<div class="gmail_quote">From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a></span><br><br><br>
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<p style="MARGIN-LEFT: 0.5in"><b><font color="maroon" size="3" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: maroon; FONT-SIZE: 12pt; FONT-WEIGHT: bold">Scaling up in international health: what are the key issues?<br>
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<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Lindsay J Mangham and Kara Hanson<br>Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine, London, UK <br>
<b><span style="FONT-WEIGHT: bold">Health Policy & Planning, March 2010, volume 25, no. 2<br></span></b>Editors' Choice Free Access paper<br><br></span></font></p>
<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Available online at: <a href="http://heapol.oxfordjournals.org/cgi/content/full/25/2/85" target="_blank"><font color="navy"><span style="COLOR: navy">http://heapol.oxfordjournals.org/cgi/content/full/25/2/85</span></font></a><br>
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<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">“…….The term ‘scaling up’ is now widely used in the international health literature, though it lacks an agreed definition. We review what is meant by scaling up in the context of changes in international health and development over the last decade. We argue that the notion of scaling up is primarily used to describe the ambition or process of expanding the coverage of health interventions, though the term has also referred to increasing the financial, human and capital resources required to expand coverage.</span></font></p>

<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">We discuss four pertinent issues in scaling up the coverage of health interventions: the costs of scaling up coverage; constraints to scaling up; equity and quality concerns; and key service delivery issues when scaling up.</span></font></p>

<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">We then review recent progress in scaling up the coverage of health interventions. This includes a considerable increase in the volume of aid, accompanied by numerous new health initiatives and financing mechanisms.</span></font></p>

<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">There have also been improvements in health outcomes and some examples of successful large-scale programmes. Finally, we reflect on the importance of obtaining a better understanding of how to deliver priority health interventions at scale, the current emphasis on health system strengthening and the challenges of sustaining scaling up in the prevailing global economic environment. ….”</span></font></p>

<p style="MARGIN-LEFT: 0.5in"><i><font color="navy" size="2" face="Arial"><span style="FONT-STYLE: italic; FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Three accompanying commentaries:</span></font></i></p>
<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Lucy Gilson and Helen Schneider <br>Commentary: Managing scaling up: what are the key issues? <br>
<a href="http://heapol.oxfordjournals.org/cgi/content/full/25/2/97" target="_blank"><font color="navy"><span style="COLOR: navy">http://heapol.oxfordjournals.org/cgi/content/full/25/2/97</span></font></a></span></font></p>

<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Susan M Cleary <br>Commentary: Trade-offs in scaling up HIV treatment in South Africa <br>
<a href="http://heapol.oxfordjournals.org/cgi/content/full/25/2/99" target="_blank"><font color="navy"><span style="COLOR: navy">http://heapol.oxfordjournals.org/cgi/content/full/25/2/99</span></font></a></span></font></p>

<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt">Viroj Tangcharoensathien and Walaiporn Patcharanarumol <br>Commentary: Global health initiatives: opportunities or challenges? <br>
<a href="http://heapol.oxfordjournals.org/cgi/content/full/25/2/101" target="_blank"><font color="navy"><span style="COLOR: navy">http://heapol.oxfordjournals.org/cgi/content/full/25/2/101</span></font></a><br><br></span></font></p>

<p style="MARGIN-LEFT: 0.5in"><font color="navy" size="2" face="Arial"><span style="FONT-FAMILY: Arial; COLOR: navy; FONT-SIZE: 10pt"> </span></font></p></div></div></div><br>