Most pressing methodological issues:
       1. Joining the “2 knowledges”
      The “what”….      Evidence-based Subject 
      Protocols/        Matter Knowledge
      Guidelines,                                            The “how”….
      Physical                                               •  Ambitious Aim to close 
      resources,                Implementation 
      Clinical Training               and                       the measured gap. 
                                 Improvement                 •  Adaptive Content 
                                                                Theory
                                                             •  Implementation 
                                            Implementation      Strategies that are 
                                                Knowledge       supported by 
                                                                measurement and 
                                                                feedback learning 
                                                                systems
                                                                                                                         P3
        Most pressing methodological issues:
       2. Getting to full scale – framework to escape 
       from “pilot” thinking
           Best 
         Practice                                                                                            Phases of 
          exists           Set-up          Build Scalable          Test  Scale-
                                                Unit                    Up              Go to Full-Scale     Scale-up
        New Scale-
         up Idea
                             Leadership, communication, social networks, culture of                          Adoption 
                                                 urgency and persistence                                     Mechanisms
                           Learning systems, data systems, infrastructure for scale-up,                      Support 
                                human capacity for scale-up, capability for scale-up,                        Systems
                                                         sustainability
       Improvements in Quantitative Methodology
                                        Register               Facility 
                    Data                  Data                                       District 
                  collected           Aggregated                sends                Health 
                  in Clinic                into              aggregate             information 
                  Registers             Monthly               report to              System
                                        Reports                District
                      1                    2                    3                    4
        What happens to routinely collected data?
                            Register Data vs Monthly Summary                   Monthly Summary vs DHIS Report
        Can routine data systems be fixed?
                                Register Data vs Monthly Summary          Monthly Summary vs DHIS Report