BMC Public Health quantity 23, Article quantity: 1902 (2023)

Abstract

Background

Scale-up and sustainability are sometimes studied individually, with few research analyzing the interdependencies between these two processes and the implementation contexts of improvements in the direction of malaria prevention and management. Researchers and implementers supply rather more consideration to the content material of improvements, as they deal with the technological dimensions and the situations for enlargement. Researchers have typically thought-about innovation a linear sequence during which scaling up and sustainability represented the final phases. Using methods considering on this manuscript, we analyze complicated scaling and sustainability processes by means of adopting and implementing seasonal malaria chemoprevention (SMC) in Burkina Faso from 2014 to 2018.

Methods

We performed a qualitative case research involving 141 retrospective secondary information (administrative, press, scientific, instruments and registries, and verbatim) spanning from 2012 to 2018. We complemented these information with major information collected between February and March 2018 within the type of 15 private semi-structured interviews with SMC stakeholders and non-participant observations. Processual evaluation permitted us to conceptualize scale-up and sustainability processes over time in accordance with totally different vertical and horizontal ranges of study and their interconnections.

Results

Our outcomes indicated six inner and exterior determinants of SMC that will negatively or positively affect its scale-up and sustainability. These determinants are effectiveness, monitoring and analysis methods, sources (monetary, materials, and human), management and governance, adaptation to the native context, and different exterior parts. Our outcomes revealed that donors and implementing actors prioritized monetary sources over different determinants. In distinction, our research clearly confirmed that the sustainability of the innovation, in addition to its scaling up, relies upon considerably on the consideration of the interconnectedness of the determinants. Each determinant can concurrently represent a chance and a problem for the success of the innovation.

Conclusion

Our findings spotlight the usefulness of the systemic perspective to contemplate all contexts (worldwide, nationwide, subnational, and native) to realize large-scale enhancements within the high quality, fairness, and effectiveness of worldwide well being interventions. Thus, complicated and methods considering have made it doable to watch emergent and dynamic innovation behaviors and the dynamics specific to sustainability and scaling up processes.