Scale Up & Scale Out: Examples from Canada and Low-and-Middle Income Countries

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Dr. Monika Kastner, North York General Hospital & IHPME and Dr. Halla Thorsteinsdóttir, Dalla Lana School of Public Health


Dr. Monika Kastner is the Research Chair in Knowledge Translation and Implementation at North York General Hospital, Affiliate Scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, and Associate Professor of Health Systems Research in the Institute of Health Policy, Management and Evaluation. She also holds a cross appointment at the Division of Epidemiology at the Dalla Lana School of Public Health, and is an Associate Editor for the Canadian Medical Association Journal (CMAJ and CMAJ Open).


Dr. Halla Thorsteinsdóttir‘s research interests focus on health innovation policies with a particular focus on low-and-middle income countries. She has, for instance, examined health innovation systems in the emerging economies, Brazil, China, India and South Africa, and studied the role of international cooperation (South-South and North-South) in the innovation process. She is also particularly interested in examining policy coherence among various policies for improving access to medicine in low-and-middle income countries.

Mark your Calendars: Webinar details to follow.

Readings to consider:

  • Greenhalgh T, Wherton J, Papoutsi, et al. Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies. JMIR 2017;19(11):e367. https://www.jmir.org/2017/11/e367/
  • Nolan K, Schall MW, Erb F, Nolan T. Using a Framework for Spread: The case of patient access in the veterans health administration. Journal on Quality and Patient Safety 2005;31(6):339-347.
  • LavisJN, Robertson D, Woodside JM, McLeod CB, Abelson J. How can research organizations more effectively transfer research knowledge to decision makers? Millbank Quarterly 2003;81(2):221-248
  • Spicer, Neil & Bhattacharya, Dipankar & Dimka, Ritgak & Fanta, Feleke & Mangham-Jefferies, Lindsay & Schellenberg, Joanna & Tamire-Woldemariam, Addis & Walt, Gill & Wickremasinghe, Deepthi. (2014). ‘Scaling-up is a craft not a science’: Catalysing scale-up of health innovations in Ethiopia, India and Nigeria. Social Science & Medicine. 121. 10.1016/j.socscimed.2014.09.046. https://www.sciencedirect.com/science/article/pii/S0277953614006133
  • Barker, P.M., Reid, A. & Schall, M.W. A framework for scaling up health interventions: lessons from large-scale improvement initiatives in Africa. Implementation Sci 11, 12 (2015). https://doi.org/10.1186/s13012-016-0374-x

This year, IHPME’s annual themed Health Services, Systems & Policy Research Seminar Series is entitled Dissemination & Implementation Science: Explained & Emerging. The Series will feature leading scholars in the areas of dissemination and implementation science, who will engage seminar participants in discussions around a variety of topics including: differentiating dissemination and implementation science and situating them within the broader KT domain; what is knowledge and approaches to its generation; the history and evolution of dissemination and implementation science; dominant and promising theory and frameworks for DIS; research approaches, methods and methodological challenges in implementation science; de-implementation and other thorny implementation issues; network perspectives on D&I; sustainability research; and contemporary research on scale up & scale out.

Please consider forwarding this information to any colleagues who might be interested.

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