Public Sector Scaling2026-08-10T15:54:02+00:00

Public Sector Scaling of Health Innovations Across Africa

Spark Health Africa brings governments, funders, and partners together to sustainably scale innovations that matter. We believe lasting change happens when governments lead and own the agenda.

Public Sector Scaling of Health Innovations Across Africa

Spark Health Africa brings governments, funders, and partners together to sustainably scale innovations that matter. We believe lasting change happens when governments lead and own the agenda.

Why scaling innovations fails without government ownership

Too many promising health innovations never reach the people who need them most. The problem runs deeper than funding or good intentions. It lives in the gaps between those who create solutions and those who must sustain them.

Governments lack clarity

When governments cannot articulate what their people actually need, innovations become solutions in search of problems. Without this clarity, scaling becomes impossible.

Power imbalances persist

Funders and implementing partners often drive the agenda while governments follow. This reversal of leadership undermines ownership and sustainability from the start.

Context gets ignored

Innovations that work in one place fail in another when local realities are overlooked. Scaling without context is just spreading failure across wider ground.

Why scaling innovations fails without government ownership

Too many promising health innovations never reach the people who need them most. The problem runs deeper than funding or good intentions. It lives in the gaps between those who create solutions and those who must sustain them.

Governments lack clarity

When governments cannot articulate what their people actually need, innovations become solutions in search of problems. Without this clarity, scaling becomes impossible.

Power imbalances persist

Funders and implementing partners often drive the agenda while governments follow. This reversal of leadership undermines ownership and sustainability from the start.

Context gets ignored

Innovations that work in one place fail in another when local realities are overlooked. Scaling without context is just spreading failure across wider ground.

Three barriers to scaling

Governments must know what their people need before solutions can take root.

Three barriers to scaling

Governments must know what their people need before solutions can take root.

Governments

Articulating real needs

Without clarity on what citizens actually require, innovations become orphaned.

Funders

Aligning with government

When funders set the terms, governments become passengers instead of drivers.

Partners

Securing government participation from the start

Early government involvement transforms scaling from an afterthought into a strategy.

Partners

Securing government participation from the start

Early government involvement transforms scaling from an afterthought into a strategy.

Building ecosystems that work

Spark Health Africa encourages transformative dialogue in existing platforms to allow governments, funders, and implementing partners to move together toward a shared vision.

Building ecosystems that work

Spark Health Africa encourages transformative dialogue in existing platforms to allow governments, funders, and implementing partners to move together toward a shared vision.

Government Leadership: Owning the Agenda

Governments are the custodians of their citizens’ health and well-being. They bear the ultimate responsibility for articulating the needs of their populations, setting strategic priorities, and ensuring that health services are delivered equitably and sustainably. In the context of scaling innovations, government leadership is not optional, it is essential.

Spark Health Africa believes that deep government ownership is the bedrock of sustainable system change. When governments step fully into their role as champions of transformation, they move beyond passive acceptance of donor-driven agendas and instead become active drivers of their own health futures. This begins with a critical mindset shift: recognizing that scaling public-sector innovations is not primarily about the technology, product, or intervention itself, it is about embracing a culture of continuous improvement and accountability.

Through our coaching and mentoring, we support government leaders to:

  • Articulate a clear vision and strategic priorities for their health systems, defining what success looks like for their citizens.

  • Operationalize their agenda by identifying context-appropriate innovations and developing robust scaling strategies using proven frameworks like those from WHO and ExpandNet.

  • Lead with transparency and accountability, modeling the behaviors they wish to see in their teams and partners.

When governments lead with clarity, confidence, and conviction, they create the enabling environment necessary for all other stakeholders to align their efforts effectively. Government leadership ensures that scaling is not something done to a country, but something driven by it—ensuring relevance, ownership, and lasting impact.

Funder Alignment: Power in Partnership

Funders play an indispensable role in advancing public health—providing the financial resources, technical expertise, and catalytic support that can accelerate progress toward health goals. Yet too often, well-intentioned funding can inadvertently undermine sustainability by fostering dependency, driving donor-driven agendas, or failing to align with government priorities.

Spark Health Africa believes that funders achieve the greatest impact when they respect and support government leadership, rather than supplanting it. When funding partners truly understand that governments are the custodians of citizen needs and are responsible for leading the strategic vision and agenda, they actively work against fostering harmful power imbalances. Instead, they become enablers of government-owned solutions.

Through our collective impact and mediation work, we help funders:

  • Understand government priorities by investing time in dialogue and relationship-building with public-sector leaders.

  • Tailor their support to the specific needs, constraints, and capacities of the governments they partner with, rather than imposing standardized solutions.

  • Resist the temptation to drive the agenda, instead positioning themselves as facilitators who amplify government efforts and fill identified gaps.

  • Embrace flexibility and long-term commitment, recognizing that sustainable change requires sustained investment beyond short funding cycles.

When funders align genuinely with government leadership, the relationship transforms from a donor-recipient dynamic into a true partnership. This alignment unlocks greater trust, more efficient use of resources, and most importantly health outcomes that endure long after funding ends. Funders who embrace this approach become not just financiers, but valued partners in building resilient, self-sustaining health systems across Africa.

Mutually Beneficial Relationships: Ecosystems That Work for Everyone

When governments lead with clarity and funders align with genuine partnership, the stage is set for something transformative: mutually beneficial relationships that unlock the full potential of all stakeholders. Yet these relationships do not happen by accident. They must be intentionally cultivated, continuously nurtured, and anchored in a shared commitment to the communities that all partners ultimately serve.

Spark Health Africa believes that radical collaboration amplifies impact, strategically and intentionally uniting people’s efforts under a common agenda increases their return on invested resources. Mutually beneficial relationships are the engine of this collaboration. They transform arms-length interactions into impact partnerships where every stakeholder government, funder, and implementing partner finds value, purpose, and tangible results.

Through our collective impact programs and mediation expertise, we help stakeholders build relationships that work for everyone by:

1: Creating Safe Spaces for Honest Dialogue

Too often, stakeholders operate on assumptions about each other’s intentions, constraints, and capacities. We guide difficult conversations to surface these underlying tensions, allowing stakeholders to speak openly about their needs, fears, and aspirations. By mediating these exchanges, we help partners move from defensive postures to collaborative problem-solving—building the trust that is essential for sustained partnership.

2. Co-Creating a Shared Agenda

Mutually beneficial relationships are built on a foundation of common purpose. We facilitate multi-stakeholder coalitions to articulate a shared vision—one that is government-led but co-owned by all partners. This shared agenda ensures that every stakeholder understands how their contribution advances not only the overall goal but also their own organizational objectives, creating alignment that is both strategic and deeply personal.

3. Aligning Incentives for Collective Success

When incentives are misaligned, even the best-intentioned partnerships can falter. We help stakeholders identify and articulate their mutual self-interests, demonstrating that what is good for the government is also good for funders and partners—and vice versa. By clarifying how each stakeholder benefits from collaboration, we create the conditions for sustained engagement and shared accountability.

4. Institutionalizing Radical Collaboration

We do not facilitate one-off agreements; we embed collaboration into the fabric of how stakeholders work together. Through ongoing coaching, mentoring, and thought partnership, we help coalitions operationalize their commitments, establish accountability mechanisms, and build the habits of radical collaboration. This ensures that the ecosystem continues to function effectively long after our direct engagement ends.

5. Fostering Transparency and Trust

Drawing on lessons from our work in Uganda—where district leadership disclosed full COVID-19 budgets to build stakeholder trust—we encourage transparency as a cornerstone of mutual benefit. When stakeholders see the full picture of resources, constraints, and decision-making processes, trust deepens, cooperation strengthens, and relationships become more resilient to the inevitable challenges that arise.

6. Celebrating Shared Wins

Mutually beneficial relationships are sustained by recognizing and celebrating progress together. We help coalitions define measurable milestones and create opportunities to reflect on achievements—whether it is improved health metrics, successful scaling milestones, or strengthened trust among partners. Celebrating shared wins reinforces the value of collaboration and builds momentum for the journey ahead.

Two technical arms driving change

Spark Health Africa operates through deep partnerships that bring global frameworks to African realities. We work at the intersection of proven scaling science and the lived experience of governments building health systems.

ExpandNet

As an Affiliate organization of ExpandNet, we support government teams to develop and implement scaling strategy using the WHO/ExpandNet frameworks, guidelines, and tools. We use the Science of Scaling Workshop as the main vehicle for formal learning of the principles of scaling, followed by on-the-job coaching and mentoring to adopt a scaling mindset.

Community leadership

As an Executive Committee member of the international Scaling Community of Practice and Co-chair of the Health Technical Working Group within the SCoP, Spark Health Africa brings its extensive knowledge of supporting African governments through its Transformative Leadership & Culture Change Program and Collective Impact Program to bridge the SCoP’s global learning agenda with the practical realities of government-led scaling across Africa.

Two technical arms driving change

Spark Health Africa operates through deep partnerships that bring global frameworks to African realities. We work at the intersection of proven scaling science and the lived experience of governments building health systems.

ExpandNet

As an Affiliate organization of ExpandNet, we support government teams to develop and implement scaling strategy using the WHO/ExpandNet frameworks, guidelines, and tools. We use the Science of Scaling Workshop as the main vehicle for formal learning of the principles of scaling, followed by on-the-job coaching and mentoring to adopt a scaling mindset.

Community leadership

As an Executive Committee member of the international Scaling Community of Practice and Co-chair of the Health Technical Working Group within the SCoP, Spark Health Africa brings its extensive knowledge of supporting African governments through its Transformative Leadership & Culture Change Program and Collective Impact Program to bridge the SCoP’s global learning agenda with the practical realities of government-led scaling across Africa.

Frequently Asked Questions

Find answers about our
Public Sector Scaling
of Health Innovations Across Africa
Why do so many health innovations fail to scale sustainably?2026-08-04T08:45:43+00:00

Many innovations fail to scale because governments lack clarity in articulating their needs, power imbalances between funders and governments persist, innovations are implemented without genuine government ownership, or solutions are not adapted to local contexts. Our program addresses these challenges by bringing together governments, funders, and implementing partners around a common, government-led agenda from the very beginning.

What is a Co-Innovation Platform, and how does it support scaling?2026-08-04T08:46:40+00:00

A Co-Innovation Platform is a space where diverse stakeholders—governments, funders, implementing partners, and civil society—come together to develop a common vision and find ways to achieve their scaling goals. We facilitate these platforms to create collective experience that spurs co-creation of public health solutions that are difficult to achieve independently. They help develop both technical capacities (like user-centric design) and behavioral capacities (like big-picture thinking and collaboration).

What frameworks and tools does the program use?2026-08-04T08:47:46+00:00

As an Affiliate organization of ExpandNet, we support government teams using WHO/ExpandNet frameworks, guidelines, and tools for developing and implementing scaling strategies. The Science of Scaling Workshop serves as the main vehicle for formal learning, followed by on-the-job coaching to help teams adopt a scaling mindset.

How does the program ensure government leadership remains central?2026-08-04T08:48:35+00:00

Government leadership is essential throughout the scaling journey. We coach government teams to clearly articulate their needs and priorities, develop robust scaling strategies, and lead the agenda-setting process. Government representation at senior levels ensures the platform carries the authority needed to drive decision-making and resource allocation. This deep ownership ensures that scaling efforts are relevant, sustainable, and aligned with national priorities.

Join the movement

Be part of scaling innovations that governments own and communities trust.

Join the movement

Be part of scaling innovations that governments own and communities trust.

Go to Top