Key definitions and their application to the SCUBY Project
| Concept | Definition | Application in the SCUBY Project |
| Roadmap | An action plan delineating the targets, planning and progression of scale-up strategies, identifying actors, actions and timelines based on priorities in place and time.21 | Scale-up intervention In SCUBY, a scale-up roadmap constitutes an overall scale-up strategy and aim; roadmap actions or activities; a problem statement, rationale and objectives/aim(s) for each roadmap action, a timeline to plan roadmap activities within a time frame; and a description of the evidence base and key partners/stakeholders involved in the scale-up (the coordination mechanism per roadmap action). |
| Policy dialogue | An essential component of the policy and decision-making process, where it is intended to contribute to informing, developing or implementing a policy change following a round of evidence-based discussions, workshops and consultations on a particular subject. It is seen as an integrated part of the policymaking process and can be conducted at any level of the health system where a problem is perceived and a decision, policy, plan or action needs to be made.30 | Implementation strategy (to guide the roadmap development to implementation) In SCUBY, policy dialogues are used as an approach in the policymaking process to engage with key stakeholders and to develop the countries’ scale-up roadmaps. They will comprise structured formal events, one-to-one interactions with key stakeholders, workshops, consultations and joining ongoing dialogues within the context.30 |
| Context | Complex adaptive systems that form the dynamic environment(s) in which implementation processes are situated63; a set of characteristics and circumstances that consist of active and unique factors, within which the implementation is embedded. As such, context is not a backdrop for implementation, but interacts, influences, modifies, and facilitates or constrains the intervention and its implementation. Context is usually considered in relation to an intervention, with which it actively interacts. It is an overarching concept, comprising not only a physical location but also roles, interactions and relationships at multiple levels.64 | Mediator The context in SCUBY is assessed at micro, meso and macro levels. Since scale-up is targeting the country level, the process evaluation focuses on the macro-level context, specifically the barriers and facilitators to scale-up. We look at the WHO health system building blocks65 66 and broader political, economic, social, technological, environmental and legal factors. |
| Scale-up | The efforts to increase the impact of health interventions so as to benefit more people and to foster policy and programme development on a sustainable basis.26 | Study aim/goal Scale-up efforts in SCUBY can include various efforts to make progress on any of the three axes. Examples of efforts are: increasing coverage of existing interventions, strengthening or expanding the existing ICP package, and changing financing or monitoring systems. |
ICP, integrated care package; SCUBY, SCale-Up diaBetes and hYpertension care.