Scale model By building on a proven concept — such as efforts to stamp out malaria in Zambia — Rotary’s new multimillion-dollar Programs of Scale grants help make good better.
As part of the polio eradication campaign, Rotary and its partners have trained millions of healthcare workers and volunteers and vaccinated nearly three billion children. Polio cases have dropped 99.9 per cent since Rotary took up the cause in 1985, and the number of countries with endemic wild polio has dropped to two: Afghanistan and Pakistan.
“What you’ve done with polio is remarkable,” says Larry Cooley, a well-known international development consultant. “But it shouldn’t be a study of one.”
Rotary is stepping up to that challenge through Programs of Scale, a new Foundation programme awarding grants to Rotary clubs or districts with evidence-based interventions that are ready to scale. The first such grant, announced in February, will provide $2 million to Partners for a Malaria-Free Zambia, a member-led programme focused on fighting malaria. Co-funders World Vision US and the Bill & Melinda Gates Foundation are also involved in malaria mitigation efforts and will each contribute $2 million to the programme. This $6 million programme will train and equip 2,500 community health workers in Zambia to support the government’s work to eradicate malaria in that country. If all goes well, Rotary members hope to expand the effort to elsewhere in Sub-Saharan Africa.
The concept of Programs of Scale dates back to 2013, when global grants, introduced through The Rotary Foundation’s updated grant model, expanded the scope and size of Rotary projects with the aim of increasing their impact. After a 2016 evaluation of the grant model, the Foundation Trustees requested that a new grant type be developed that would fund “scalable” grant projects in the areas of focus — meaning projects that were planned in a way that allowed them to be expanded, built upon, and further developed. “Something between large global grants and PolioPlus was needed,” says Francis “Tusu” Tusubira, a member of The Rotary Foundation Cadre of Technical Advisers and a past member of Rotary’s Strategic Planning Committee.
The Programs of Scale grants are the result: a way to fund large-scale, high-impact projects that can attract partners while tapping into Rotary members’ capacity and enthusiasm. “While global grants and district grants have been very successful, we want to give opportunities for projects with even more impact,” says Foundation Trustee Sangkoo Yun, who was on the Programs of Scale selection committee. “We want to better quantify that impact and share what we learn with all Rotarians engaged in international service.”
So what, in this context, does “scale” mean?
“It’s a simple question with a complicated answer,” says Cooley, who is an expert on the topic. One way to think about it, he says, is that you are looking for a solution that matches the scale of the problem. If you define the problem in local terms, then the scale of the solution is local. If you define it as international, as with polio, then the scale of the solution is international.
“Problems have denominators,” he says. “If somebody said, we helped distribute blankets to 10,000 villagers, I’d say, congratulations, but how many villagers needed blankets? If the answer is that it was 10,000 out of 15,000, I’d say, holy mackerel, that’s great. If it’s 10,000 out of 10 million, I’d say that’s still great, but that’s not the right strategy.”
Clubs can think about scale when-ever they’re developing a project, not only when they are aiming to apply for a Programs of Scale grant. Cooley suggests that rather than focusing on projects, Rotarians focus on problems. “Take on a problem and don’t let go until it’s solved, or materially improved, whether at the community or national level,” he says.
When thinking about scaling up, Tusubira notes, you can take a successful project and add new aspects to it to deepen the impact. Or you can expand the project to reach more people, as is the case in Zambia, where Rotarians are building on successful global grants and other programmes that funded training for community health workers in other parts of the country. The challenge, he says, is figuring out which are the unique environmental factors that are responsible for the success of a project in order to be sure you are scaling up the right things.
By Mar 1, 2020 — the application deadline for the first Programs of Scale grant — the Foundation had received more than 70 proposals representing programmes across Rotary’s areas of focus to be implemented around the world. After a rigorous review process, those were narrowed down to a select group, and the clubs involved were invited to submit full applications. A team of cadre members and staff experts conducted virtual site visits and evaluated the proposals based on readiness to scale up the project, readiness to learn and share results, and how well the clubs involved would work with local communities and partner organisations. Three finalists were recommended.
“I was bowled over by the quality and strength of the applications, and by the expertise and experience of Rotarians on the ground and the connections they have,” says selection committee member Judith Diment. “What I really liked about the malaria project in Zambia was the partnerships and the collaboration they had established,” adds Diment, who is also the dean of the Rotary Representative Network and a longtime polio advocacy adviser. “It had many parallels with the polio programme.”
Rotary’s success in the polio eradication programme provides valuable lessons for clubs — not only those interested in applying for a Programs of Scale grant, but those planning any project.
One lesson, as Diment notes, is about the power of partnerships. The Global Polio Eradication Initiative is one of the most ambitious public-private health partnerships in history. “Collaborating with partners gives you a much bigger opportunity for large-scale change,” she says.
A second lesson is the need for large-scale programmes to grow out of Rotarians’ interests. Before polio was adopted by Rotary on a global scale, individual clubs were already tackling the disease through Rotary-funded projects, including a 1979 project to administer oral polio vaccine in the Philippines. Programs of Scale, Tusubira
notes, will give Rotary members the chance to come up with ideas they can demonstrate will have a sustainable impact and bring partners to the table.
Another lesson is about deploying Rotary’s power of network. Rotarians around the world have used their connections — local, national, and international — to draw attention to and garner support for polio eradication.
Cooley, the development consultant, says he’s fascinated by Rotary’s potential to scale-up projects. “These are the most prominently placed people in a community, all of whom are trying to do something good,” he says. “Look at Rotary as an asset. There are lots of problems Rotary could make a big difference on.”
The new Programs of Scale grants will give Rotarians a way to do it.
Rotary members expand on a proven concept in Zambia
Bill Feldt recalls the first conversation he had about solving Zambia’s malaria problem at scale. It was in 2012, after he worked on his first matching grant for malaria with Mwangala Muyendekwa, a physician and a member of the Rotary Club of Kalulushi, Zambia. It was a $57,000 project distributing 6,500 bed nets in Zambia’s Copperbelt province. “By the time they were distributing those nets, Mwangala emailed me and said, ‘This is good, but not sufficient. We’ve got to go to scale,’ ” recalls Feldt, a member of the Rotary Club of Federal Way in Washington state.
Now Muyendekwa’s vision is coming to fruition in a big way as the work, which has continued since then, expands. With this first $2 million Programs of Scale grant, Partners for a Malaria-Free Zambia (as the initiative is now known) is seeking to help reduce the incidence of malaria over time by 90 per cent in 10 heavily affected districts in the Central and Muchinga provinces. They’ll do this by training 2,500 community health workers, as well as other health facility staff and officials who will work with them. The community health workers, equipped with the necessary medicine and supplies, will respond to malaria cases, work to prevent transmission, and provide other needed healthcare interventions — which will in turn reduce the burden on clinics.
Malaria, a preventable disease caused by parasites spread through the bites of infected mosquitoes, continues to be one of Zambia’s leading causes of illness and death, contributing significantly to infant and maternal mortality.
The grant proposal included pledges from the Bill & Melinda Gates Foundation and World Vision US to match Rotary’s $2 million grant, for a total of $6 million for the initiative. “Rotary’s credibility is so amazing,” Feldt says. “We’ve got a lot to offer. Let’s demonstrate that.”
We asked Feldt for his insights about the application process and about the project.
What makes this project a program of scale?
It’s expanding on a proven concept, which I think is really important and was compelling to Rotary in awarding this grant. We’ll be impacting about 1.3 million Zambians who will have healthcare in their communities for the first time. That means testing for, treating and preventing malaria, and that also means treating diarrhoea and pneumonia as well as providing information about Covid-19. We think that’s a program of scale. We’re very excited about that.
How does this grow out of previous work Rotarians have done?
We’ve written three global grants in the past two years. When the third grant project is complete, we will have trained more than 1,500 community health workers in the Copperbelt province. That gave us credibility with The Rotary Foundation. We think we’re pretty good at it. What we’re really doing is supporting the government in Zambia, which has a superb six-day training curriculum. There are about 12,000 community health workers trained under the auspices of the Ministry of Health. With the global grants and Programs of Scale grant, we are adding about 33 per cent more.
How did you adapt what you learned in previous projects?
We’re going into areas where there are no community health workers. Once the new workers are trained, doctors and nurses need to learn how to interact with them. We’re paying for some of those strengthening activities in the global grants and now even more with the Programs of Scale grant because we’ve learned that’s such a vital component of sustainability.
Another thing we’ve learned is that the best community health workers are people who are established in their communities. They aren’t getting paid. It’s really about prestige. A study concluded that people do this because it’s a good thing to do, and it makes them a leader.
Why is this the right programme to tackle malaria in Zambia?
Not just Zambia. Sub-Saharan Africa too.
One key success factor is that there is a supportive, committed government in Zambia. If the government isn’t committed, it’s going to go nowhere. One of our project partners, an organisation called PATH — which is based in Seattle and receives funding from the Gates Foundation — supported the Zambian Ministry of Health and the National Malaria Elimination Centre in the launch of the government’s community health worker initiative. This is a concept that UNICEF and the World Health Organisation have been defining and encouraging. Between 2012 and 2015, the Ministry of Health and the National Malaria Elimination Centre, with support from PATH, did its first real project in the southern province of Zambia, and they drove malaria rates down to near zero using community health workers. That’s really the proof of concept. The model seems to work, the government is committed, and obviously the Gates Foundation thinks it’s a good model because it’s been supporting the PATH programme in Zambia for nearly a decade.
What advice do you have for Rotarians looking for partners?
Make organisations aware of what you’re doing. Connecting is the whole game. I think that’s what Rotary wants to do through Programs of Scale. In Africa, and all over the world, local Rotarians can open doors through their connections. My view is that we have a leg up on a lot of people looking for money because of what Rotary has done with polio. It is central to our credibility.
If we visit the project in 2026, what should we see?
I would hope we would see a dramatic reduction in malaria incidence. We’d want to see a self-sustaining health system that is fully utilising community health workers, where they are diagnosing 60 to 70 per cent of whatever small number of cases of malaria there are. They will probably be working on pneumonia and diarrhoeal diseases more than they had been. Hopefully, they’ll be doing telemedicine. We’ll see that turnover for community health workers is low and that there’s retraining. They’ll have been retrained twice by that time, and they’ll be a core part of the health system. They will represent the last kilometre of a health system that’s very successful.
Key Terms
Scale
The concept of expanding a proven innovation to benefit more people
Sustainability
Impact that continues beyond the time frame of the grant funding
Target population
The group that an innovation is designed to reach
Programme participants
The group of people the programme directly engages
Beneficiaries
The group of people or organisations who will experience the intended changes supported by the programme, either through direct participation or through interactions with programme’s participants
Implementing partner
An organisation that supplements another by carrying out an objective
Impact
Measurable, positive change
Frequently asked questions
What is a program of scale?
The Rotary Foundation has introduced a competitive $2 million grant to provide Rotary members with resources to implement large-scale, high-impact programmes in Rotary’s areas of focus while fostering policy development and sustainable programmes. The grant will invest in promising, locally led interventions that have already demonstrated success. Throughout the life of the grant (three to five years), Rotary members must work with an implementing partner and be prepared to document the programme’s success.
Why is the Foundation now awarding a $2 million grant?
To increase our impact. Through this grant, the Foundation will support high-quality, member-led programmes that have proven outcomes. Lessons learned will be shared with clubs and districts everywhere to further strengthen our service projects.
What are the attributes of a strong implementing partner?
Implementing partners must have expertise, experience and programme management systems, and must be an active participant in carrying out programme activities. Implementing partners may be international or local NGOs, government entities, private sector organisations, or other Rotary entities, such as Rotary Community Corps or Rotary Action Groups. A programme may have more than one implementing partner.
Why is an implementing partner required?
Ideally, implementing partners will add value to the programme by complementing the strengths of the Rotary members involved. Having a strong relationship with an adept and experienced implementing partner is critical. Also, in the first round of the Programs of Scale process, the Foundation encouraged co-funding from philanthropic, private, and other sources. Co-funding can help increase the number of beneficiaries as well as demonstrate the partner’s strong commitment to the programme’s success. Though co-funding is now required, it does not have to come from the implementing partner.
What is Rotary’s role in a program of scale?
Rotary members have a unique role as trusted community members and neighbours, as well as leaders who are globally connected and who are committed to positive change. Whether Rotarians assume technical, programmatic, or advocacy leadership roles, applicants should demonstrate why Rotary members’ active engagement is essential to the programme’s success.
What type of project has the best chance of being awarded a Programs of Scale grant?
The successful proposal will outline a longer-term project that:
- Is evidence-based and can already demonstrate success.
- Is locally relevant to the intended beneficiaries.
- Is ready to grow because it has the right stakeholders and systems in place.
- Monitors, evaluates, and shares data.
- Employs the unique strengths of Rotary.
Who reviews the applications?
All completed concepts and applications go through a rigorous review by members of The Rotary Foundation Cadre of Technical Advisers, Rotary staff, and other experts. More than 25 Rotary members and staff contributed to the review and selection process for the first Programs of Scale award.
Why was partners for a Malaria-Free Zambia awarded the first $2 million grant?
A number of factors contributed to the success of this proposal. Among them are that the programme:
- Is expanding on an innovation that is backed by clear evidence and has worked in the past.
- Has a high likelihood of working on a larger scale.
- Is logically organised and grounded in experience.
- Has partners that have the experience, trust, and strong respect needed to successfully scale up the programme with Rotary.
- Has co-funders — the Gates Foundation and World Vision US — with the ability and desire to support the programme with Rotary.
- Is set up for sustainability and aligned with government efforts.
- Has clear indicators of programme’s success and systems set up to measure them.
- Has strong demand; malaria is a leading cause of death in Zambia.
- Allows Rotary members to interact with the programme by volunteering, raising money, mobilising communities, and conducting national-level advocacy work.
- Has the potential to expand further to combat malaria across Africa.
Ready to scale up?
If your club is interested in applying for the next Programs of Scale grant, start by asking the following questions:
- Is your club or district project successful — and is that assessment based on strong evidence?
- Does it solve a problem for the target population?
- Is there a clear and logical implementation plan that can be scaled up?
- Does the implementing partner have the ability and leadership to deliver a larger programme over several years?
- Are all stakeholders committed?
The next round of applications will be accepted starting in June.
To apply, visit rotary.org/programsofscale.
Key dates
June:
Grant competition launch
August:
Concept notes due
October:
Invitation to submit a full proposal
February 2022:
Site visits (virtual and/
or in-person)
April 2022:
Award decision
The Top Projects
What stood out about the top five applicants? We annotated their proposals with feedback from the selection committee.
Partners for a Malaria-Free Zambia (Programs of Scale grant awardee)
This programme impressed the committee because of its experienced partners and incredible funding. It won the grant because of the strong involvement of local Rotarians and the participation of the local government.
Area of focus: Disease prevention and treatment
Proposal: To reduce the incidence of malaria by training 2,500 community health workers along with health facility staff and officials. The community health workers will respond to malaria cases, help prevent transmission, and provide other healthcare, thereby reducing the burden on local health clinics.
Location: Zambia
Rotarians bring unparalleled energy and dedication to global health challenges.
— Philip Welkhoff
director of the malaria programme at the Bill & Melinda Gates Foundation
Rotary role: Malaria Partners Zambia will co-implement the programme with World Vision Zambia. The Rotary Club of Federal Way, Washington, will serve as the sponsor club, while the Rotary Clubs of Kabwe, Lusaka, Mansa, Ndola, Ndola Kafubu, and Nkwazi, Zambia, will provide support.
Primary partners: The $2 million Programs of Scale grant award will be matched by the Bill & Melinda Gates Foundation and World Vision US in line with their commitment to fighting malaria, for a total of $6 million in funding. Other partners include the Zambian National Malaria Elimination Centre, the PATH Malaria Control and Elimination Partnership in Africa, and Malaria Partners International.
Expected outcome: To help reduce the incidence of malaria over five years by 90 per cent in 10 target districts in Zambia and bring healthcare closer to home for 1.3 million Zambians.
Every Child Learning Well (Finalist)
This application stood out because the Pratham Education Foundation is an excellent partner with methods that are data-driven and proven to improve literacy and numeracy within a short time.
Area of focus: Basic education and literacy
Proposal: To improve education quality by bringing Pratham’s internationally-recognised Teaching at the Right Level literacy and numeracy programme to 1,500 primary schools and improve the fundamental skills of 200,000 students between the ages of six and 12.
Location: Jalna district, Maharashtra, India
Rotary role: Members of the Rotary Club of Pune Pride are the main sponsors of this proposal with support from five Rotary clubs in Jalna. Members in Jalna would ensure that the programmes run smoothly and receive community recognition. In addition to providing funding and oversight, Rotary and Rotaract members would volunteer directly with the programme and work to improve the local education system.
Primary partner: Pratham is one of the largest nongovernmental organisations in India. Its programmes aim to improve the quality of education across the country by working directly with children as well as the government.
Expected outcome: To improve the reading and writing levels of at least 80 per cent of participating students.
Sustainability tip: This programme is simple enough that teachers should not have trouble continuing it beyond the life of the grant.
When we bring impact-focused organisations together, we can do more to help the world’s most vulnerable reach their potential.
— Edgar Sandoval Sr
president and CEO of World Vision US
Save to Grow 2.0 (Finalist)
The Aga Khan Foundation is a strong partner because it is already working in many parts of Tanzania. It has 43 staff members in the country, over half of whom work on either developing agricultural markets or supporting savings groups.
Area of focus: Community and economic development
Proposal: To promote the creation of shared-interest savings groups, in which members learn to use digital platforms to save money, make loans to one another, and receive payments. The participants, primarily women and young people in rural and peri-
urban areas, would also learn smart farming practices and receive coaching on how to expand their agriculture-
based businesses. Ultimately, the groups will self-govern.
Location: Northern Tanzania
Rotary role: The Rotary Club of Bainbridge Island, Washington, is the sponsor club, with support from the Rotary Club of Poulsbo-North Kitsap, Washington, and the Rotary Clubs of Arusha, Arusha West Side, and Usa River, Tanzania. Members would spearhead raising financial support, conduct programme oversight, and serve as programme participant mentors.
Primary partner: The Aga Khan Foundation would implement the programme and manage the technical aspects, including partnerships with digital banking services and support for the entrepreneurs.
Expected outcome: To improve the economic well-being of 24,000 smallholder farmers and 240 entrepreneurs — particularly women and young people — through the creation and strengthening of 1,600 shared-interest savings groups, agricultural training and entrepreneurship support.
Innovation tip: This proposal brings digital financial services to remote areas by making use of the proliferation of cellphones.
Sustainable Improvement of Reproductive Maternal, and Child Health (Honourable mention)
Rotarian leadership of this programme is very strong. Building on Nigeria’s success in the polio eradication campaign, Rotary members are connected to leaders at the highest levels of the country’s health infrastructure. Rotary is trusted and is therefore able to deliver important, sometimes difficult, messages about maternal health —
such as the health benefits of child spacing.
Area of focus: Maternal and child health
Proposal: To improve maternal health and family planning services while strengthening systems at the national, state and local levels; increase demand for maternal care and family planning services by educating community members about their benefits; and train healthcare workers to track data on maternal and neonatal deaths so interventions can be tailored to specific needs.
Location: Nigeria
Rotary role: This programme is sponsored by Rotary District 1860 (Germany) in partnership with Rotary District 9125 (Nigeria) and the Rotary Action Group for Reproductive, Maternal, and Child Health. Rotarians in Nigeria coordinate project activities, oversee training, lead advocacy efforts, and engage with the government. Members in Germany lend their technical and administrative expertise to support management, monitoring and evaluation.
Primary partners: Nigeria’s federal and state ministries of health and the Population Council.
Expected outcome: To increase the number of pregnant women, new mothers, and children who have access to improved maternal and child health services, and improve support for men and women who are interested in family planning.
Infrastructure Improvements to Water Systems, Helping Communities and Schools (Honourable mention)
This programme stood out because it works to strengthen the public sector — a key element of any sustainable programme.
Area of focus: Water, sanitation and hygiene
Proposal: To provide an improved and sustainable water supply to more than 100,000 people, along with water systems, bathroom facilities, and septic systems that meet UNICEF standards for 30 schools serving 6,000 students and 400 teachers.
Location: Bonito Oriental, Sabá and Tocoa municipalities, Honduras
Rotary role: The Rotary Club of Concord, California, would provide overall programme management and guidance. Members of the Rotary Club of Tocoa, Honduras, would assist with data collection, maintain communication with local governing entities, review data and solve problems as needed.
Primary partner: Water Mission, an engineering nonprofit that builds water, sanitation and hygiene solutions, would be the implementing partner.
Expected outcome: To provide 100,000 Hondurans with clean water and 30 schools with improved water and sanitation facilities.
