From a selected innovation to local ownership — in under five years.
The RTC five-stage framework for scaling and transitioning a TB innovation. Each stage has a distinct goal; in practice, stages overlap. Use the map below to move through the stages — every stage has room to record what was common across both partners and where they differed.
Doing TB programming differently
Context before the framework — what we set out to do, and why it is structured this way.
Time-bound by design. A costed hand-off from catalytic funding to domestic ownership is built in as the final stage — not left to chance. (Most frameworks treat sustainability as a dimension, not a scheduled hand-off.)
It starts upstream. The innovation is chosen with the people who deliver and use it, through co-creation — rather than assuming a pre-selected intervention, where most scale-up frameworks begin.
A different starting point
For decades, global-health innovations were introduced through long, top-down, donor-led projects that rarely outlasted their funding. RTC puts the people who use and deliver TB services at the centre of choosing and shaping the innovation, so it fits the country from the very start.
Time-bound by design
The catalytic investment was deliberately not meant to fund the same work for years. From day one the aim was a hand-off within roughly five years — additive support that strengthens national systems rather than repeating them, with the country carrying the work forward once the programme ends.
What it leaves behind
Across three lenses — institutions, systems, and workforce capacity — RTC focused on strengthening systems (national data, financing, and delivery channels) and workforce capacity (the people and skills that keep the innovation running).
Stage 4 is also called interim sustainability: the catalytic investment is steadily replaced by domestic budget and other donors, then fully removed in Stage 5 for complete local ownership.
Five stages, one launch plan
Use the folder tabs to move between stages — one stage shows at a time, so the page stays short. Each stage records what was what you planned, did, and learned.
Plain-language spine. Under each stage title, ≈ italics show the equivalent step in recognized frameworks (EPIS, Stage-Gate, ExpandNet/WHO) — see References.
Co-creationTemplate: Needs assessment & coalition building≈ Explore and decide
It begins with a people-centered design process: partners constitute a Leadership Group and run successive workshops to identify, prioritize, and select an innovation. The Leadership Group becomes the core advisory board, and early stakeholder engagement secures the buy-in needed to scale and transition later.
Pre-AssessmentTemplate: Pre-introduction assessment≈ Build a business case
With an innovation selected, the team pressure-tests every assumption and fills out the entire Innovation Launch Plan. This precursor to introduction surfaces risks early and starts planning for transition from the very beginning.
IntroductionTemplate: Innovation introduction≈ Implement and launch
The innovation is officially introduced. This is where many traditional projects start — but the groundwork in Stages 1 and 2 optimizes and accelerates it.
Scale-upTemplate: Introduction to national scale-up≈ Expand & bridge to sustainability
Also known as interim sustainability: the innovation scales nationally on support from beyond the catalytic investment — other donors or domestic budget. Inclusion of the innovation in the country’s National Strategic Plan is the key milestone.
TransitionTemplate: Transition of ownership to government≈ Sustain and exit
What the whole framework builds toward: domestic budgets are allocated, hosting and maintenance responsibilities move over, and the catalytic investment is fully removed for complete local ownership.
People-centered design
Begins in Stage 1 and informs every decision after it; the choice of innovation stays rooted in lived experience.
Leadership Group & stakeholders
Convened early as the core advisory board, so buy-in and commitment to scale and transition are in place from the start.
Risk & assumption testing
Stage 2 fills out the whole framework and stress-tests assumptions, so risks surface before introduction, not after.
Sustainability & transition planning
Planned from day one; realized as interim sustainability in Stage 4 and full local ownership in Stage 5.
National Strategic Plan integration
The anchor for scale-up: the innovation is written into the country’s NSP so it has political and budget standing.
Funding handover
The catalytic investment is steadily replaced by domestic budget and other donors until it is removed entirely.
Achievements & onward capacity
Concrete results at handover, and how the work strengthened systems and the workforce.
Concrete achievements
Workforce & onward capacity
Sustainability & Transition Plan
How the innovation will be handed over and sustained after the programme ends.
Objective — a short framework for the operational handover of activities, to be completed by .
Summary
≤ 200 wordsKey activities / products
10–15 items| Activity / product | Current → future owner | Transition date | Transition activity |
|---|---|---|---|
NSP & policy alignment
≤ 200 wordsKey risks & mitigation
3–5 risks| Key risk | Mitigation strategy |
|---|---|
Future opportunities
≤ 200 wordsRole going forward & handover
≤ 200 wordsCross-cutting elements
These don't belong to a single stage — they're started early and carried all the way through to transition.
Reach the team
How and why people can get in touch.
Recognized frameworks
The plain-verb spine and the italic per-stage equivalents draw on these established frameworks.
- EPIS — Exploration, Preparation, Implementation, Sustainment (Aarons et al., 2011). episframework.com · systematic review
- ExpandNet / WHO — Nine Steps for Developing a Scaling-Up Strategy (2010); vertical (institutionalization) & horizontal (expansion) scaling. WHO · ExpandNet
- Stage-Gate — idea-to-launch new-product framework, with go/kill gates (Cooper). stage-gate.com
- NASSS — Non-adoption, Abandonment, Scale-up, Spread, Sustainability of health & care technologies (Greenhalgh et al., 2017). JMIR
- Also referenced: RE-AIM (Glasgow et al., 1999); Rogers’ Diffusion of Innovations; Design Council “Double Diamond”.