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Designing for scale and taking scale to account: Lessons from a community score card project in Uganda.

Christine Aanyu*, Elizabeth Ekirapa Kiracho, Rebecca Racheal Apolot, Sara Bennett, Suzanne N Kiwanuka, Ligia Paina

Background: Planning for the implementation of community scorecards is an important, though seldom documented process. Makerere University School of Public Health (MakSPH) and Future Health Systems Consortium set out to develop and test a sustainable and scalable model. This paper documents the process of planning and adapting the design of the incorporating key domains of the scalable model such as embeddedness, legitimacy, feasibility and ownership, challenges encountered in this process and how they were mitigated.