The aim of this study was to identify the critical steps and conditions required to foster the sustainability of maternal and newborn health (MNH) innovations in Ethiopia, Uttar Pradesh, India and Gombe and Adamawa, Nigeria. It addressed the following objectives: [1] document what happens to case study foundation-funded MNH innovations that are adopted and scaled in the longer-term; [2] identify the attributes of the case study innovations that foster their sustainability, including their effectiveness and relative advantages, observable benefits, acceptability to health workers and communities, and simplicity and costs, as well as potential challenges; [3] assess the most important actions and conditions required to foster sustainability at scale of selected MNH innovations, including ways the foundation and other donors can take steps to foster sustainability relating to the following dimensions: financial, fiscal and political sustainability, institutionalisation, organisational capacity and programmatic sustainability, partner support, routinisation and social sustainability; [4] identify the contextual factors within the broader health system, socioeconomic and geographical settings, that enable and inhibit the scale-up and sustainability of selected MNH innovations and assess how barriers have been overcome.

The file of expanded field notes for this study is held on the LSHTM Secure Server, but cannot be made available due to the extent of personal information and difficulty of anonymisation without context loss.

Scale-up, Sustainability, Ethiopia, India, Nigeria