Fajans, Peter, Nguyen, Thi Thom, Whittaker, Maxine, Satia, Jay, Tran, Thi Phuong Mai, Trinh, Dinh Can, Do, Thi Thanh Nhan, and Newton, Nancy (2007) Strategic choices in scaling up: introducing injectable contraception and improving quality of care In Viet Nam. In: Simmons, Ruth, Fajans, Peter, and Ghiron, Laura, (eds.) Scaling Up Health Service Delivery: from pilot innovations to polices and programmes. World Health Organisation, Geneva, Switzerland, pp. 31-51.

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Abstract

This chapter analyses the process of scaling up introduction of the injectable contraceptive depot-medroxyprogesterone acetate (DMPA) as part of a package of interventions to improve quality of care in the provision of all contraceptives in the Vietnamese family planning programme. After a strategic assessment of the need for contraceptive introduction and pilot testing of the interventions in three provinces, these interventions were scaled up to 21 of Viet Nam's 64 provinces. Although DMPA was widely introduced, going to scale did not fully achieve the gains in quality of care for all methods found in the pilot phase. Three interrelated variables affected this outcome: the degree of change required in the service delivery system, the pace of expansion, and available resources to support expansion. In this case, scaling up proceeded faster than was desirable, given the extensive changes entailed by the interventions and the limitations in resources. Before embarking on rapid expansion involving complex programmatic changes, planners of scaling-up strategies should carefully assess the balance between these three variables.

Item ID:	48019
Item Type:	Book Chapter (Research - B1)
ISBN:	978-92-4-156351-2
Keywords:	Vietnam, health systems, injectable contraception, scale up, health service delivery, innovation
Date Deposited:	09 Aug 2017 02:57
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111708 Health and Community Services @ 70% 16 STUDIES IN HUMAN SOCIETY > 1603 Demography > 160302 Fertility @ 30%
SEO Codes:	92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 100%
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