextual



Internal


Contextual



Internal

Task 1: Create a Vision1A. The Model: What Is

Being Scaled Up?

11BB.. TThhee MMeetthhooddss::HHooww WWiillll SSccaalliinnggUUpp BBeeAAccccoommpplliisshheedd??



EExxppaannssiioonn here refers to taking a modelto scale by increasing the scope ofoperations of the organization thatoriginally developed and piloted it.Often, expansion occurs in cases of pilotor demonstration projects, where aproject fills a vacuum in terms ofdelivering products or services, andwhere the model and the organization inwhich it is embedded are eitherinextricably linked or the originatingorganization is unwilling to relinquishcontrol.

The most common form of expansion isgrowth, which normally occurs bybranching out into new locations.Sometimes this growth is accompaniedby decentralization or restructuring, whichwe regard here as a distinct method ofexpansion because of the specialdemands it places on the originatingorganization. Two other methods ofexpansion are franchising the model toorganizations operating as agents orclones of the originating organization,

and spinning off aspects or parts of theoriginating organization to operateindependently.

RReepplliiccaattiioonn involves increasing the use ofa particular process, technology, ormodel of service delivery by gettingothers, including the public sector, totake up and implement the model. Inthese cases, an arms-length relationshipbetween the originating and “adopting”organizations (defined below) exists.Replication can occur betweenorganizations of the same type (e.g.,NGO to NGO) or between organizationsof different types.

One of the most common types ofreplication is policy adoption, when amodel is scaled up from a pilot run by anNGO to a program or practice mandatedand often run by the public sector.Another common form of replication isgrafting, where a model—or one



The SUM Framework groups third-stage

“expansion” methods into three

categories—eexxppaannssiioonn,, rreepplliiccaattiioonn,, and

ccoollllaabboorraattiioonn—distinguished from one

another by the degree to which the

originating organization continues

to control implementation as the model

goes to scale.

Table 1. Types and Methods of Scaling Up

Type HowExpansion Growth

Restructuring orDecentralizationFranchisingSpin-Off

Replication: Policy AdoptionGraftingDiffusion and SpilloverMass Media

Collaboration Formal Partnerships, JointVentures, and Strategic AlliancesNetworks and Coalitions

component of a model—is incorporatedinto another organization’s array ofservices or methods of service delivery.Policy adoption and grafting can occurtogether, as when a public sector agencyincorporates a technique innovated byNGOs into its services, such as aparticipatory approach to HIV education.Diffusion and spillover are other methodsof replication. They tend to bespontaneous in nature and occur when amodel spreads by informal networkingwith new or existing organizations orthrough the use of more deliberatedissemination efforts. Use of mass media isa special case of diffusion that bypassesorganizations altogether by marketingnew ideas directly to the affected public.

CCoollllaabboorraattiioonn, the third method forscaling up, falls somewhere between theexpansion and replication approaches.Collaboration mechanisms run the gamutfrom formal partnerships to informalnetworks and include a number ofinnovative structures and governancearrangements. Formal partnerships, joint

ventures and strategic alliances areincreasingly common methods fororganizing collaborative efforts, as areless formal networks and coalitions basedon memoranda of understanding ormerely a handshake. Typically, thesearrangements include some division ofresponsibility among the collaboratingorganizations.

Some of these arrangements include thepublic sector as a key partner; manyothers are agreements among civil societygroups and/or partnerships with privatefirms, such as an NGO involved ineducation and awareness that partnerswith media organizations to co-createnew methods of delivering products andservices to an expanded audience.Recognition by private firms ofcommercial opportunities among thepoor15 and a growing emphasis oncorporate social responsibility havegreatly expanded the opportunities forthese types of partnerships.

Balancing the Pros and Cons

Each of the ten methods listed in Table 1has pros and cons, and choosing amongalternative scaling-up methods involvesbalancing a number of considerations.Take, for example, the case of replicationthrough policy adoption—the transfer of amodel from an NGO to public sectorinstitutions. The clear advantages of policyadoption are mandatory compliance andaccess to resources, as state and national



Each of the ten scaling-up methods

has pros and cons, and choosing among

alternatives involves balancing a number

of considerations.

15 See, for example, the recent book: Prahalad, C. K. The Fortune at the Bottom of the Pyramid. Philadelphia: Wharton School ofPublishing, 2004.

governments have greater financialresources than most NGOs. Moreover,governments generally have greater publiclegitimacy, especially if they aredemocratic; and donors and foundationsfrequently view operating at scale on asustainable basis as a more appropriaterole for government than for NGOs. Policyadoption also has the advantage that it canoccur fairly rapidly in a system wheredecision making is highly centralized andcan cover a large area quickly. On theother hand, organizational congruence—the match between the skills, procedures,and values of the NGO and those of thegovernment—can be a serious problem.For example, where the model beingtransferred involves a highly participatoryapproach, adoption by bureaucratic publicagencies may be impractical. For thisreason, policy adoption is typically moreeffective when the model involved isprimarily technical than when processsensitivity and community participationare key factors in its success.16

The pros and cons of using expansion asa scaling-up method largely mirror thoseassociated with policy adoption. Majorchallenges for expansion are the ability ofexisting management to undertake andimplement the necessary internalchanges—and to secure sufficientfinancial resources—both to support thescaling-up exercise and to operate at

scale. Expansion by NGOs across sociallyand political diverse regions andaudiences is a particular challenge.

The pros and cons of collaborationdepend on the nature of theorganizations, governance structures,and partnership model that is used.Collaboration has greatest potentialwhere various organizations havedifferent and complementary skills orresources, have shared or overlappingobjectives, and have a high level ofmutual trust. For example, networksbetween similar institutions, such asbetween NGOs or between public sectoragencies, can be a powerful form ofscaling up. However, because networksare voluntary and frequently lackexternal resources, the rate of adoptionand coverage of the program may beslower and less widespread, respectively,than with other strategies.



This second element of Task 1 entails

weighing these options and arriving at

preliminary decisions about which scaling-

up methods are to be used, with a clear

understanding of the implications.

16 This corresponds to the distinction between the “hardware” (the technical components) and “software” (participation, quality ofservice, and other less tangible components) aspects of change.

Table 2 displays critical factors affectingthe choice among alternative scaling-upmethods along with the implications ofeach of these factors for preferredmethods:

This second element of Task 1 entailsweighing these options and arriving atpreliminary decisions about whichscaling-up methods are to be used, with aclear understanding of the implications.

1C. ORGANIZATIONAL ROLES:WHO PERFORMS THE

KEY FUNCTIONS?

The third element of Task 1 is decidingwho needs to do what in order for scalingup—and operating at scale—to besuccessful.

Drawing on a typology developed bySimmons and Shiffman (2003),17 at leasttwo different organizational roles areinvolved in scaling up: the oorriiggiinnaattiinnggoorrggaanniizzaattiioonn that develops and pilots themodel, and the aaddooppttiinngg oorrggaanniizzaattiioonnthat takes up the model. Adoptingorganizations may be newly created forthe purpose of taking up the model, ormay be pre-existing. In the case ofcollaborative strategies, the role of theadopting organization is sometimesshared between the originatingorganization and one or more partners. Incases where scaling up takes placethrough expansion, the originating andadopting organizations are one and thesame. Nevertheless, the conceptualdistinction is useful because significantexpansion will almost certainly requirethe originating organization to undergomajor change.



17 Simmons, Ruth and Jeremy Shiffman. Scaling-up Reproductive Health Service Innovations: A Conceptual Framework. Paper preparedfor the Bellagio Conference: From Pilot Projects to Policies and Programs, March 21–April 5, 2003. November 15, 2002.

Table 2. Choosing a Scaling-up MethodFactors to Consider Method Preferred

Type of ModelTechnology Intensive AnyProcess Intensive Expansion or Collaboration

Comprehensiveness of ModelSpecific Practice AnyComplete Model Expansion

Capacity of Originating OrganizationStrong Expansion or CollaborationWeak Replication

Source of FinancingInternal AnyExternal Replication or Collaboration

Availability of Formal Evaluation andDocumentation of the Model

Yes AnyNo Expansion

Observability of ResultsHigh AnyLow Expansion

Ease of Transfer to Other OrganizationsHigh Replication or CollaborationLow Expansion

Quality of GovernanceHigh Replication Low Expansion or Collaboration

Presence of NGO NetworksStrong Replication Weak Expansion or Collaboration

Social HomogeneityHigh AnyLow Replication

Simmons and Shiffman have noted theimportance of the compatibility of amodel with the values, norms, andsystems of potential adoptingorganizations.18 This means that, whenconsidering potential adoptingorganizations, it is important to look athow similar the organizational contexts,capacities, and values are; how muchadaptation and capacity building will beneeded; and what resources will berequired.

For example, community-based projectsfrequently owe their success toparticipation by program participantsand stakeholders, including localownership, volunteer labor, use of localresources, and priorities determined bycommunity needs. Large public sectorbureaucracies embody, almost bydefinition, exactly the oppositecharacteristics. Supply-driven and lessresponsive to local needs, they areunlikely to make extensive use of localresources or engender a strong sense oflocal ownership. While publicbureaucracies have compensatingvirtues—legitimacy, resources, andinfrastructure—differences in their“software” (processes) and values maymake transfer difficult and ultimatelyjeopardize the viability of scaling up incases where these components arefundamental to the success of the model.

Considerations of compatibility applyequally to the social environment in

which the originating and adoptingorganizations are embedded. If the visionof scaling up involves a new populationor location, this requires at least apreliminary assessment of the contextwhere scaling up will occur. Theobjective of this assessment is to ensurethat the scaling-up strategy takes intoaccount opportunities and threats in thenew environment and adjusts to socialconditions present in the new context.This should include an assessment of thesupply and demand for the services thatare to be provided and whether there areany “competitors” present who may bethreatened by the scaling-up effort.

Most discussions of scaling up assumethat the originating organization is alsothe organization that does the workneeded to transfer the model or take themodel to scale. Experience and theoryboth suggest, however, that many of thetasks involved in successfullytransferring or expanding a model canbest be done by, or with the assistance of,a neutral third party or iinntteerrmmeeddiiaarryy



The third element of Task 1 is deciding

who needs to do what in order for

scaling up—and operating at scale—to

be successful.

18 Simmons, Ruth and Jeremy Shiffman. Op. cit.


Being Scaled Up?

1B. The Methods: How WillScaling Up BeAccomplished?

11CC.. OOrrggaanniizzaattiioonnaallRRoolleess:: WWhhooPPeerrffoorrmmss tthhee KKeeyyFFuunnccttiioonnss??


oorrggaanniizzaattiioonn charged specifically withassisting the scaling-up process. The tasksthese organizations perform can includeconducting visioning and planningexercises; project evaluation and processdocumentation; political mapping andstakeholder assessment; coalitionbuilding; design and conduct of advocacycampaigns; and fundraising. In the caseof collaborative strategies for scaling up,intermediary organizations can also beessential in designing and forminginnovative partnerships. In strategies thatdepend on expansion or replication, theyoften play essential roles in assessing andstrengthening the internal capacity

required in originating and adoptingorganizations.19

Figure 2 summarizes the organizationalroles involved in scaling up. The roles ofthe originating organization, adoptingorganization, and intermediaryorganization can each be performed bypublic sector agencies, NGOs, privatevoluntary organizations, consultingfirms, and community-basedorganizations.

This third element of Task 1 involvesidentifying the organizations best suitedto perform each of these functions andthe major organizational changes thatscaling up will require of them.

1D. DIMENSIONS OF SCALING

UP: WHERE DOES THE

SCALING UP OCCUR?

So far, we have reviewed three of thefour the key elements of scaling up: themodel, the types and methods of scalingup, and organizational roles. The fourthand final element needed to complete a

vision of the scaling-up process isddiimmeennssiioonn—the size ofthe intended scaling-up effort and thevector along which themodel or project is tobe extended.



Figure 2. Organizational Roles in Scaling Up

OOrriiggiinnaattiinnggSSoocciiaall

OriginatingOrganization

IntermediaryOrganization

(Process Facilitator)

AAddooppttiinnggSSoocciiaall

AdoptingOrganization

This third element of Task 1 involves

identifying the organizations best suited to

perform each of these functions and the

major organizational changes that

scaling up will require of them.

19 One of the major findings from MSI’s research and fieldwork is that there are few intermediary organizations in mostdeveloping countries with the range of skills needed to support scaling-up. Also noteworthy is the absence of funding to coverthese services in most donor-assisted projects.

Extension of a pilot project’s services orbenefits can be along any of thefollowing five vectors:

Geographic coverage (extending tonew locations);

Breadth of coverage (extending tomore people in the currently servedcategories and localities);

Depth of services (extendingadditional services to currentclients);

Client type (extending to newcategories of clients); and

Problem definition (extendingcurrent methods to new problems).

To clarify these distinctions, consider aproject being piloted in a particularvillage and intended to lower infantmortality by educating pregnant womenabout infant diseases and the need forante- and post-natal care. When scalingup is discussed, frequently only thegeographic dimension is considered—expanding the project to reach morevillages or a larger region, such as adistrict or the entire country. However, anumber of other dimensions might alsobe considered. These could includeextending services to more pregnantwomen within the original village(breadth of coverage); offering nutritionalinformation and/or access to ante- andpost-natal care (depth of services);widening the target population toinclude all women of childbearing age(client type); or applying the approach toaddress other issues, such as maternalmortality (problem definition). Decidingon how many people will be served and

along which of these directions theexpansion will occur is the fourth andfinal element in developing a vision andbroad strategy for scaling up.

PUTTING TASK 1 INTO ACTION

The starting point for Task 1 depends onwho initiates it and at what stage of thepilot effort. Experience clearlydemonstrates that scaling up is highlyunlikely without some level of activesupport from the originatingorganization. However, the focus onscale often begins with donor or host-government interest in fashioning asolution that can be provided to largesegments of the affected population. Incases where the NGO responsible for thepilot project does not share this emphasison coverage, a mismatch of expectationsis likely. The most typical result is vaguelanguage about scaling up in the fundingdocuments for the pilot project andlimited attention to scaling up duringimplementation. The best protectionagainst this is clear and candid



The fourth and final element needed

to complete a vision of the scaling-up

process is ddiimmeennssiioonn—the size of the

intended scaling-up effort and

the vector along which the model or

project is to be extended.


Being Scaled Up?

1B. The Methods: How WillScaling Up BeAccomplished?


11DD.. DDiimmeennssiioonnss ooffSSccaalliinngg UUpp:: WWhheerreeDDooeess tthhee SSccaalliinnggUUpp OOccccuurr??

communication early on about eachparty’s vision for the future scale of theeffort, and their willingness to worktoward that future.

Timing is also critically important. Often,discussion of scaling up begins only aftera pilot project is well underway orcompleted. These projects are oftenassumed to be successful and ready forscaling up based on anecdotal evidencerather than a thorough, evidence-basedevaluation of the extent and reasons for amodel’s success; an assessment of themodel’s strengths, weaknesses, and cost-effectiveness; and a comparison withalternative models or mechanisms forachieving the same goals. Taking the timeto do an evaluation, assessment, andcomparison with alternatives is importantand, ideally, should be done by someonewho is detached and independent. Third-party assessments often provide elementsessential to the scaling-up process,including documentation or credibleverification of impact, which can be usedto publicize and market the model.20

In other cases, multiple candidates maybe appropriate for scaling up to fill alarger need, and a selection must bemade. For these, prioritization of projectsfor scaling up should be based on thescalability assessment criteriaenumerated in Task 2 below.

In the best-case scenario, scaling up isanticipated during the initial design of apilot project. In such cases, widelyaccepted best practices suggest that thefollowing elements be incorporated intothe original design and implementationof the pilot project: doing a baselinesurvey; documenting the model,especially processes such as workingwith local communities; building in anongoing method for monitoring,measuring, evaluating and publicizingresults; and building in mechanisms forgaining buy-in from policymakers andother representatives of potential users oradopting organizations.

Regardless of entry point, scaling updepends on a shared vision incorporatingthe elements described in Task 1 of theSUM Framework. Much of the workneeded for ironing out these issues can bedone in a workshop setting with officialsfrom the originating organization,potential donors, potential adoptingorganizations, and selected otherstakeholders. Field-tested models andmaterials have been developed tosupport this planning effort and areavailable upon request.21



Experience clearly demonstrates that

scaling up is highly unlikely without

some level of active support from the

originating organization.

20 Ashman, Darcy. Closing the Gap between Promise and Practice: A Framework for Planning, Monitoring and Evaluating SocialDevelopment Networks. Unpublished, Mimeo.

21 For more information, contact Richard Kohl at Management Systems International ([email protected]).

The second part of the planning processinvolves reaching pragmatic judgmentsabout the ssccaallaabbiilliittyy of the model orprogram in question. While some of thefactors that affect scalability relate to themodel itself, many relate to the largercontext in which scaling up would takeplace. As a result, the task of assessingscalability should usually be undertakenat the same time as Task 1 to ensure thatthe vision and plan are fully informed bythe realities of the situation.

The following questions can help toguide Task 2:

Do relevant stakeholders, potentialpartners, and intended beneficiariesperceive a need for this kind ofmodel?

Has the model been documented,including the process component,and has its cost-effectiveness beenobjectively assessed? Does evidenceindicate that the model is more cost-effective than other approaches?

Are there obvious economies ordiseconomies of scale?

How easily can the institutionalcharacteristics that were key to theoutcomes achieved be replicated orenlarged?

Is there anything special or uniqueabout the social context, politicalcontext, or general circumstances ofthe pilot project (e.g., cultural, ethnic,or religious values/characteristics;distribution of power; homogeneity;economic conditions) that would

need to be present for the model tobe replicated successfully?

Does the adopting organization havethe appropriate organizational andimplementation capacity, or themeans to develop that capacity?

Does the needed funding exist forreplicating the model on a largescale?

Are the central mission,organizational culture and values ofthe proposed adopting organizationsufficiently compatible with thosenecessary to adopt and implementthe model successfully?

These issues are discussed in greaterdetail below.

2A. DETERMINING THE VIABILITY

OF THE MODEL FOR SCALING UP

In analyzing the comparative scalabilityof various pilot projects, Ruth Simmonsenumerated seven useful criteria basedon the characteristics of successfultechnological or economic innovations.She summarizes them as follows:




While some of the factors that affect

scalability relate to the model itself, many

relate to the larger context in which

scaling up would take place.

Task 2: Assess Scalability22AA.. DDeetteerrmmiinniinngg tthhee

VViiaabbiilliittyy ooff tthheeMMooddeell ffoorr SSccaalliinnggUUpp

2B. Analyzing theOrganizational andSocial Context

Innovations [Models] must be:

(1) ccrreeddiibbllee,, based on sound evidenceor espoused by respected personsor institutions;

(2) oobbsseerrvvaabbllee to ensure that potentialusers can see the results in practice;

(3) rreelleevvaanntt for addressing persistentor sharply felt problems;

(4) having a rreellaattiivvee aaddvvaannttaaggee overexisting practices [positive cost-benefit, including implementationcosts];

(5) eeaassyy ttoo ttrraannssffeerr aanndd aaddoopptt;

(6) ccoommppaattiibbllee with the existing users’established values, norms, andfacilities; and

(7) aabbllee ttoo bbee tteesstteedd oorr ttrriieedd withoutcommitting the potential user tocomplete adoption when resultshave not yet been seen.22

In addition, experience demonstrates thatthe easiest pilot efforts to scale up arethose that involve a cclleeaarr aanndd rreepplliiccaabblleetteecchhnnoollooggyy and that sseellff--ggeenneerraattee ffiinnaanncciiaallrreessoouurrcceess needed for expansion. Thishelps to explain why many of the mostcommon examples of scaling up arecommercial or fee-for-service productssuch as micro-credit, and why it hasgenerally been easier to scale upinnovations, such as new seeds or cellphones, than models where process, valuesand organizational context are critical.23

The checklist shown in Table 3 is a crudetest of the scalability of pilot projectsbased on the factors noted above. Everycheck placed in Column A indicates afactor that simplifies scaling up; andevery check in Column C represents acomplicating factor. A check placed incolumn B indicates an intermediate orneutral situation with regard to aparticular characteristic. By counting thenumber of checks in Column A andsubtracting the number of checks inColumn C one gets a rough measure of amodel’s scalability. The higher thenumber, the easier it will normally be toscale up the model.24

The Scalability Checklist is intended tostimulate, not substitute for, serious



22 Simmons et al. (2002), p. 63. Emphasis added.23 The World Bank paper cited above (op. cit., p. 9) uses the terms “universalist” and “contextualist” to distinguish these twobroad approaches and provides the following definitions of each:

“UUnniivveerrssaalliisstt aapppprrooaacchh ttoo ssccaalliinngg uupp.. In this approach, experience provides a set of universal generalizations that can bereplicated, directly expanded, or adopted elsewhere with a simple set of rules. This does not require identifying and dealingwith local variability. For that reason, it may take less time and effort than a contextualist approach to scaling up.CCoonntteexxttuuaalliisstt aapppprrooaacchh ttoo ssccaalliinngg uupp. In this approach, practices to be scaled-up are tailor-made at the outset to addresscontext-specific conditions”

24 Adapted from Implementing Policy Change Project Technical Note #3, Management Systems International(www.msiworldwide.com/ipc).

Experience demonstrates that the easiest

pilot efforts to scale up are those that

involve a cclleeaarr aanndd rreepplliiccaabbllee tteecchhnnoollooggyy

and that sseellff--ggeenneerraattee ffiinnaanncciiaall rreessoouurrcceess

needed for expansion.

dialogue and analysis. It is best used notas a scorecard to determine what can bescaled up and what can’t, but as an aidfor prioritizing alternatives and a meansfor identifying some of the actions thatcan be taken to simplify the scaling-upprocess. Every time it is possible to makea change that removes a check fromColumn C (and, perhaps, changes itsufficiently to replace it with a check inColumn A), the task of implementationhas probably been made easier. Forexample, any action that makes thebenefits of adopting a model moreapparent almost certainly increases theease with which it can be scaled up.

2B. ANALYZING THE

ORGANIZATIONAL AND

SOCIAL CONTEXT

In many types of development projects,organizational factors are mostresponsible for pilot-scale success. It isthus particularly important to identifythe organizational features that need tobe retained, recreated, or substituted forscaling up the model successfully. Inidentifying potentially unique ordistinguishing features of theorganization that implemented the pilotproject—what we call elsewhere in thispaper the “originating organization”—thecategories and methodology used in theInstitutional Development Framework(IDF)25 are a useful guide. These are:

Organizational culture andvalues/principles,

Staffing skills and requirements,

Management and leadership style,

Financial system and resources,

External partnerships, and

Monitoring and evaluation.

The broader social and political contextin which projects are located can alsoexercise substantial impact on thescaling-up process. For this reason, it isimportant to assess the externalenvironment in which the pilot projecthas been operating to identify contextualfactors that may have been essential tothe success of the model. Here again, thegoal of the analysis is to identify featuresthat need to be recreated or substitutedfor if the model is to be successfullyscaled up. This analysis of the socialcontext can be particularly important, asthese factors are often invisible to thosewho—like fish unaware that they swim



The Scalability Checklist is best used ... as

an aid for prioritizing alternatives and a

means for identifying some of the

actions that can be taken to simplify

the scaling-up process.

25 For more information, tools and guidelines, contact Mark Renzi ([email protected]) or see Renzi, Mark. “An IntegratedTOOLKIT for Institutional Development.” Public Administration and Development. Vol. 16, pp. 469-483. 1996. Also available athttp://www.msiworldwide.com/gral/nwproductsinfo/institutional_dev.htm

Task 2: Assess Scalability2A. Determining the

Viability of the Modelfor Scaling Up

22BB.. AAnnaallyyzziinngg tthheeOOrrggaanniizzaattiioonnaall aannddSSoocciiaall CCoonntteexxtt

22 From Vision to Large-scale Change—A Management Framework for Practitioners

Table 3. Scalability Checklist


Little or no solid evidence

Not evaluated by independentsources

Not supported or espoused by respected individuals

and institutions

Not very visible; not easilycommunicated to public

Not clearly associated with theintervention

Addresses a temporary problem

Addresses a need not sharplyfelt by the target population

Addresses a need that is notsharply felt by potential

adopting organization(s)

Current solutions areconsidered adequate

Little or no objective evidence ofsuperiority to current solutions

Large departure from currentpractices and behaviors for

target population

Many decision makers areinvolved in adoption of model

Model has high technicalsophistication

Significant emphasis on valuesand/or process

High complexity; integratedpackage with many components

Does not include a clear andeasily replicated technology

Requires new infrastructureand facilities

Unable to be tested withoutcomplete adoption

Much more expensive thancurrent practice

No dedicated funding source;zero or low cost recovery

Based on sound evidence

Evaluated by independentsources Supported and espoused by respected individuals and institutions

Very visible to casual observation;easily communicated to public

Clearly associated with theintervention

Addresses a persistent problem

Current solutions areconsidered inadequateSuperior cost-effectivenessclearly established

Small departure from currentpractices and behaviors for targetpopulation

Few decision makers are involvedin adoption of model

Little emphasis on values and/orprocess

Includes a clear and easilyreplicated technology

Model has low technicalsophistication

Low complexity; simple with fewcomponentsAble to use currentinfrastructure and facilities

Able to be tested by users ona limited scaleMuch less expensive thancurrent practice

Fully funded by revenues or adedicated funding source

Has little or no clearemotional appeal

Has a clear emotional appeal

Large departure from currentpractices and culture of potential

adopting organizations

Small departure from currentpractices and culture of potentialadopting organizations

Characteristics of the Model

ASimplifying Factor

BNeutral

CComplicating Factor

Is the model credible?

How observable are themodel’s results?

Does the model have relativeadvantage over existingpractices?

How easy is the model totransfer and adopt?

How testable is the model?

Is funding likely to beavailable and/or willresources be saved?

How relevant is the model?

✓✓ ✓

Total Number of Checks

Addresses a need that is sharplyfelt by the target populationAddresses a need that is sharplyfelt by potential adoptingorganization(s)

in the ocean—have no point ofcomparison.26 Among the key factors thatshould be considered in such analysis,especially noteworthy are the quality ofgovernance; the respective roles andfiscal capacity of national, state and localgovernments; the extent and nature ofNGOs and NGO networks; the prevailingcultural and religious norms; and theextent of social homogeneity.

PUTTING TASK 2 INTO ACTION

As noted, Task 2 is most effective whencarried out in conjunction with Task 1. Inits most basic form, Task 2 involves (1)filling out the checklist, (2) brainstormingoptions for simplifying the scaling-upprocess, and (3) carrying out specialanalyses of the organizational, social, and

political context for scaling up. A numberof tools are available for these purposes,including the Institutional DevelopmentFramework and political mapping.27 Thisprocess often benefits from theinvolvement of neutral third-partyfacilitators or analysts, possibly drawnfrom the same intermediary organizationthat supports other aspects of the scaling-up process.28



26 For additional guidance on practical techniques for analysis of social and political context, contact Larry Cooley ([email protected]) or see Brinkerhoff, Derick and Ben Crosby. Managing Policy Reform. Bloomfield, CN. Kumarian Press. 2002.27 See Annex 4 for links to these and other methods.28 For additional guidelines on this process and the role of neutral third parties, contact Richard Kohl ([email protected]).

The broader social and political context

in which projects are located can also

exercise substantial impact on

the scaling-up process.


In principle, the next task afterdeveloping a vision and completing ascalability assessment is the developmentof a scaling-up plan. As a practicalmatter, however, Tasks 1 and 2 almostalways reveal a number of information ordocumentation gaps that need to be filledbefore developing such a plan. Task 3 isdedicated to filling those gaps.

While, in some cases, roughapproximations and anecdotal evidence

will suffice, governments and donororganizations increasingly demand solidevidence prior to initiating a seriouseffort to scale up a model or intervention.The items most frequently found to bemissing include:

Documentation of the model,including goals and distinguishingtechnical, organizational and/orprocess elements;

Analysis of need or demand for theservice among the larger population;



29 The typical small-scale project allocates less than 5% of its resources for monitoring and evaluation. When that project is aserious candidate for scaling up, experience suggests that donors need to be prepared to allocate up to 20% of project costs forthese purposes unless an alternative source of funding exists for Task 3 activities.30 See CLP case study (op. cit.) for a detailed example.31 A useful discussion of the factors that influence the impact of information on decisions about scaling up, policy adoption anddiffusion of innovation can be found in two unpublished memoranda developed by Liza Weinstein for the MacArthur Foundation—”Diffusion of Innovation” (October 29, 2004) and “Diffusion of Programmatic and Policy Innovation” (December 15, 2004).

Analysis of the changes needed tomake the model applicable to otherparts of the country or to other targetgroups;

(Comparative) analysis of the costsassociated with the model;

Evaluation of the model’s(comparative) impact and success;

Refinement and simplification of themodel;

Analysis of the possibilities forachieving economies of scale;

Analysis of the institutionalrequirements for implementing themodel; and

Identification of the main actions andresources needed to transfer themodel.

The time and resources needed tocomplete Task 3 obviously depend on thenature of the gaps that need to be filled.

They also depend on the informationdemanded by those responsible formaking decisions about whether and howscaling up is to proceed. Experience inMexico and Nigeria suggest that sixmonths to one year is a realisticallowance for the time needed to performthis Task for most pilot projects. Thatsame experience suggests that this stageof the scaling-up process is a particularlyvulnerable one, because neither the pilotproject nor the potential adoptingorganization has a budget or dedicatedpersonnel to conduct the neededanalyses.29 It should thus be a particularpriority for foundations and otherinterested agencies to find practical waysof supporting and facilitating this Task.30

Task 3 typically begins with a review andmapping of decisionmakers’ unmetinformation requirements, followed bythe development of a schedule andbudget for meeting these requirements.At the same time, a series of issues thataffect the credibility and persuasivenessof the information and documentationmust be considered. Among theconsiderations affecting the impact ofinformation on decisionmakers,particular attention should be given tothe need to translate technical findingsinto terms that make sense to theintended audience and the need forcredible interlocutors.31

A number of information or

documentation gaps need to be filled

before developing a scaling-up plan ... and

technical findings need to be translated

into terms that make sense to the

intended audience.

Task 3: FillInformation Gaps




Step 1 culminates in a practical andworkable scaling-up plan, and theconsolidation of that plan is the work ofTask 4. This relatively brief document(perhaps ten pages plus annexes) shouldsummarize the thinking and analysis thattook place throughout the previous threetasks of Step 1. In many cases, theintermediary organization that helpedwith initial visioning (Task 1), ScalabilityAssessment (Task 2) and FillingInformation Gaps (Task 3) can andshould play a key role in pulling thismaterial together during Task 4.Audiences for the plan are both internal(the originating organization and itsBoard of Directors), and external—networks, adopting organizations,government agencies, and potentialproject funders—and the documentshould be written with these variousaudiences in mind.

While a Scaling-up Plan can be organizedand presented in several ways, thefollowing outline is as a useful guide:

4A. PART ISSuummmmaarryy ooff tthhee NNeeeedd, including,where possible, hard data on the sizeand distribution of the problem—one paragraph;

VViissiioonn, including a one- to two-paragraph history and description of

the pilot project; one paragraph eachon the model (“what”), methods(“how”), organizations (“who”), anddimensions (“where”) of theproposed scaling-up effort; and

EEvviiddeennccee supporting the value andfeasibility of scaling up the model,summarizing any data that exists onthe (comparative) impact and cost-effectiveness of the model, andestablishing the demand for andapplicability of the model outsidethe pilot area.

Step 1 culminates in a practical and

workable scaling-up plan that summarizes

the thinking and analysis that took place

to produce it.

The document should be written

with both internal and external

audiences in mind.

Task 4: Prepare aScaling-up Plan44AA.. PPaarrtt II4B. Part II

4B. PART IIPPrrooppoosseedd AAccttiioonnss grouped under thefollowing headings: legitimizingchange, constituency building,realigning and mobilizing resources,modifying organizational structures,coordinating action, trackingperformance and maintainingmomentum (see discussion below oneach of these topics).

TTiimmeettaabbllee,, RRoolleess aannddRReessppoonnssiibbiilliittiieess, including a Ganttchart and an organizationalresponsibility chart for majoractivities.

RReessoouurrcceess, identifying the budgetand other resources needed tosupport the scaling-up effort and foroperating at scale.



Task 4: Prepare aScaling-up Plan

4A. Part I

44BB.. PPaarrtt IIII

This portion of the SUM Frameworkfocuses on translating aspirationsinto reality. This usually involves

action by many people—legislators,national leaders, activists, serviceproviders, and donors, to name but afew. It involves reaching agreements andturning those agreements into tangibleresults.

Published case studies rarely describe inany detail the steps and considerationsinvolved in implementing a scaling upplan, and there are thus few documentedbest practices on which to base step-by-step guidelines. The discussion in thissection augments the published literatureon scaling up with insights drawn fromthe literature and practice, as well asMSI’s fieldwork, on two closely relatedtopics—organizational development andmanaging policy change.32 It assumes theexistence of a vision and plan.

This two-part section presents,respectively, Steps 2 and 3 of the scaling-up process. SStteepp 22,, EEssttaabblliisshh tthhee

PPrreeccoonnddiittiioonnss ffoorr SSccaalliinngg UUpp, includesthree tasks: legitimizing action (Task 5),constituency building (Task 6), andrealigning and mobilizing resources(Task 7). SStteepp 33,, IImmpplleemmeennttiinngg tthheeSSccaalliinngg--uupp PPrroocceessss,, is comprised of threeadditional tasks: modifyingorganizational structures (Task 8),coordinating action (Task 9), and trackingperformance and maintainingmomentum (Task 10).

These six tasks, and the links betweenthem, are displayed in Figure 3, whichillustrates that, even though the six Taskshave a logical sequence, each Task affectsand is affected by each of the others.


Establish Preconditionsand Implement a Scaling-up Process

32 See Brinkerhoff, D. & Crosby, B. Managing Policy Reform: Concepts and Tools for Decision-Makers in Developing and TransitioningCountries. Bloomfield, CT.: Kumarian Press, Inc., 2002. For additional technical notes, research notes, and case studies, seeManagement Systems International. Implementing Policy Change Series. Washington, DC (www.msiworldwide.com/IPC)

Translating aspirations into reality

involves action by many people, reaching

agreements, and turning those agreements

into tangible results.


Establish Preconditions and Implement a Scaling-up Process

Figure 3. An Overview of the Scaling-up Process

Primary linkage

Secondary linkage

Primary linkagePrimary linkage

Secondary linkageSecondary linkage

Task 110Track Performance and Maintain Momentum

Task 77Realign and

Mobilize Resources

Task 66Build a Constituency

Task 55Legitimize Change

Task 99Coordinate Action

Task 88Modify Organizational

Structures

SStteepp 22:: EEssttaabblliisshh tthhee PPrreeccoonnddiittiioonnss ffoorr SSccaalliinngg UUpp

SStteepp 33:: IImmpplleemmeenntt tthhee SSccaalliinngg -uupp PPrroocceessss

Step 1: Develop a Scaling-up Plan(Tasks 1–4)



Step 2: Establish the Preconditions for Scaling Up

The intended result of Step 2 is thatthe decisions and resources neededfor scaling up are approved and in

place. This requires getting the issue ontothe agenda of key decisionmakers,aligning constituencies to support theneeded changes, and securing therequired resources. The followingsections explore each of these tasks.


Translating aspirations into reality

involves action by many people, reaching

agreements, and turning those agreements

into tangible results.

Given all the issues that compete forattention and resources, scaling up a newmodel will most likely make progressonly when decisionmakers think thatchange from the status quo is imperative.For this to be the case, they must see theproblem needs as critical and the affectedconstituency as a priority. Existingresponses must be acknowledged asinadequate, and decisionmakers mustbelieve there are viable ways to addressthe need.

Because change often represents asignificant break from tradition andrequires shifts in attitudes and actions, itis important that there be “legitimizers”or “champions” who enjoy widespreadcredibility. These individuals can comefrom any of the public, non-profit orprivate sectors. However, if policyadoption is the chosen method of scalingup, it is essential to attract high-levelgovernment involvement and support atthe earliest feasible date.



Task 7: Realign and Mobilize Resources

Step 2: Establish the Pre-Conditions for Scaling Up

Building legitimacy is time consuming

but essential.

Task 5: LegitimizeChange

Building legitimacy is time consumingbut essential. It has been termed by some“going slow to go fast.” Experiencesuggests, and the literature on scaling upconfirms, that there is a systematictendency to underestimate theimportance of this Task. This is in partbecause donors are impatient oruncomfortable with political orconsciousness-raising activities andprefer to focus on capacity building andservice delivery. It also complicatesmatters that opportunities forlegitimation are unpredictable and arefrequently linked to a crisis or otherattention-focusing events.33 Numerouscase examples indicate, however, thatinattention to legitimation results infailed efforts or in a need to return to thisTask later in the process.

In the case of policy change, legitimizingchange is essential for getting policiesapproved, budgetary priorities adopted,and developing the broader and deeperbase of support needed for

implementation by bureaucraticinstitutions and others. More generally, itis critical for attracting potential adoptingorganizations; for persuading funders toprovide support; and for ensuring awarm reception of the model among newlocations, client populations, andpotentially competing organizations.

Establishing or increasing legitimacy canbe accomplished through a variety ofmethods, including:

Enlisting prominent spokespersonsor celebrities as advocates;

Developing and popularizingimages, slogans and symbols;

Creating “blue ribbon” commissions;

Establishing high-level advisoryboards;

Mounting local, national andinternational media campaigns;

Implementing public educationprograms; and

Conducting policy debates.

Information plays a critical role inlegitimizing change, as it is vital todemonstrate that the proposedinnovation or model is successful, cost-effective and feasible. This is normallyachieved through publicizing the modeland its effectiveness, building on thedocumentation and evaluation materialsassembled during Step 1, and packagingthose materials for a wider audience.34



33 For a fuller discussion of the literature on agenda setting, see Jeremy Shiffman. “Generating political will for safe motherhoodin Indonesia.” Social Science and Medicine 56 (2003). pp. 1197 1207. 34 The concept of “ripeness,” as articulated by William Zartman, also plays an important role in legitimation and conveys theimportance of capitalizing on the timeliness of issues.

Numerous case examples indicate,

however, that inattention to legitimation

results in failed efforts or in a need to

return to this Task later in the process.


QUESTIONS AND ISSUES TO BE

ADDRESSED DURING TASK 5What more needs to be done topersuade relevant decision makers,funders and opinion leaders thatnew solutions are necessary anddesirable?

What more needs to be done topersuade relevant decision makers,funders and opinion leaders that theproposed model is successful, cost-effective, and feasible?

Which spokespersons, conveners,messages and methods are most

likely to have an impact on theseaudiences?

If existing legitimation is not deemedsufficient, this Task includes formulationand implementation of a legitimationstrategy. A variety of analytical tools(e.g., political mapping ) and processes(e.g., deliberative dialogue) have beendeveloped for this purpose.35 Theseactions can and usually should beginduring Step 1, by involving keyaudiences in the planning process and byanticipating their questions andinformation needs.

Implementation requires active andongoing support to overcome commontendencies toward inaction andbacksliding. Likely constituencies includethose who can hope to be better off as aresult of scaling up, other organizationsworking in the field, and/ororganizations and individuals whosupport the change philosophically. TheTask of Constituency Buildingcomplements and amplifies thelegitimation process by going beyondpassive acceptance of the need for changeand mobilizing action in favor of specificchanges and models.

Beneficiaries of the current system andexisting service delivery organizations

are among those often reluctant tochange. Because change normally affectsbudget allocations and funding priorities,the strongest opposition frequentlycomes from those whose budgets wouldneed to be reduced in order to free upthe resources necessary for scaling up. Ifthe originating organization is an NGO,



35 See Annex 3 for links to these and other methods.

Implementation requires active and ongoing

support to overcome common tendencies

toward inaction and backsliding.

Task 6: Build aConstituency

other NGOs may feel threatened, both interms of competition for funding or moregenerally in terms of recognition,reputation and visibility. Bureaucraticinterests that lose old functions or thatmay be asked to take on new ones mayfeel similarly threatened by the proposedchanges. Part of the task of constituencybuilding is understanding andovercoming these sources of resistance.

Mobilizing support for scaling up a newmodel or innovation is akin in manyways to community organizing.Particularly in countries with little or nohistory of participatory democracy,representative governance, and publicaccountability, there is a tendency to relyon one-on-one lobbying with the personperceived to be “in charge.” Experiencestrongly suggests, however, that forchange to be realized and sustained—particularly when that change primarilybenefits poor and unempoweredgroups—it is important to mobilize awider range of stakeholders.

Potential tactics for building the neededconstituencies include:

organizing multi-stakeholdercoalitions:

working through one or morepolitical parties:

conducting advocacy campaignswith legislators and legislativecommittees:

direct outreach to business, religious,labor, or other civil society groups:and

mobilizing grassroots campaigns.

Among the tools that can help to guideTask 6, stakeholder analysis, networkmapping, and forcefield analysis areparticularly useful.36 Together, these toolshelp to identify the different pointsthrough which a proposed change passesto become approved and implemented;the actor(s) in charge of each step; howone can gain access to these actors; whoelse might be willing and able to supportthese efforts; what resources they are ableto mobilize for the purpose; and whatarguments are likely to be persuasive toeach of these groups. Figure 4 illustrateshow this process works.

For purposes of this example, assumethat an NGO wishes to scale up throughthe government its successful program ofproviding trained traditional birthattendants in rural areas. Assume furtherthat the NGO believes they have theenthusiastic support of the HealthMinister for doing this. They know thatthe key actors in the policy and budgetdecision-making process are the HealthMinister, the Minister of Finance, the



36 See Annex 3 for additional references and links.

Among the tools that can help to guide

Task 6, stakeholder analysis, network

mapping, and forcefield analysis are

particularly useful.

President and the Congress. But withinthat process, there are several others whocan and do influence decisions. Forexample, the Minister of Finance’sbudget staff is charged with preparationof the budget and shapes most of theprocess. Who are the members of thisstaff, and might there be some way togain access and be persuasive to them?

Figure 4 suggests that importantconstituents of the President’s politicalparty include the health workers unionand the medical association. Perhapsthese groups could be brought into somekind of alliance that could bring pressure

to bear on the President. Within theCongress, it seems that the committeeson budget and finance are in charge ofapproving the budget submitted by thePresident. Might there be somemechanism to influence the committee orthe committee staff charged with thepreparation of authorization bills for thebudget? Does a certain member of thecommittee have a keen interest in theproblems of rural health? Perhaps theMinister could bolster member interestwith pertinent and timely informationthat could be used to defend the policy incommittee debates or hearings.



Figure 4. Policy Network Map—Health Sector of Boliguay

Lines of direct access

Lines of indirect access

Lines of direct accessLines of direct access

Lines of indirect accessLines of indirect access

Medical associations

Mayors Association

Health associations

MMiinniisstteerr ooff HHeeaalltthhMMiinniisstteerr ooff HHeeaalltthh

CCoonnggrreessssCCoonnggrreessss

Agricultural Workers Union

Budget committee

MMiinniisstteerr ooff FFiinnaanncceeMMiinniisstteerr ooff FFiinnaannccee

Finance committee

Budget officeCCaabbiinneett MMiinniisstteerrss

National Cooperative Association

PPrreessiiddeenntt ooff BBoolliigguuaayy

PPrreessiiddeenntt ooff BBoolliigguuaayy


Finally, the pressure of rather diversegroups such as the Mayors’ Association,the National Cooperative Association,and the Agricultural Workers Unionmight also be brought to bear. Whilethese groups are not direct players in thepolicy process, in contrast to themembers of Congress or the Minister,they are the eventual stakeholders andcan be important sources of influence onelected officials such as the President orthe members of the Congress.

While all of these points of access arepossible, their usefulness depends onmobilizing them. This will requireinitiative, time, and energy on the part ofsome credible convener.

CRITICAL QUESTIONS AND

ISSUES DURING TASK 6Which organizations, organizationalunits or individuals are responsiblefor key decisions regarding thefunding and implementation ofscaling up? Who has authority tomake the decisions within theseorganizations?

What arguments, appeals oradvocacy strategies are likely to haveaccess and be persuasive to thesedecision makers?

What are the most effective networksand alliances for carrying out thisadvocacy, and how can they be mostefficiently mobilized and organized?

How can buy-in from the leadershipand staff of potential implementingorganizations best be achieved?

Task 6 normally includes a determinedeffort to mobilize new constituencies andimplement a systematic advocacystrategy. It often includes efforts to secureformal adoption of new policies andfunding by the government or bypotential adopting organizations. Likelegitimation, work on this Task can beginin conjunction with the planning processdetailed in Step 1.



Task 6 normally includes a determined

effort to mobilize new constituencies

and implement a systematic

advocacy strategy.

Task 7: Realign and Mobilize Resources

For scaling up to be successful, resourcesneed to be mobilized for ooppeerraattiinngg tthheenneeww mmooddeell oonn aann eexxppaannddeedd ssccaallee.Equally important, resources are neededto ssuuppppoorrtt tthhee ssccaalliinngg--uupp pprroocceessss. Task 7is concerned with securing both types ofresources. Each poses distinct challenges.

The resources for scaling up and foroperating at scale are rarely in place atthe outset, and old priorities do notdisappear simply because new prioritiesarise. Funding for operating a new modelat scale imply a redirection of currentbudget and operational priorities withina sector, or somehow securing additionalresources for that sector. Almost always,this entails overcoming substantial inertiaor active resistance, particularly whenbudgets are stretched; when the newmodel is additional to or more costlythan the current alternative; and whenthe new model does not self-generate theresources it requires.

Funding the transition period (i.e., thescaling-up process) is a particular concern,given the absence of resources earmarkedfor such purposes and the inability toredistribute human and financial resourcesto new priorities on short notice. Inaddition to complicating the scaling-upprocess, this raises the potential for gapsor shutdowns once donor resources forthe pilot project are exhausted.

Moreover, the resource problem is notsimply financial. Often, no individual,

team or agency is charged withmanaging the scaling-up process andcoordinating the introduction of the newprograms, policies, or approaches

necessary to implement it; likewise, theadopting organizations often lack theneeded organizational skills and systems.Like the first two tasks—legitimizingchange and constituency building—thosemanaging the task of realigning andmobilizing resources must often reachbeyond the boundaries of individualorganizations to find the neededcapabilities. Donors can be particularlyuseful in supporting internal advocatesduring this part of the change effort.

Organizations that implement pilotprojects usually lack the resources andcapacity to take a model to scale, even if“all” that is involved is transferring it to alarger organization. A particularly weakpoint for many scaling-up projects hasbeen the burden on staff of theoriginating organization, who areexpected to provide training, mentoring,and other support for the adopting



The resources for scaling up and for

operating at scale are rarely in place at the

outset, and old priorities do not disappear

simply because new priorities arise.

Task 7: Realign andMobilize Resources

organization, while continuing to runtheir own programs.

Among the common approaches andmechanisms used during Task 7 are thefollowing:

donor roundtables;

budget hearings and budgettransparency campaigns;

fiscal decentralization;

bridge financing; and

expanded use of marketmechanisms.

Partnerships between institutions withcomplementary resources and strengthscan be a synergistic way to provide theresources needed for the scaling-upprocess. For example, the public sectorfrequently has political legitimacy, butlacks technical expertise, financialresources, or the ability to operateflexibly at the local level. The private for-profit sector often has financial resourcesand technical expertise, but lacks politicallegitimacy. The non-profit sector hastechnical expertise and the capacity forflexible local implementation, but usually

lacks political legitimacy and large-scaleorganizational capacity. Localcommunities and community-basedorganizations are often overlooked aspotential sources for in-kind resources,and can also help create legitimacy.Partnerships that bring together the bestof each partner can be a powerful andefficient way to mobilize the resourcesneeded for the scaling-up process and areincreasingly fashionable in developmentcircles. For all these reasons, the work ofassembling and establishing theguidelines for such partnerships oftenplays a central role during Task 7.


ISSUES DURING TASK 7What additional human, institutionaland financial resources will beneeded to support the process of“going to scale,” and what needs tobe done to ensure that theseresources are available?

What human, institutional andfinancial resources will be needed for“operating at scale,” and what needsto be done to ensure that theseresources are available?

What, if any, new partnerships needto be established?

Among the most important skillsrequired for realigning and mobilizingresources are budget analysis and the setof skills commonly called “advocacy.”Where the groups involved lack thisexpertise, donors can be of assistance inproviding access to others with such



Partnerships between institutions with

complementary resources and strengths can

be a synergistic way to provide the resources

needed for the scaling-up process.

expertise and/or providing relevanttraining. The table of contents shown inFigure 5, drawn from an existingadvocacy training manual, is typical ofthe skills taught in such programs.37

The culmination of Tasks 5, 6, and 7—ifsuccessful—is a set of decisions byadopting organizations to scale up themodel; a set of commitments toprovide the resources needed for thescaling-up effort and for operating atscale; and a foundation of legitimacyand support that can help sustain thescaling-up effort through the difficultimplementation stage that lies ahead.



37 Developed by the USAID-financed Policy Project managed by The Futures Group in Washington, DC(www.futuresgroup.com).

Figure 5. Advocacy Network Training ManualTable of Contents

Section 1: The Power of Numbers—Networking forImpact

Unit 1: What are Advocacy Networks?Unit 2: Effective Communication—Understanding One

AnotherUnit 3: Cooperation Not Competition—Building a

TeamUnit 4: Decision Making—Reaching Group ConsensusUnit 5: Mission Statements—Creating a Common

PurposeUnit 6: Putting It All Together—Managing the

Network

Section 2: Actors, Issues, and Opportunities: Assessingthe Policy Environment

Unit 1: The Policy Process—Government in ActionUnit 2: Decision Making for Reproductive Health—

Analyzing the Policy ClimateUnit 3: Prioritizing Policy Issues—Making the Best

Matches

Section 3: The Advocacy Strategy—Mobilizing forAction

Unit 1: What is Advocacy?Unit 2: Issues, Goals, and Objectives: Building the

FoundationUnit 3: Target Audiences—Identifying Support and

OppositionUnit 4: Messages—Informing, Persuading, and

Moving to ActionUnit 5: Data Collection—Bridging the GapUnit 6: Fundraising—Mobilizing ResourcesUnit 7: Implementation—Developing an Action PlanUnit 8: Monitoring and Evaluation



Step 3: Implement the Scaling-up Process

Tasks 8, 9, and 10 are devoted toimplementing the scaling-up effort.First and foremost, these tasks

involve creating organizational capacityto transfer and receive the model, or, inthe case of expansion, growing theorganization. Once this capacity iscreated, Task 9 involves the actual

transfer, adoption, and adaptation of themodel and clearly assigning roles,responsibilities. and accountability foreach action and for overall coordination.Task 10 covers monitoring andevaluating progress and feeding thatinformation back into public oversightand modification of the model.

Task 8: Modify and Strengthen Organizations

Implementing meaningful large-scale change almost always calls forthe creation of new organizationalstructures or for major changes toexisting ones. Some organizationsare affected directly in what they doand how they do it. Even when thisis not the case, there is greater needfor sharing information andresources and for more concertedcoordination, particularly during thetransition period.

The need for change is most apparent inthe organization expected to implementthe model on a scaled-up basis—theadopting organization. Yet, changes arealso needed in other organizations. Thisincludes changes in attitudes andbehavior within the organization thatoriginated the model and now faces theprospect of either expanding itself orhanding off responsibility to others. If

There is greater need for sharing information

and resources and for more concerted

coordination, particularly during the

transition period.

Task 8: Modify and Strengthen Organizations


Task 10: Track Performance and MaintainMomentum

Step 3: Implement the Scaling-up Process

this organization is responsible for thescaling-up effort, it must also figure outwhat actions this requires and how tointegrate these actions with its ongoingprogrammatic responsibilities.

Transfer of knowledge and know-how38

is one of the most neglected aspects ofscaling up. In addition to proceduressuch as process engineering, developingmanuals, and training of trainers, thisoften requires a substantial simplificationof the model because resources necessaryfor intensive mentoring and capacitybuilding are often not available. Evenwhen the originating and the adoptingorganization are the same, majororganizational obstacles to change arelikely, especially when expansion occursby creating new branches.

In replication, transferring the model’stechnology, process and know-how canbe particularly difficult if the originatingand adopting organizations havediffering organizational cultures, values,internal structures, and incentives. Incases where the values and norms of theadopting and originating organizationsare dissimilar, part of the scaling-upeffort requires transforming the model oraligning theses values so that transfer canoccur. This is especially the case whenthe originating organization is an NGOand the adopting organization is a

government agency, given the naturaldifferences between these types oforganizations and the history of distrustbetween governments and NGOs inmany countries.

Fortunately, the field of organizationaldevelopment has a wealth of experienceand a wide range of useful tools to aid inthis process. W. Warner Burke provides auseful overview of organizationaldevelopment options and issues,39 andthe Institutional DevelopmentFramework, referenced above,40 offers aparticularly useful toolkit with which tobegin. In addition to changes in systems,structures, and procedures, leadershipand management face special challengesduring scaling up. Coaching and otherleadership development programs can beespecially helpful during this stressfulperiod.41

Some of the most effective mechanismsand approaches used for this Taskinclude:



38 Regarding technical transfer and change, “knowledge” is used to describe information, processes and procedures, which areeasily formalized and written down. “Know how” describes the informal, tacit knowledge needed to make formal knowledgework in actual application. 39 Burke, W. Warner. Organizational Change: Theory and Practice. Chicago, IL. Sage Publications. 2002.40 Renzi, op. cit.41 Useful discussion of leadership and management development and the relationship between leadership and organizationalchange can be found in: Kotter, John P. Leading Change. Boston, MA. Harvard Business School Press. 1996; Bryson, John M. BrysonStrategic Planning Set. San Francisco, CA. Joussey-Bass. 2004; and Bennis, Warren. On Becoming a Leader. New York. Perseus Press.2003.

Transfer of knowledge and know-how

is one of the most neglected aspects

of scaling up.

Task 8: Modify andStrengthenOrganizations


Task 9 focuses on establishing andapplying the multi-organizationmanagement processes, coordinationmechanisms, and accountabilityprocedures needed to ensure thatdecisions are translated into concreteaction.

The development management literatureprovides useful guidance on the subjectof multi-party programming and inter-organizational coordination. GeorgeHonadle and Lauren Cooper’s

deconstruction of the term “coordination”is particularly relevant to the situationfaced by many scaling-up efforts. Theydistinguish between four aspects orapproaches to coordination—sharinginformation, sharing resources, jointplanning, and joint action—and arguethat (1) coordination is by its nature verytime consuming, and (2) each of the fourapproaches is successively moredifficult.42 The operational implicationsfor those implementing scaling-upprograms are to limit, where possible, the



Apex organizations;

Future Search conferences andretreats;

Business process reengineering;

Leadership development andcoaching; and

Comprehensive staff retraining.

Each of these processes benefits from theuse of independent, third-party facilitators.


ISSUES DURING TASK 8What, if anything, needs to be doneto encourage and assist theoriginating organization to relinquish

control and make the other changesnecessary for successful transfer andscaling up of the model?

What changes need to be made in the“adopting organization”?

Which organizations are responsiblefor the transfer process and whatchanges do they need to make totheir own capacity—structure,staffing or operations—to do thissuccessfully?

Task 8 includes developing and executinginstitutional capacity building andorganizational development plans for allof the organizations with major roles toplay in either the scaling-up process or insubsequent efforts to operate at scale.

42 Honadle, George and Lauren Cooper. “Beyond Coordination and Control: An Interorganizational Approach to StructuralAdjustment, Service Delivery and Natural Resource Management.” World Development. 1989: No. 10. pp. 1531 1541.

extent of coordination that is necessary;favor less complex forms of coordination;and ensure that responsibilities andresources for coordination are clearlyestablished.

Since coordination and cooperation taketime, cost money, and entail loss ofautonomy by each of the participatingorganizations, these efforts only succeedwhen perceived benefits outweigh thecosts for each of the organizationsinvolved. As a practical matter, this putsa premium on designing mechanismsthat incorporate tangible incentives forworking together or penalties for thefailure to do so.

Central to this task is the establishment oftransparent and efficient governancestructures for networks and coalitions,and here too there is a growing body ofpublished literature and experience uponwhich to draw. The emerging field ofpublic-private alliances has, for example,developed a wide range of options formanaging pooled and parallel resourcesin ways that are directly applicable toscaling up.43

Some of the approaches commonly usedto achieve the coordination necessary foreffective scaling up are:

Multi-party action plans andmemoranda of understanding;

Interim secretariats;

Formal joint ventures andpartnerships;

Performance-based reimbursementplans, grants and contracts; and

Virtual networks.

Particularly when a coalition, network orworking group forms to support oroversee the scaling-up process, the use ofOrganizational Responsibility Charts ishelpful for disentangling the respectiveroles of the individuals and groups.Preparing the chart offers a systematicway of brokering agreements about themajor activities to be done and, for eachactivity, clarifies who must approve it,who is responsible for executing it, whoshould be providing tangible support,and who needs to be kept informed.44

While the matrix can be completed by



43 USAID Global Development Alliance. Tools for Alliance Builders. Available at:http://www.usaid.gov/our_work/global_partnerships/gda/tab.html 44 See Annex 3 for links to additional information about Organizational Responsibility Charts and other tools.

Task 9 focuses on establishing and

applying the multi-organization

management processes, coordination

mechanisms and accountability procedures

needed to ensure that decisions are

translated into concrete action.

Task 9: CoordinateAction



one or more analysts, it is most effectivewhen used interactively by the partiesdirectly affected as a way to clarify andstreamline their working relationships.

In scaling up pilot activities, Task 9includes those implementation actionsnecessary to transfer the modelsuccessfully to others, as well as thoseneeded for ongoing operations at ascaled-up level.


ISSUES DURING TASK 9Are action plans and budgets inplace for implementing the scaling-up effort and, if not, what moreneeds to be done?

Have responsibilities been clearlyallocated and efficient mechanismsestablished for coordinating thescaling-up effort?

If more than one organization isinvolved, who will be responsible formonitoring these efforts and forresolving any conflicts?

Task 9 includes the instituting of actionplans, coordinating mechanisms andgovernance procedures for the scaling-upactivity and for operating at scale.

Task 9 includes the instituting of action

plans, coordinating mechanisms and

governance procedures for the scaling-up

activity and for operating at scale.

Task 10: Track Performance and Maintain Momentum

It is important to track the effects ofintroducing the new model and to makeadjustments if the results differ fromwhat was intended. Such monitoring andevaluation ideally begins early in theprocess with assessments during Step 1of the effectiveness of the pilot project. Inaddition to the usual requirements forsound project management and donorreporting, such studies need to anticipatethe questions and concerns of thebroader audience involved in approving,funding and implementing the scaling-up process. This puts a particularpremium on any such monitoring andevaluation being done in a credible,public and transparent manner, and thereis considerable value to involvingindependent third parties in this effort.Also of critical importance is the creationof avenues for feeding this informationback to the public and to decisionmakers, and for ensuring that it is widelydiscussed. The press, academia, and non-partisan monitoring organizations canplay important roles in this process.

In addition to assessing outcomes, it isimportant to monitor progress inimplementing the scaling-up process.Among other things, this monitoring is acatalyst for maintaining momentum andaccountability, and for keeping thescaling-up process on track, following theadage “what gets monitored gets done.”

Such monitoring begins by defining adescriptive list of stages or milestoneevents in the scaling-up process and alimited number of expected outcomes.This disaggregates the change processinto “units” that are more easilyunderstood and tracked, and helpsmanagers better analyze the monitoringand evaluation information collected.

Some of the approaches and techniquesused for this Task include:

Citizen oversight panels;

Public hearings;

Blue-ribbon panels;

International monitoring groups;

Listservs and other Web-based,open-access dissemination;

Third-party monitoring andevaluation contracts;

Comparative scorecards; and

Sustained media coverage.



It is important to track the effects of

introducing the new model and to make

adjustments if the results differ from

what was intended.

Task 10: TrackPerformance andMaintain Momentum


ISSUES DURING TASK 10Are there adequate procedures fordocumenting the progress, lessonslearned and impact of the scaling-upeffort?

What mechanisms most effectivelyensure that this information is fedback to key stakeholders and to thebroader public and that theinformation is used to makenecessary course corrections?

The link between monitoring andevaluation, on the one hand, and scalingup on the other, is attracting increasedattention. Among Foundations, theMacArthur Foundation has shownparticular interest in this connection;several papers on the topic have beenpresented at the American EvaluationAssociation, and a variety of tools areunder development.45



45 For additional information, contact Larry Cooley ([email protected]) or Richard Kohl ([email protected]).

ConclusionScaling up is drawing the attention of anever-increasing circle of donors,philanthropists, governments, NGOs,activists, and researchers. As interestgrows, so do their concerns regarding thereplicability of successful innovations andthe challenges of reaching large numbersof those in need. Despite this growinginterest and an expanding array ofdocumented cases, relatively littleevidence-based advice exists aboutmaximizing the prospects for new andinnovative service-delivery models toachieve scale.

Written primarily for officials chargedwith making funding decisions andimplementing programs, this paper seeksto provide concrete advice derived fromtheory and practice. It is intended toinform decisions about:

Selecting projects with the potentialto go to scale;

Designing projects to maximize theirscalability; and

Managing the scaling-up process.

The SUM Framework presented in thispublication is organized as a series of Stepsand Tasks. This approach is based on theconviction that scaling up can besuccessfully managed and that thisprocess can be carried out mosteffectively by breaking it down intoconcrete strategies and actions.

It is our hope that the development andhumanitarian communities will be filledin future years with a growing number ofentrepreneurial idealists bringing ever-increasing professionalism to the scaling-up process.


Annex 1:Summary of Field TrialExperience in Mexico andNigeria

Mexico

Following initial consultations andworkshops with a range ofreproductive health NGOs in which

needs and objectives were defined, a short-listwas prepared of projects showing promisefor, and interest in, scaling up their pilotefforts. Beginning in July 2004, MSI assigned aMexico-based associate to work with thedesignated local organizations to assist themwith their scaling- up efforts, to documentthose efforts, and to draw observationallessons that could inform revisions to theSUM Framework. The projects andorganizations selected for initial attentionincluded:

1. OOrrggaanniizzaattiioonnaall SSccaalliinngg UUpp ooff MMeexxFFaamm::Expansion of MexFam’s ability to providecommunity-based maternal and childcareservices.

2. GGoovveerrnnmmeenntt AAddooppttiioonn ooff aann IImmpprroovveeddSSeexxuuaall EEdduuccaattiioonn CCuurrrriiccuulluumm::Supporting a coalition of grantees insecuring Government adoption andimplementation of improved sexualeducation curricula in selected States.

3. SSccaalliinngg UUpp IImmpprroovveemmeennttss iinn SSeexxuuaallEEdduuccaattiioonn CCuurrrriiccuulluumm ffoorr IInnddiiaannPPooppuullaattiioonnss:: Collaborating with grantees,the Mexican Government and IndianUniversities on scaling up improvedsexual education content in teachertraining programs directed to MexicanIndians.

In addition to its role helping granteesdetermine strategies and plans for scaling uptheir efforts, MSI served as a facilitatorhelping the parties to establish, broker, andsustain effective collaborative arrangementswith one another.

ORGANIZATIONAL SCALING UP

OF MEXFAM

MexFam is a well-established, country-wide,and highly professional NGO that hasreceived substantial support from outsidedonors for a number of years. The need forand success of its model of community-basedservice provision were well-documented andwell-established. Faced with a growingdemand for its services, coupled with


significant reduction in core funding frommajor donors, MexFam had begun to exploreways to change its business model and becomemore financially self-reliant. Its goal was toexpand the breadth and depth of its services or,at a minimum, continue to provide thosecommunity-based maternal and childcareservices it was already providing.

It was determined at the beginning of theintervention that the first two steps of thescaling-up process (develop a plan and establishthe preconditions for scaling up) had alreadybeen initiated by MexFam and that emphasisshould be placed on organizational redesign andtransformation of MexFam’s business model(Tasks 7 and 8 in the SUM Framework).Beginning with an initial assessment oforganizational structure and objectives—followed by a rough scalability assessment—theintervention focused on facilitating internaldecisions about organizational structures bettersuited to large-scale operations, given currentrealities. To do this, MSI was asked to conduct aclassic organization-development process. As aresult of that process, it became clear that theorganization’s growth and sustainabilitydepended on its being more responsive to itsclientele and more diversified in its revenuesources. This, in turn, resulted in decisions bythe organization to move towards adecentralized, fee-for-service, model of serviceprovision. MexFam is implementing this newmodel through coordinated action (Task 9 of theSUM Framework), and considering the mosteffective and efficient ways to incorporate thenecessary performance monitoring (Task 10).

GOVERNMENT ADOPTION

OF AN IMPROVED SEXUAL

EDUCATION CURRICULUM

Under the Fox Administration, the MexicanMinistry of Education initiated several majorreforms, including making teacher training animportant element of education policy reform.A special commission headed by the Ministryof Education was charged with identifyingtraining gaps, reviewing and updating trainingmaterials, and designing a career plan forprofessional development for teachers.

MSI’s initial review identified a window ofopportunity for reproductive health NGOs,including DEMYSEX, THAIS, MexFam, andAFLUENTES, to participate in this policyreform process and to scale up content anddelivery by providing teacher training and newcurriculum material based on their existingmaterials and capabilities in the area of sexualeducation and reproductive health. Results todate include a signed memorandum ofunderstanding at the national level between theconsortium of grantees and the Government ofMexico establishing the legal framework andoverall objectives of the effort; establishment ofnetworks of trainers at the State level;agreement between the government and thetraining network on plans and procedures forimplementing and funding teacher training;agreement on training materials; and theinitiation of teacher training in selected states.

This effort began with a strategic planningprocess (Tasks 1–4 of the SUM Framework).This resulted in the development of a cohesivevision and strategy in which partners identifiedcommon goals for the scaling-up effort and keyroles to be played. A strategy of geographic

Annex 1: Summary of Field Trial Experience in Mexico and Nigeria


expansion at the state level was selected, andthe group focused on the initial tasks oflegitimizing change (Task 6) and constituencybuilding (Task 7). COESPOS (Mexico’s State-level population council) was invited toparticipate as a linking institution togovernment entities in the states and toguarantee grantees’ representation inpopulation activities and promotion of trainingteams to disseminate materials. After reviewingfactors such as the political environment(including the election calendar and newgovernment transitions); the targetedpopulation; and grantee resources within allstates of the Mexican Republic, five states wereinitially selected to start the collaborationstrategy. Nine more were subsequently addedto the project.

MSI helped coordinate efforts to identify thefinancial resources needed to implement thisprogram (Task 7). The grantee networkdeveloped a budget, and one membervolunteered to function as the network’sadministrative and financial coordinator.Efforts were then undertaken to establish clearand efficient mechanisms for coordination ofthe formal network of grantees with theMinistries of Interior and Education andCOESPOS (Task 9). This extended networkfocuses mainly on deepening the legitimation(Task 5) and constituency building (Task 6) thatare seen as key elements of going to scale.Significant outputs from this network include,in addition to those noted above:

Developing, identifying, redesigningtraining materials:

Development by the network of grantees ofa comprehensive inventory of shared

materials and a database for use by federalgovernment institutions.

Agreement from the Ministry of Educationthat the network of grantees would reviewtheir programs and materials inreproductive health and sexual educationand suggest new content.

Formalization of an MOU with thegovernment to obtain their support forprinting grantees’ materials.

Development by the network of grantees ofa common proposal for the revision oftraining materials, including proposedimprovements in both content and format.

Training of trainers: Creation of a national team of sexual andreproductive health specialists to reviewthe current training program and developa training program for teachers.

Creation of training cells in each of theStates to train teachers, based on theabove-mentioned materials.

SCALING UP IMPROVEMENTS IN

SEXUAL EDUCATION CURRICULUM FOR

INDIAN POPULATIONS

The Mexican Federal Government considers theIndian population to be at high risk for sexualand reproductive health problems and hastargeted this population with specific healthpolicy and educational projects. MSI’s initialreview identified an opportunity to scale upsuch efforts through collaboration betweenMacArthur grantees and the Mexicangovernment on educational programs andmaterials development.

As with the broader network discussed above,this activity began with a visioning and




Nigeria

As in Mexico, work in Nigeria began witha review of pilot projects implementedby reproductive health NGOs. Two

projects were selected as the focus forintensified scaling-up efforts based on apreliminary analysis of their scalability and theorganizations’ interest in working with MSIand the SUM Framework. There was adeliberate decision to select one grantee in theNorth and one in the South of the country, andto select one pilot project that was wellestablished and another that was justbeginning. The projects and organizationsselected were:

1. SSccaalliinngg UUpp ooff tthhee CCoommmmuunniittyy LLiiffee PPrroojjeecctt((CCLLPP)):: Local expansion of CLP’s holisticmodel of community-based healtheducation, and national replication of themodel through the Federal MOH, theCatholic Church, and beyond.

2. SSccaalliinngg UUpp ooff tthhee PPaatthhffiinnddeerr MMaatteerrnnaallMMoorrttaalliittyy aanndd MMoorrbbiiddiittyy ((MMMMMM)) PPrrooggrraamm::Integration of the MMM model into a free,

government-sponsored maternal healthcare program at the state and local level.

Interventions with each of the twoorganizations began with an in-depth strategicvisioning process and scalability assessment(Tasks 1 and 2) to collaboratively assess thepotential and future direction for scaling upexisting pilot programs. Through a series ofworkshops facilitated by MSI, the organizationsidentified a scaling-up vision, as well as thosechallenges and opportunities that might furtheror detract from this vision. The workshopsincluded establishing criteria for identifyingpotential partners and supporters; estimatingwhat resources and training materials would berequired; and developing action plans formoving forward.

MSI subsequently facilitated a second round ofworkshops with both CLP and Pathfinder tocreate concrete strategies and implementationplans for putting in place the necessarypreconditions for effective scaling up (Task 4).

planning exercise (Tasks 1 4) that involvedcareful identification of goals and objectives fora network that included the Ministry of PublicEducation and grantees. As the group movedforward to identify additional partners and allies(Task 6), three recently founded Indianuniversities were identified for furthercollaboration: Universidad Aut noma Ind genade México “Mochicahui” at Sinaloa, Universidadde Totonacapan at Veracruz, and UniversidadComunitaria Intercultural at San Luis Potos .

MSI worked with grantees to identify anddefine program and content, using materialsalready developed for this purpose. Granteesalso participated in the design, contentdefinition and production of 20 radio programsin Indian dialect. MSI also worked withgrantees on Task 3: Realign and MobilizeResources, by helping with a budgetingexercise to assess the need for, and availabilityof, additional resources, and to determine thepossible need for a fundraising strategy.


In the course of this planning effort, a variety ofgaps were identified in existing documentationand analysis, and these became the focus foradditional work (Task 3).

The following provides more detaileddiscussion on each of the two Nigeria cases:

SCALING UP OF THE COMMUNITY LIFE

PROJECT (CLP)

Founded as a reproductive health educationproject with the vision of reaching traditionallymarginalized populations through a demand-driven, participatory model, the CommunityLife Project (CLP) focuses on addressing healthholistically through education by working inpartnerships with community-basedorganizations. From the outset, CLP’s goal wasto serve as a pilot project leading to replicationelsewhere, and nascent scaling-up efforts weremade through expansion into neighboringcommunities, development of a broader rangeof health topics, and by growing its network oforganizational partners.

In 2001 CLP moved to another stage of scalingup, when it began to transfer its model toFederal Community Development officers insix states, and to design a sexuality curriculumfor the Catholic school system. MSI’sintervention with CLP began with theorganization already in the early stages of thisnext phase of scaling- up; with an existingmodel regarded by many as successful; andwith Government officials and representativesof both the private and NGO sectors interestedin adopting all or parts of the CLP model.

The plan developed with CLP included a two-track approach to scaling up. On the first track,CLP decided to focus its attention on scaling up

with two existing partners: a sexualityeducation curriculum for the Catholic Church,for use in Catholic schools, and assistance toFederal Community Development Officers insix states to integrate CLP’s holistic, grass rootsmodel into their work.

The second track involved an 18-24 monthseries of activities designed to find additionalscaling-up partners with whom to work oncethe first track was completed. A planningworkshops led by MSI laid out severalstrategies for finding partners and resources forscaling up, including outreach to internationalreproductive health NGOs; organization of anational summit on grassroots, participatorycommunity development; and soliciting theNigerian private sector for funding.

Participants in the planning workshop alsoagreed that several steps were needed for CLPto do the marketing, outreach and publicitynecessary to build support for their efforts andattract these new scaling-up partners (Tasks 3,6 and 7). Among these steps, the mostimportant were to produce betterdocumentation of CLP’s model and itscomponents, and to conduct a formalevaluation of CLP’s impact.

MSI employed a Nigerian consultant toproduce a detailed document describing CLP’smodel of working with partner organizations inthe community. This document provided astep-by-step delineation of the process CLP hasused and is intended to serve as the basis forboth explaining and transferring the model topotential adopting organizations.

The planning process also indicated that CLPneeded a formal evaluation of its impact toconvince potential adopting organizations,



especially in the government, of itseffectiveness. MSI helped CLP design andconduct the evaluation, with financial supportobtained from the Ford Foundation. At MSI’ssuggestion, CLP has also commissioned awritten history of the organization.

A detailed analysis of MSI’s efforts to supportscaling up at CLP and the lessons learned from thatexperience are available as a stand-alone case study.

SCALING UP OF THE PATHFINDER

MATERNAL MORTALITY AND

MORBIDITY (MMM) PROGRAM

The Pathfinder Maternal Mortality andMorbidity (MMM) Program, which focuses onreducing maternal mortality through aneducation and outreach-based model, began asa pilot project in three states in Nigeria in 2004.MSI entered at the beginning of a three-yearproject to help put in place a pre-scaling-upfoundation so that, once the project provedsuccessful, scaling up could proceed rapidly.

In November 2004, MSI conducted a scaling-upplanning workshop (Tasks 1 and 4) for theMinjibir, Kano State project. Initial discussionshad made it clear that Pathfinder was notinterested in scaling up these projects as“Pathfinder projects” but instead wanted totransfer the model to appropriate governmentinstitutions at the local and state levels. Withthis in mind, the workshop was strategicallytimed to coincide with an effort by Kano StateMinistry of Health officials to expand freematernal care in Kano. Participants in theworkshop included representatives of both thestate Ministry of Health and Ministry of LocalGovernment, identified as the two key players

in the State’s efforts to expand and improvematernal health services. The workshopresulted in a strategy to integrate thePathfinder education and outreach model intothe government’s efforts to scale up freematernal health care and for establishing acommittee to implement this collaborativeeffort. A representative from the Ministry ofHealth emerged as a policy champion to leadthat effort.

Unfortunately, shortly after the planningworkshop took place, Pathfinder put the projecttemporarily on hold. Pathfinder managementrecognized—partially as a result of theworkshop and scalability assessment conductedby MSI in preparation for the workshop—thatseveral problems with the existing modelneeded to be addressed before scaling up couldproceed. One problem was a lack of localownership: Operating the project’s three fieldsites with staff flown in from Lagos wasresulting in activity only occurring whenPathfinder staff planned a visit. Anotherproblem was that the poor quality of publichealth facilities undermined the effectiveness ofawareness-raising and educational activities.Accordingly, Pathfinder decided to addressthese issues by partnering more closely withlocal public health officials; moving the locus ofPathfinder staff closer to the three locations;hiring local staff; and partnering with a CEDPAproject engaged in a similar exercise, allowingfor greater leveraging of funds. A new modeluses local staff seconded by the State MOH.

MSI is in contact with the Pathfindermanagement about resuming the scaling-upwork once the new approach to managing theproject is in place.



Annex 2:Steps, Tasks, and Questions for Developing and Implementinga Detailed Scaling-up Plan


What organizational, process, and technical factors were critical to success on a pilot scale?

Can the model be simplified without undermining its effectiveness? Is it absolutelynecessary to replicate all elements of the model on a large scale?

Does the organization that carried out the pilot project have the desire and organizationalcapacity to expand its operations and deliver services on a substantially larger scale?

If not, which organization(s) are best suited and motivated to implement the model on ascaled up basis or to serve as partners in implementing the model?

Should the scaling-up effort include policy change by the government or rely exclusively onvoluntary adoption by private and non-governmental organizations?

Is there need for one or more intermediary organizations to support the scaling-upprocess? If so, what help is needed and which organizations are best suited to performingthese roles?

Along what dimension(s) should scaling up take place?

What would scaling up look like if it were successful?

Do relevant stakeholders, potential partners, and intended beneficiaries perceive a need forthis kind of model?

Has the model been documented, including the process component, and has its cost-effectiveness been objectively assessed? Is there any evidence that the model is more cost-effective than other approaches?

Are there obvious economies or diseconomies of scale?

How easily can the institutional characteristics that were key to the outcomes achieved bereplicated or enlarged?

Is there anything special or unique about the social context, political context, or generalcircumstances of the pilot project (e.g., cultural, ethnic, or religious values/characteristics;distribution of power; homogeneity; economic conditions), and that would need to bepresent for the model to be replicated successfully?

Does the adopting organization have the appropriate organizational and implementationcapacity, or the means to develop that capacity?

Does needed funding exist for replicating the model on a large scale?

Are the central mission, organizational culture, and values of the proposed adoptingorganization sufficiently compatible with those necessary to adopt and implement themodel successfully?


Task 2: AssessScalability

What additional information or documentation is needed as basis for planning and toaddress stakeholder concerns?

Does the plan summarize the need, the vision, and the evidence for scaling up themodel?

Does the plan include a clear description of proposed actions, timetable, roles andresponsibilities, and resources?


Annex 2: Steps, Tasks, and Questions for Developing and Implementing a Detailed Scaling-up Plan


What more needs to be done to persuade relevant decision makers, funders, andopinion leaders that new solutions are necessary and desirable?

What more needs to be done to persuade relevant decision makers, funders, andopinion leaders that the proposed model is successful, cost-effective, and feasible?

Which spokespersons, conveners, messages, and methods are most likely to have animpact on these audiences?

Which organizations, organizational units, or individuals are responsible for keydecisions regarding the funding and implementation of scaling up? Who has authorityto make the decisions within these organizations?

What arguments, appeals, or advocacy strategies are likely to have access and bepersuasive to these decision makers?

What are the most effective networks and alliances for carrying out this advocacy, andhow can they be most efficiently mobilized and organized?

How can buy-in from the leadership and staff of potential implementing organizationsbest be achieved?

What additional human, institutional, and financial resources will be needed tosupport the process of “going to scale,” and what needs to be done to ensure that theseresources are available?

What human, institutional, and financial resources will be needed for “operating atscale,” and what needs to be done to ensure that these resources are available?

What, if any, new partnerships need to be established?

Task 3: FillInformationGaps

Task 4: Preparea Scaling-upPlan

Task 5:LegitimizeChange


Task 7: Realignand MobilizeResources


Annex 2: Steps, Tasks, and Questions for Developing and Implementing a Detailed Scaling-up Plan

Step 3: Implementing the Scaling-up Process

What, if anything, needs to be done to encourage and assist the originating organization torelinquish control and make the other changes necessary for successful transfer and scalingup of the model?

What changes need to be made in the “adopting organization”?

Which organizations are responsible for the transfer process and what changes do theyneed to make to their own capacity—structure, staffing, or operations—to do thissuccessfully?

Are action plans and budgets in place for implementing the scaling-up effort and, if not,what more needs to be done?

Have responsibilities been clearly allocated and efficient mechanisms established forcoordinating the scaling-up effort?

If more than one organization is involved, who will be responsible for monitoring theseefforts and for resolving any conflicts?

Are there adequate procedures for documenting the progress, lessons learned, and impactof the scaling-up effort?

What are the most effective mechanisms for ensuring that this information is fed back tokey stakeholders and to the broader public and that the information is used to makenecessary course corrections?

Task 8: Modifyand StrengthenOrganizations

Task 9:CoordinateAction

Task 10: TrackPerformanceand MaintainMomentum

54 From Vision to Large-Scale Change—A Management Framework for Practitioners

Future Search

Force-FieldAnalysis

DeliberativeDialogue

Political andPolicyMapping

StakeholderAnalysis

Annex 3: Useful Tools for Planning and Implementing a Scaling-up Strategy

Weisbord, Marvin R. and Sandra Janoff. FutureSearch: An Action Guide to Finding CommonGround in Organizations and Communities. SanFrancisco: Berrett-Koehler, 1995.

Hall, C. S. and Lindzey, G., 1978. Theories ofPersonality, 3rd Ed. New York: John Wiley & Sons

Crosby, Benjamin L. “Stakeholder Analysis: A VitalTool for Strategic Managers.” Implementing PolicyChange Technical Note 2. Washington, DC:Management Systems International and USAID,March 1991. www.msiworldwide.com/ipc


A technique for systematicallyidentifying and analyzing the rolevarious actors are able and willing toplay with respect to a given policyissue or intended change

A graphic technique for identifyingpower dynamics and points ofpolitical access to foster policy orsystemic change

A technique for organizing andchanneling widespread debate ofpublic policy issues

A technique for identifying forcessupporting and restraining specificchanges

A systematic and highly participatoryprocess for developing a sharedvision of future directions forprograms, organizations, andcommunities

Crosby, Benjamin L. "Management and theEnvironment for Implementation of PolicyChange: Part Two." Implementing Policy ChangeTechnical Note 5. Washington DC: ManagementSystems International. 1992.

McCoy, Martha L. and Patrick L. Sully. “DeliberativeDialogue to Expand Civic Engagement.” CivicReview. Vol. 91, no. 2. Summer 2002.


55From Vision to Large-scale Change A Management Framework for Practitioners


InstitutionalDevelopmentFramework

OrganizationalResponsibilityCharting

LogicalFramework

Management Systems International. “OrganizationalResponsibility Charts.” MSI Technical Note. Prems.Unpublished, 1990.

Cooley, Larry. “The Logical Framework: ProgramDesign for Program Results.” The EntrepreneurialEconomy. July/August 1989. pp. 8-15.

A widely used project-planningframework summarizing intendedobjectives, performance measures,and key assumptions

A graphic technique for identifyingand assigning roles and responsibilitieswithin multi-organization teams,networks, and coalitions

A set of tools for collaborativelyidentifying and tracking key elementsof organizational maturation orchange

Step 3: Implementing the Scaling-up Process

Renzi, Mark. “An Integrated TOOLKIT for InstitutionalDevelopment.” Public Administration andDevelopment. Vol. 16, pp. 469–483. 1996.

56 From Vision to Large-Scale Change A Management Framework for Practitioners

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Sources Cited

Founded in 1981, MSI is a woman-owned consulting firm located in Washington, DC, and serving clientsworldwide. MSI provides management consulting services to local organizations, foundations andinternational donor agencies in a number of areas including Managing Policy Change; Planning,Measurement and Evaluation; Institutional Development; and Training.

This publication may be found electronically at http://www.msiworldwide.com/documents/ScalingUp.pdf

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Washington, DC 20024www.msiworldwide.com

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