Using a theory of change in monitoring, evaluating and steering scale-up of a district-level health management strengthening intervention in Ghana, Malawi, and Uganda
This BMC paper [opens a new tab] presents PERFORM2Scale’s theory of change (ToC) and reflections upon and adaptations of that ToC over time. The article aims to contribute to understanding the benefits and challenges of using a ToC-based approach for monitoring and evaluating the scale-up of health system strengthening interventions, given the limited documentation of this in the literature. We found that:
- PERFORM2Scale’s experience shows that ToCs can help in establishing a common vision on intervention scale-up.
- ToC-based approaches should include a variety of stakeholders and require their continued commitment to reflection and learning on intervention implementation and scale-up.
- ToC-based approaches can help in adapting interventions as well as scale-up processes to be in tune with contextual changes and stakeholders involved, to potentially increase chances for successful scale-up.