The challenges of scaling up a community – based health planning and services (CHPS) initiative in Ghana from an experimental project to a national program have been discussed elsewhere, and if IPTc is to be launched on a larger scale in Ghana, those responsible for its implementation could learn from some of the constraints to scaling up identified in the CHPS study [34], [35].
In summary, virtually all the constraints to scaling up that are listed in Table 1 apply to syphilis screening.
This table is an adapted typology of the main constraints to scaling up child survival interventions in LMICs [ 2, 3].
Then the section discusses constraints to scaling up related to community and household demand-side constraints, service delivery supply-side constraints and management.
These categories were adapted from two previous typologies of scaling up Hanson and colleagues' typology of constraints to scaling up [ 18], and Simmons and Shiffman's typology of components affecting scale-up success [ 19].
It is important to systematically assess the factors contributing to impact and constraints to scaling up, whether these factors can be influenced by the immediate stakeholders or are more external.
"…they just pay for one month then they carry forward the rest of the months, you see when a person is permanently employed at the end of each month at least…[they get their salary]" Upgrading nursing student Inadequate human resources have been identified as a key constraint to scale up of health interventions [ 7, 8].
When you can convince investors to give you money and when cash is the constraint to scaling your business," Kan said to kick off our program.
In 2007 the World Health Organization (WHO) noted that: "Weaknesses in general managerial capacity at all levels of the health system, but especially at the local level, are widely cited as a binding constraint to scaling up health services and achieving the MDGs.
