June 2005

According to this paper from CARE India, successful efforts in reproductive and child health often depend on innovations that help change behaviour, leverage improved systems or expand availability of and access to services. Once an innovation is proven to work, expectations shift to increasing its scope – also known as 'scaling up'” Often, non-governmental organisations (NGOs) and government agencies are accused of focusing too much on creating new projects and not scaling up proven innovations. How can an organisation with scarce resources expand proven pilot programmes and/or creative interventions? How can an innovation be linked to potential users, clients or beneficiaries? The authors propose that scaling up means more than simply expanding a pilot project; it requires an explicit, institutionally grounded strategy for replicating a tested, validated innovation. Replicating a best practice gives individuals and organisations a chance to learn from shared experiences and develop together into a collective platform for sustainable impact.

To help CARE staff and partners scale-up successful programmes, CARE India has identified an appoach called 'Demonstration and Replication.' This approach was first developed as a way to further successes that had been identified from the first phase of the Integrated Nutrition and Health Project (INHP), as it moved into the second phase, INHP-II. The key elements include:

• Innovation – innovate and then demonstrate those innovations in the project; evaluate the results of the innovation and repeat it in multiple contexts and sites to validate it as a best practice.
• Documentation – describe best practices e.g., steps, channels, inputs, problems, and document them in both descriptive (what it is) and instructive (how and why) terms.
• External Marketing – 'sell' best practices to key participants and other stakeholders, and advocate with them for needed policy and regulatory changes; identify replicators and define their roles.
• Assessment & Capacity Building – assess capacity and preparedness of replicators; build targeted capacity while monitoring training and practice.
• Support – motivate potential replicators and support active ones; monitor the rate and quality of replication; reward successful replicators.

In the first year of INHP-II, the project team worked with a facilitator to (1) create broad principles based on implementation experiences in INHP-I and (2) begin developing a replication strategy to scale up innovations in INHP-II. The team began fleshing out the skeleton replication strategy from the Development Activity Proposal (DAP) by identifying and defining key concepts.

Lessons learned:

• Develop an agreed-upon process for identifying and reviewing innovations, with a clear timetable for the innovation-evaluation/validation-demonstration process;
  avoid an aggressive timetable.
• Make clear the criteria and standards for validating innovations and selecting them for replication or scaling-up; avoid an ad-hoc process that may undermine
  confidence in the results.
• Build consensus for the criteria and the process, ideally including stakeholders and replicators to make explicit links between best practices and expected results.
• Go beyond documentation that describes the innovation (what) and also communicate operational instructions (how).
• Develop detailed descriptions of the innovation in order to build a common vision; avoid generalities that can confuse or, worse, support competing visions of the
  desired operational results of scaling up.
• Refine and revise documentation (descriptive and instructive) as replication unfolds, incorporating evolving changes.
• Expand early consensus on best practices selected for replication by including potential leaders, or 'champions,' among stakeholders; build commitment to the
  process by linking the expected results of best practices to their goals.
• Define roles for all replicators; this helps reduce risks and fear of failure.
• Develop links between replicators (horizontal, at the operational field level, and vertical, between champions and field staff) that will support future capacitybuilding
  efforts.
• Involve potential replicators in identifying capacity gaps (through self-assessment) and incorporate their experiences in designing/refining training activities.
• Implement a capacity-building strategy that uses all these elements: skills training, knowledge transfer, on-the-job mentoring/twinning (linking organizations and/or
  communities) and coaching/supportive supervision.
• Select indicators for monitoring both outputs and outcomes of capacity building; avoid a skewed focus on numbers of persons trained and strive instead for indicators
  to monitor quality.
• Plan a realistic yet vigorous timetable for replication; avoid a straight-line in favor of schedules that recognize the learning curve for the first round of replications.
• Develop indicators and mechanisms to monitor both the pace and quality of replication, ideally involving replicators and stakeholders in the process; avoid
  overemphasis on easily collected data on pace, which moves the focus away from quality.
• Articulate in advance the replication process, or model, that will be used to scale up program innovations or best practices, and build consensus for it.
• Assess the risks associated with adding innovations/best practices in multiple “rounds” over time. (This is different from a phased plan for scaling up, in which
  areas are taken up in succession. The phased plan is highly desirable.