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2. Why Scaling Up is Important
   Last updated: 16.08.02
 
The last quarter of the 20 th century witnessed a proliferation of non-governmental organisations in social development (Edwards and Hulme 1992) and in health specifically (DeJong 1991; Gilson et al. 1994; Jareg and Kaseje 1998). Ironically, the role of NGOs was promoted both on the political left and right (Bratton 1989) and supported through donor assistance across the spectrum. On the one hand, NGOs were sought out by the political right as an avenue to circumvent the public sector, perceived to be slow in its response, bureaucratic and often corrupt. The advent of structural adjustment programmes calling for government cutbacks and a reduction in state-subsidised services paved the way for NGOs to fill the gaps left by reduction of state activity. At the same time, however, NGO expansion was also fuelled by voices on the left. They argued that their participatory nature, the fact that they represented the poor and marginalised, and their concern to address sensitive issues perpetuating underdevelopment and social problems make them a liberating influence on political processes in developing countries.

A more pragmatic argument for the contribution of NGOs has arisen with the recognition that in resource-poor settings where state capacity is weak, achieving broad national coverage in all areas of social development is beyond the capacities – and indeed sometimes the interests – of governments acting alone. This is arguably particularly the case in HIV/AIDS.

In recent years, however, this unchecked optimism has been somewhat moderated by the more sober assessment that while laudable, the impact of NGOs has often been limited in scale, in many cases fails to address the broader structural determinants of the problems they are addressing and does not translate into sustainable national programmes (Drabek 1987; Edwards and Hulme 1992). Moreover, there has been belated recognition that to achieve wider effect, in many cases NGOs need to abandon their staunch independence and forge better and more strategic links with government, despite the political difficulties in so doing on both sides of that relationship. NGOs, in this view, “ignore government at their peril” (Edwards and Hulme 1992).

Thus in development circles at least, there has been a growing chorus of voices calling for NGOs to increase the scale and impact of their activities and to build strategic alliances such that the effects of any one organisation are multiplied and the pool of beneficiaries increases exponentially. Yet there has also been recognition that expansion may bring with it trade-offs – among them, between quality, quantity and costs, and between accountability to one’s declared constituency and accountability to external funders financing the costs of expansion (eg. Edwards and Hulme 1997; Pearce 1993). Thus, while a tentative consensus is emerging over the importance of scaling up, there is much less shared understanding of the contexts most conducive to scaling up, the type of organisations or programmes appropriate to expand, the relative costs of different types of programmes, the internal implications of scaling up, how to define objectives, measure the impact of scaling up and how these processes depend on and interact with the political and social environment.

Source: A Question of Scale
This is an extract from A Question of Scale: The challenge of expanding the impact of non-governmental organisations’ HIV/AIDS efforts in developing countries,
by Jocelyn DeJong, published by the Horizons Project of the Population Council with the International HIV/AIDS Alliance in 2001. To view the whole report follow this link.

To download, complete with graphics, in pdf format (which requires Adobe Acrobat software to read it) follow this link (file size 1.43 Mbytes).