The same shortage of health professionals that impeded scale-up of antiretroviral treatment for HIV/AIDS in Africa promises to challenge delivery of PrEP.
This wastes resources due to the duplication of effort, and also impedes scale up.
Since coverage of evidence-based care for mothers and newborns is often unknown, or data may be old or not locally available, this is a major "bottleneck", impeding scale up of high-impact, evidence-based interventions for newborns.
You need to assess your human, social, political, financial, technological, and natural-resource capital, as well as your access to key markets, to see if shortcomings in any of these areas might seriously impede scaling.
At the same time, the instability in the political system impeded the scaling up process, as it constrained the formulation and implementation of the policy in the later phase.
This study aimed to: (a) explore the barriers that have impeded such scale-up in LMICs, and (b) lay out an "implementation research agenda"—a series of key research questions that need to be addressed in order to help overcome such barriers.
But this cultivation mode does possess several challenges, among which cheap carbon sources, bioreactor design, and downstream processing are the major bottlenecks impeding large scale cultivations for producing biofuels in a cost-effective way.
One interesting additional feature of these systems is that physical barriers microns in dimension can be added to restrict movement of ligands, for example to impede large scale receptor clustering and thereby gain insights into its role in cell function.
Most countries surveyed have many of the essential policies and program elements to prevent/manage PPH and PE/E, but absence of commodities (especially misoprostol), limitations in scope of practice for midwives, and gaps in inclusion of maternal health indicators in the national data systems have impeded efforts to scale up programs nationally.
However, logistical and ethical issues impede large-scale clinical trials.
Because sensitivities and concerns about stigma or a husband's reaction may impede the scale-up of infection screening programs, such as syphilis screening, there is a need for social science research into the context-specific and cross-cultural concerns facing women when choosing to seek or not to seek screening and treatment.
