It is not enough to give money for demonstration projects. From the very beginning plans should be made for the scaling-up of successful innovations.
When ownership is local and national, and various stakeholders work together, program innovations have a greater chance to take root and survive.
We wanted to see how access to care can be expanded and service quality can be improved when one uses a participatory approach to program development. We showed that major changes become possible if you work in a participatory manner, listen to local people, diagnose what the problems are, provide training and identify where there are opportunities for mobilizing local resources to take action. In time leaders from other municipalities expressed interest in replication and the project succeeded in expanding innovations to three other areas.
In the late 60s, 70s and possibly early 80s, social scientists were interested in researching the diffusion of innovation and studying the link between applied research and policy and program development. Recently there has been less interest in these issues and we feel that this interest must be rekindled.
Our practical purpose is to facilitate expansion of service innovations on a larger scale to improve access to, and the quality of reproductive health care. We are very grateful to have received support from the Bill and Melinda Gates Foundation to continue our work.
If we succeed in learning more about how to expand program innovations from pilot projects so that they have broader program impact, this should be very relevant for public health initiatives in Michigan and elsewhere in the US.
I would like to see policy makers and international donor agencies realize that it is not enough to give money for demonstration projects. From the very beginning plans should be made for the scaling-up of successful innovations.
International "experts" from technical assistance agencies or universities can make important contributions, but they certainly don't have all the answers. When ownership is local and national, and various stakeholders work together, program innovations have a greater chance to take root and survive.
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