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

09 Aug 2022
Maryse Kok, Susan Bulthuis, Marjolein Dieleman, Olivier Onvlee, Rebecca Murphy, Patricia Akweongo, Justine Namakula, Hastings Banda, Kaspar Wyss, Joanna Raven & Tim Martineau

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.

There's more on PERFORM2Scale's ToC here.

Theory of change