A framework for measuring the launch and scale of service delivery interventions in low-resource settings
Creators: name: Crissman, Kate
name: Olson, Katharine
name: Hodges, Elina Urli
name: Silimperi, Diana
name: Sowmya Rajan
name: Udayakumar, Krishna
Publisher: name: Gates Open Research
Year: 2023

description: Low-and middle-income countries are increasingly faced with competing health challenges that<br> may be addressed through health care interventions implemented by organizations operating<br> outside of the public sector. Insufficient public sector care delivery infrastructure and limited<br> workforce, combined with slow scaling of service delivery interventions implemented by social<br> enterprises, NGOs, and the private sector, leads to a global delivery gap in these settings (Ben<br> Charif et al., 2022). Evidence-based frameworks are useful for contextualizing barriers and<br> enablers to scale, and for identifying steps in the pathway to scale both of which can be used to<br> aid rapid scale up across contexts.<br> <br> The Launch and Scale Speedometer Framework (Speedometer Framework) was originally<br> developed for product-based interventions like vaccines, drugs, and diagnostics. We adapted<br> the Speedometer Framework for service delivery interventions, ultimately to help identify the<br> key factors that inhibit and/or enable launch, implementation, and scale up of service delivery<br> interventions in order to rapidly and more effectively scale. The Speedometer Framework was<br> adapted through insights gathered from desk reviews, subsequent validation through in-depth<br> interviews, and a collective workshop with two service delivery organizations. To further<br> understand the application of the Speedometer Framework to service delivery interventions we<br> interviewed three organizations implementing digital health services with artificial intelligence<br> (AI) chatbots.<br> <br> We identified three key findings from our framework review and key informant interview<br> process. Each finding is described in more detail below.<br> <br> 1. The scale pathway measurement of service delivery interventions is generally consistent<br> with that of product interventions.<br> <br> 2. The Speedometer Framework should be adapted with new characteristics and<br> milestones, including health system governance, regulatory activities, health workforce,<br> and facility density to enable the measurement of the scaling of service delivery<br> interventions, but also product interventions.<br> <br> 3. Contextual information on the scaling pathway is important to be able to understand<br> the nuances of service delivery implementation.<br> <br> Application of the Speedometer Framework enables us to collect and analyze data to<br> understand key influencing factors of the launch and scale pathways for both products and<br> service delivery processes. Understanding these influencing factors helps to accelerate the<br> journey to sustainable scale of proven interventions to have greater impact in saving lives by<br> reducing morbidity and mortality. We hope that a range of stakeholders from implementing<br> organizations to investors and funders can adopt this tool to increase impact