Scale-up and sustainment of effective interventions

Abstract The widespread and ongoing use of most beneficial health interventions is required to maximize the benefits of the health system to the community. Within implementation science, the field of “scale-up” and “sustainability” have an important role to play in contributing to improving the health system to this end. Diverse and inconsistent use of terminology remains and represents challenges for the advancement of the science of scale-up and sustainability. While conceptual understanding of each continues to evolve, formative research has identified their complexity and documented a range of factors that influence program implementation and sustainability. Perhaps most nascent is experimental studies and other research methods to better understand the factors that are causally related to the scale-up and sustainability of evidence-based interventions and, importantly, the effectiveness of strategies in facilitating such outcomes. The conduct of these studies represents a significant opportunity for further research.