Scaling down to scale up: Translating a pilot program into a national policy in Ghana

11:30 am
1:00 pm
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B2 Conference Room
Dr. Jim Phillips
The Heilbrunn Department of Population and Family Health
Seminar Series
The Heilbrunn Department of Population and Family Health
Open to the Columbia Community
The Heilbrunn Department of Population and Family Health Seminar Series

Presents: Dr. Jim Phillips

Discussing: "Scaling down to scale up: Translating a pilot program into a national policy in Ghana"

In 2000, the "Community-based Health Planning and Services" (CHPS) program was introduced as a national policy in Ghana. CHPS aimed to scale-up a field experiment which had showed that a community-based primary health care system could accelerate progress in achieving MDGs 4 and 5. Scale-up included the development of field demonstration sessions for 38 visiting teams of managers, supervisors, and community workers who were then equipped with small grants for financing "scaled down" pilots of the primary health program in their home districts. The seed grants were leveraged with local resources for incremental costs and scaling up was catalyzed by community mobilization and political consensus. This presentation discusses a statistical analysis of factors affecting the scale up. Scaling up was relatively slow if scale-up relied solely upon policy guidance and in-service training workshops. However, where participating district implementations teams were exposed to participatory peer demonstration and funded to scale-down operations to local pilots, the pace of scaling up was rapid and extensive. Small grants for scaling down CHPS to pilot enabled participating district managers and workers to acquire practical implementation experience which subsequently catalyzed the CHPS scaling up process. Findings indicate that appropriate data system designs, demonstration opportunities and seed funding can catalyze the pace, spread, and content of scaling up.

James Phillips, PhD, conducts research on health systems and policy issues in Africa and Asia. Dr. Phillips collaborated with the Ghana Health Service in designing, implementing, and evaluating the Navrongo Experiment, a study that provided conclusive evidence that family planning services can lead to fertility decline in a traditional African societal setting. Improvements in maternal and child health associated with the project represent the most rapid declines in maternal and childhood mortality ever recorded for a rural African population, with service systems of the project becoming the model for a national program in Ghana known as the Community-based Health Planning and Services (CHPS) Initiative. In the 1980s, Dr. Phillips developed and tested methods for accelerating the pace of scaling-up initiatives in Bangladesh that have since been used around the world, including in Vietnam, where Dr. Phillips collaborated with provincial health authorities on models for reducing ethnic disparities in health service utilization. Later, in the 1990’s, Dr. Phillips developed models for mechanizing the replication of database systems, leading to the proliferation of longitudinal health research in Africa and Asia. Dr. Phillips has published various papers in leading journals documenting his work and the impact of policy experiments in Ghana and Bangladesh. Presently, Dr. Phillips is the Director of a new program, Advancing Research on Comprehensive Health Systems (ARCHeS), based in the Heilbrunn Department of Population and Family Health ( He is also the Principal Investigator of two large-scale health systems development and research projects, including the Ghana Essential Health Intervention Program (GEHIP) and the Connect Project (Tanzania).

Lunch will be served.


Courtney Hooper