India faces mammoth challenges in achieving the Millennium Development Goals (MDGs). In the sphere of Maternal and Child Health (MCH), the challenge pertains to reducing the Infant Mortality Rate (IMR) from 53 (SRS 2009) to less than 30 and the Maternal Mortality Ratio (MMR) from 254 (SRS 2004–06) to less than 100 by 2015.
To address this challenge, the government has increased efforts aimed at strengthening the public health sector by increasing health sector financing, launching initiatives like the National Rural Health Mission (NRHM) and promoting innovative pilots at the state and district levels.
Numerous civil society organizations too, have intensified their efforts for developing and implementing innovative reproductive health pilots, some of them demonstrating impressive success. Yet, the decline in IMR and MMR has been far from satisfactory.
The limited impact can be attributed to the fact that pilots are often not scaled up to their full potential. The primary reason behind this apparent gap has been the assumption that scaling up is a spontaneous process, where actual implementation on a large scale is taken for granted. Instead, a more pro-active approach to scaling up is required, which includes processes such as evidence building, assessment of the environmental and technical challenges for scaling up, engagement of multiple stakeholders, creating capacity for large-scale implementation and effective advocacy at various levels.
As a Centre of Excellence
We at PFI are working to develop ourselves as a Centre of Excellence. We recognize that India cannot afford to lose out on the potential of innovative and promising models. We have initiated efforts towards working with civil society organizations and the government to successfully scale up models with demonstrated evidence of impact.
PFI, with technical support from Management Systems International (MSI) and financial support from the MacArthur Foundation, has been working on scaling up since 2006. It has been using MSI’s Scaling Up Management Framework as a tool to help facilitate the scaling up process. PFI has provided technical support to a diverse range of promising practices or pilot projects in reproductive and child health (RCH) and young people’s reproductive and sexual health (YPRSH). Each outcome, whether a success, or a partial success or even a failure, has resulted in an enriching learning experience, contributing to both scaling up literature and practice.
Organizational capacity building-
- Identifying and building up a pool of master trainers in scaling up management
- Organizing knowledge and skill enhancement and trainings on documentation, institutional development etc.
Integrating ‘scaling up’ in proposal development and grant making of all projects-
- Incorporating capacity building and programme development as an integral part of projects
- Strengthening monitoring & evaluation mechanisms
- Building advocacy and partnership development into programmes.
Supporting organizations in scaling up promising practices or successful pilots projects-
- Conducting theme-based scans and identifying scalable models through scalability assessments
- Envisioning and strategic planning for scaling up
- Supporting institutional strengthening, capacity building and advocacy for scaling up
- Developing mechanisms for monitoring implementation at scale and evaluation of scaled up programmes.