I help health programmes do the one thing most pilots are never designed to do: survive the government handover and scale.
For more than a decade I have worked on the implementer side of public health in Nigeria, across family planning, reproductive, maternal, newborn and child health, and health-systems strengthening. I have seen first-hand how a well-run pilot can produce strong results and still collapse the moment the project funding ends, because the design never accounted for who would own it, who would fund it, and whether the routine system could actually deliver it.
My work is grounded in the ExpandNet/WHO systematic scale-up framework: the same body of practice behind "Beginning with the End in Mind", the readiness diagnostics, and the nine-step strategy process. I apply it not as theory, but as a practical discipline for the real conditions of a government health system: limited budgets, competing priorities, and the long, unglamorous work of institutionalisation.
Recently I have been turning that practice into tools: practical, framework-based checks any practitioner can use on their own programme, so designing for scale does not depend on having a consultant in the room.