Trans-National Scale-Up of Services in Global Health

Background Scaling up innovative healthcare programs offers a means to improve access, quality, and health equity across multiple health areas. Despite large numbers of promising projects, little is known about successful efforts to scale up. This study examines trans-national scale, whereby a prog...

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Main Authors: Shahin, Ilan, Sohal, Raman, Ginther, John, Hayden, Leigh, Mossman, Kathryn, Parikh, Himanshu, McGahan, Anita, Mitchell, Will, Bhattacharyya, Onil, MacDonald, John Angus
Other Authors: Massachusetts Institute of Technology. Media Laboratory
Format: Article
Language:en_US
Published: Public Library of Science 2014
Online Access:http://hdl.handle.net/1721.1/92495
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author Shahin, Ilan
Sohal, Raman
Ginther, John
Hayden, Leigh
Mossman, Kathryn
Parikh, Himanshu
McGahan, Anita
Mitchell, Will
Bhattacharyya, Onil
MacDonald, John Angus
author2 Massachusetts Institute of Technology. Media Laboratory
author_facet Massachusetts Institute of Technology. Media Laboratory
Shahin, Ilan
Sohal, Raman
Ginther, John
Hayden, Leigh
Mossman, Kathryn
Parikh, Himanshu
McGahan, Anita
Mitchell, Will
Bhattacharyya, Onil
MacDonald, John Angus
author_sort Shahin, Ilan
collection MIT
description Background Scaling up innovative healthcare programs offers a means to improve access, quality, and health equity across multiple health areas. Despite large numbers of promising projects, little is known about successful efforts to scale up. This study examines trans-national scale, whereby a program operates in two or more countries. Trans-national scale is a distinct measure that reflects opportunities to replicate healthcare programs in multiple countries, thereby providing services to broader populations. Methods Based on the Center for Health Market Innovations (CHMI) database of nearly 1200 health programs, the study contrasts 116 programs that have achieved trans-national scale with 1,068 single-country programs. Data was collected on the programs' health focus, service activity, legal status, and funding sources, as well as the programs' locations (rural v. urban emphasis), and founding year; differences are reported with statistical significance. Findings This analysis examines 116 programs that have achieved trans-national scale (TNS) across multiple disease areas and activity types. Compared to 1,068 single-country programs, we find that trans-nationally scaled programs are more donor-reliant; more likely to focus on targeted health needs such as HIV/AIDS, TB, malaria, or family planning rather than provide more comprehensive general care; and more likely to engage in activities that support healthcare services rather than provide direct clinical care. Conclusion This work, based on a large data set of health programs, reports on trans-national scale with comparison to single-country programs. The work is a step towards understanding when programs are able to replicate their services as they attempt to expand health services for the poor across countries and health areas. A subset of these programs should be the subject of case studies to understand factors that affect the scaling process, particularly seeking to identify mechanisms that lead to improved health outcomes.
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spelling mit-1721.1/924952022-10-03T08:53:39Z Trans-National Scale-Up of Services in Global Health Shahin, Ilan Sohal, Raman Ginther, John Hayden, Leigh Mossman, Kathryn Parikh, Himanshu McGahan, Anita Mitchell, Will Bhattacharyya, Onil MacDonald, John Angus Massachusetts Institute of Technology. Media Laboratory Sloan School of Management MacDonald, John Angus Background Scaling up innovative healthcare programs offers a means to improve access, quality, and health equity across multiple health areas. Despite large numbers of promising projects, little is known about successful efforts to scale up. This study examines trans-national scale, whereby a program operates in two or more countries. Trans-national scale is a distinct measure that reflects opportunities to replicate healthcare programs in multiple countries, thereby providing services to broader populations. Methods Based on the Center for Health Market Innovations (CHMI) database of nearly 1200 health programs, the study contrasts 116 programs that have achieved trans-national scale with 1,068 single-country programs. Data was collected on the programs' health focus, service activity, legal status, and funding sources, as well as the programs' locations (rural v. urban emphasis), and founding year; differences are reported with statistical significance. Findings This analysis examines 116 programs that have achieved trans-national scale (TNS) across multiple disease areas and activity types. Compared to 1,068 single-country programs, we find that trans-nationally scaled programs are more donor-reliant; more likely to focus on targeted health needs such as HIV/AIDS, TB, malaria, or family planning rather than provide more comprehensive general care; and more likely to engage in activities that support healthcare services rather than provide direct clinical care. Conclusion This work, based on a large data set of health programs, reports on trans-national scale with comparison to single-country programs. The work is a step towards understanding when programs are able to replicate their services as they attempt to expand health services for the poor across countries and health areas. A subset of these programs should be the subject of case studies to understand factors that affect the scaling process, particularly seeking to identify mechanisms that lead to improved health outcomes. 2014-12-24T15:44:12Z 2014-12-24T15:44:12Z 2014-11 2013-07 Article http://purl.org/eprint/type/JournalArticle 1932-6203 http://hdl.handle.net/1721.1/92495 Shahin, Ilan, Raman Sohal, John Ginther, Leigh Hayden, John A. MacDonald, Kathryn Mossman, Himanshu Parikh, Anita McGahan, Will Mitchell, and Onil Bhattacharyya. “Trans-National Scale-Up of Services in Global Health.” Edited by Jeremy D. Goldhaber-Fiebert. PLoS ONE 9, no. 11 (November 6, 2014): e110465. en_US http://dx.doi.org/10.1371/journal.pone.0110465 PLoS ONE Creative Commons Attribution http://creativecommons.org/licenses/by/4.0/ application/pdf Public Library of Science Public Library of Science
spellingShingle Shahin, Ilan
Sohal, Raman
Ginther, John
Hayden, Leigh
Mossman, Kathryn
Parikh, Himanshu
McGahan, Anita
Mitchell, Will
Bhattacharyya, Onil
MacDonald, John Angus
Trans-National Scale-Up of Services in Global Health
title Trans-National Scale-Up of Services in Global Health
title_full Trans-National Scale-Up of Services in Global Health
title_fullStr Trans-National Scale-Up of Services in Global Health
title_full_unstemmed Trans-National Scale-Up of Services in Global Health
title_short Trans-National Scale-Up of Services in Global Health
title_sort trans national scale up of services in global health
url http://hdl.handle.net/1721.1/92495
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