A Systems Approach to Scale-up for Population Health Improvement

Despite many important global public health successes, for many public health problems there is a continued lack of interventions that have been sufficiently scaled up to achieve sustainable and equitable population health improvement. Implementation science approaches have dominated the scale up literature, which typically promote a sequential and mechanistic spread of interventions. Systems change plays a major role in the relation between implementation processes and institutionalization of public health interventions; yet systems approaches remain underutilized in scaling up. This presentation will present evidence from scaled up physical activity and nutrition interventions, to illustrate why reorientating the scale-up discourse to embrace a complex systems perspective has the potential to improve sustainable implementation and impact of population interventions.