By Ann Larson
How can new or under-utilized healthcare practices be expanded and institutionalized to achieve audacious and diverse global health outcomes, ranging from eliminating polio to reversing the rise in non-communicable diseases? How can complex adaptive systems with diverse components and actors interacting in multiple ways with each other and the external environment best be dealt with? What makes for an effective scale-up effort?
Four in-depth case studies of scale-up efforts were used to explore if there were different pathways to positively change a complex adaptive system.