Reproductive health researchers, donors, and program managers are concerned with why
evidence-based best practices are rarely incorporated or scaled up into standard practices.
Serious gaps exist in understanding the process by which innovations are implemented and
sustained. In order to address this gap and take a systematic approach to scale-up, the Institute for
Reproductive Health of Georgetown University (IRH/GU) is conducting a six-year prospective,
multi-site comparative study of the processes and outcomes of scaling up Fertility Awareness
based Methods (FAM) in five countries using the ExpandNet/WHO model for scaling-up health
innovations. Specifically, IRH is studying the process and results of scaling up the Standard Days
Method (SDM) in Guatemala, Mali, Rwanda, DRC and India.