Blog Global Health Center

Theories of change for a complex world

Written by Melissa Edmiston, MPH, Vice President of Operations for Mavuno

Melissa Edmiston in Uganda Photo credit: Mavuno

Like many of us, I sat in MPH classes and learned the keys to program planning, implementation, and evaluation. I’m proud to say I can draw a logic model — the glorious one-page fits all diagram displaying exactly how a program will unfold — in my sleep. Then I started working in global health, and I realized that very few things in this field fit into a clean, linear picture.

The reality of this work is that things are complex, multidimensional, and evolving. Don’t get me wrong, I think logic models have a place, and they can be great tools for helping to describe processes, but I do think they have limitations.

Mavuno equips local leaders to solve extreme poverty and stimulates the creation of enterprises to create sustainable income. Photo credit: Mavuno.

In my role as Vice President of Operations for Mavuno, an organization that works in eastern Democratic Republic of Congo empowering local leaders to end extreme poverty in their communities, I have learned to embrace the complexity and look for creative ways to balance planning and rigor with the realities of a complicated world. One way we have done this is by utilizing Theories of Change (ToC) as our key program planning and evaluation tool. There is no set definition for a ToC, but the general consensus is that it describes a set of assumptions which lead to an intended outcome, a visual explaining how and why an initiative works. They are used to show the causal linkages in an intervention.

Theories of Change also don’t have a standard format. You can find a few examples here. They can be diagrams, pictures, or a combination, some also include narrative text. ToC’s are more causal in design, rather than focusing solely on components, more explanatory than descriptive. In a logic model, there is a lot that happens in the arrows. You typically see the following:

Mavuno drives economic development in rural villages of eastern Congo, using agriculture, education, and sanitation. Photo credit: Mavuno.

But how does an output become an outcome? What must happen within that arrow to ensure, for example, that increased crop yields will result in diversified diets? A ToC is good for drawing out some of those assumptions and showing the pathways to achieve various outcomes and, ultimately, impact. At Mavuno, our ToC is central to the evaluation process. We collaboratively develop the ToC ideas, and then we use that to build our indicators and monitoring and evaluation plans. Our ToC development process consists of three components: cultural knowledge and input from local leaders, research and evidence based practice, and assumptions.

Interested in developing your own theory of change? Here are three tips to get you started:

  1. Begin with the end in mind. Start with a clear mission or goal and work backwards on how to accomplish it. You must balance an unwavering commitment to an end result, while embracing the various pathways by which it can be accomplished.  Think through what interventions/activities will create the needed preconditions, and then develop indicators to measure those.
  2. Look at the big picture. One of my mentors in graduate school always referred to the public health professional as a “jack of all trades, master of none,” and I have found that to be true.  On any given day, our work at Mavuno involves economics, behavioral science, finance, agronomics, history, anthropology, nutrition, business, and political science (to name a few). We must be willing to think interdisciplinary, collaborate, and realize the myriad factors that may go into something seemingly as simple as a household deciding what types of food to eat. Lines in a ToC can come from multiple directions, and that’s OK. That’s how the world works.
  3. Use what you have developed. We have all seen the beautiful logic model that does nothing more than sit on a shelf and collect dust. For this tool (or any for that matter) to be useful, it must be used. A ToC should be central to your organization, it should be key to not only programs and evaluation, but communication, fundraising, etc. Invite the entire team to be part of the development, and allow time for discussion, iteration, and opinions. Create an organizational culture where everything is done with the goal of forwarding the mission, and ensure everyone understands their role in accomplishing it.

Mavuno won the Skandalaris Center Award in Washington University’s 2016 Social Enterprise and Innovation Competition (SEIC).

Other good resources for ToC information: