Don't Leave Change to Chance

Ishmael Kwasi Selassie

Youth Program Coordinator, Planned Parenthood Association of Ghana

This is a guest post written by Ishmael Kwasi Selassie, a Youth Programme Coordinator for the Planned Parenthood Association of Ghana (PPAG).

We do not have to leave the process of change to chance. Scaling up good practices in health is not a matter of “business as usual” – it requires focus above and beyond a daily routine, and a deliberate effort to observe and ensure change. However, clear and focused processes remain essential.

The community need for sexual and reproductive health education; information; and services, especially in Africa, cannot be overemphasized. Moreover, access to comprehensive sexuality education, reproductive health services, family planning and contraceptive services, and the use of evidence-based approaches to achieve sustainable results reach far beyond achieving the Millennium Development Goals (MDGs); they save women’s lives during childbirth. Magic formulas will not end preventable child and maternal deaths in Africa. Instead, their reduction will be the result of a deliberate and concerted effort. Sustainable improvements in child and maternal mortality rates will result from a focused application of results-oriented strategies that are cost effective, impact-driven, robust, and scalable. The pre-conference workshop before the first ECOWAS Good Practices in Health Forum on Ending Preventable Mother and Child Deaths in West Africa demonstrated the importance of scale-up. Too often, pilot initiatives scratch the surface on community challenges, but do not build the necessary capacity or provide the necessary resources to sustain their initiatives. This leaves communities in a lurch, trying to survive by chance, and can create irreparable damages. It is also an example of an incoherent strategy and waste of resources.

"If you think you are a leader, take a look behind you. If no one is following, you are just taking a walk." (Photo: Sarah Lindsay)

The pre-conference workshop on sustainable scale-up, held on July 28, by the World Health Organization, the U.S. Agency for International Development-funded Leadership, Management & Governance Project, the Evidence to Action Project, the International Planned Parenthood Federation (IPPF), and Marie Stopes International, provided a platform and voice for a series of case studies on scalable health interventions, including IPPF's "Fostering Change for Scale-up of Good Practices in the WAHO Region: The Case of CSE Linking Services in Togo by ATBEF." Two tools were shared with participants in the workshop's small group discussions: the Guide to Fostering Change to Scale-up Effective Health Services, and Nine Steps for Developing a Scaling-up Strategy. These tools were critical for reviewing the effectiveness and scalability of the programs highlighted in case studies (including IPPF's) shared at the workshop. These tools–and the workshop's case studies–taught important lessons. They highlighted the need to identify and recognize a program's effectiveness, status and scalability, opportunities for expansion, and the critical requirements that must be planned and monitored when a program is scaled, including: environment, partners, competitors, funding and donors, resource requirements, and the potential for success. All of these factors are essential to the decision-making process before scaling-up an intervention. Overall, the pre-conference workshop served as a strong proving ground for this key takeaway: "Don't leave change to chance."

  • Take deliberate steps to observe and notice changes during a program's implementation; and
  • Focus and learn from changes in a community, targets, results, and the resources applied.

When you wonder to yourself, "just how am I going to do this?" the IBP Initiative's Guide to Fostering Change to Scale-up Effective Health Services becomes a more useful tool than ever before to guide the process.