The India Country Office at the Bill & Melinda Gates Foundation (BMGF) is working to reduce maternal, child, and neonatal mortality in India. The BMGF approached the START Center to conduct a literature review of exemplars for diffusion of maternal and child health programs and interventions in low- and middle-income settings, with a particular focus on institutional delivery and family planning interventions. The START team was also asked to explore how public-private partnerships and training of program staff and health professionals might contribute to diffusion of programs. From nineteen examples identified through literature review and informant interviews, the START team found that partnerships between stakeholders, including public-private partnerships; training both new and existing program staff to increase the workforce and ensure quality service delivery; and implementation of program evaluations to inform program staff of progress were often attributed to successful diffusion of programs. Leaders and champions were also identified as driving forces behind the success of program diffusion, though problems could arise if programs depended too heavily on these leaders or champions. Finally, no single factor was solely attributed to the success of program diffusion; all examples described a combination of multiple factors contributing to successful diffusion. Details of each example are presented in a final report and table.
