Definitions of The Challenge Initiative’s 4 Domains for Sustainable Scale-Upa

Domain of ChangeDefinition
Knowledge, attitudes, practiceThe progression from awareness of an innovation, to forming positive attitudes about the innovation, to the adoption of knowledge for decision-making purposes or for application in practice and policy.
Political and financial commitmentsThe multidimensional nature of political commitment is usually captured through the level of spending on intervention since it requires action by both the executive and legislative branches of government—implying commitment of funds and establishment of enabling policies. Statements of leaders are also commonly examined to measure political commitment.
SystemsThe building blocks that make health systems function well: leadership and governance, health workforce, medical products and technologies, information and research, including data demand and use.12
Access and qualityElements that impact access to family planning services, such as geographic distance, economic, administrative, awareness of services, and psychosocial issues (e.g., individual attitudes or social norms). Elements that impact the quality of services, such as choice of methods; appropriate client-provider interaction; and availability of competent providers, space, and an appropriate constellation of services.13