Fostering Change

The Guide for Fostering Change to Scale Up Health Services, published in English (2007), French (2010), and reprinted in English (2013). A virtual training program launched in 2009.

The IBP Partners had long recognized that improving or strengthening services and introducing and scaling up new practices requires changes in infrastructure, systems and practices. Therefore, change management has always been a key component of the IBP strategy. “The missing link between introducing and effectively implementing best practices”, declared an IBP Task Team, is “the ability to foster, lead, and manage the change process…”.

In a collaborative effort between USAID’s MAQ Initiative and the IBP, the Fostering Change Task Team, led by Management Sciences for Health (MSH), set out at first to collect and organize the managerial tools and approaches that IBP partners offer to help countries improve and increase access to services. In the process, the team realized that fostering change is a continuum of activities, supported by a variety of management practices, which in the past have usually been taught separately. The team reviewed various managerial and change management theories, evidence on what works, and managerial guidelines and tools produced by the partners.

As the team described it, “The Guide provides a clear pathway that links proven change practice to “how to” steps for successful change”. It takes the reader through the steps to identify, champion, demonstrate and scale up a proven effective practice. The guide links these steps with the corresponding management tools from the IBP partners. These tools support such processes as leadership development, change management, and Performance Improvement.

The steps in the process of fostering change are these:

Phase I: Defining the Need for Change

  1. Identify the problem
  2. Identify and agree on the desired change

Phase II: Planning for Demonstration and Scale-Up

  1. Select a dedicated change agent and change team
  2. Identify and analyze relevant effective practices from other settings
  3. Choose and adapt an appropriate effective practice
  4. Plan to implement and monitor the desired change at test sites
  5. Plan for scaling up a successful change effort

Phase III: Supporting the Demonstration

  1. Help create and maintain an encouraging environment for change
  2. Continually assess, monitor, and modify the change effort

Phase IV: Going to Scale with Successful Change Efforts

  1. Evaluate lessons learned and decide whether or not to scale up
  2. Select an appropriate scale-up strategy
  3. Engage stakeholder commitment and secure resources
  4. Implement the scale-up strategy
  5. Measure and communicate results.

A 3-hour skills-building workshop, regional and country specific fostering change workshops, international conferences and the virtual training program have been used by the partners as forums to introduce the Fostering Change process in all the activities they support.

In May 2007 partners supported a skills building workshop to introduce the Guide for Fostering Change as part of the Global Health Council. A plenary and workshop session was held during the ANE Scaling-up Best Practices meeting, Bangkok, September 2007 to introduce the Guide. Participants also had the opportunity to work through the E-learning module. 

Partners have also discussed ways to link the dissemination of the Guide for Fostering Change with the Family Planning Global Handbook. The proposal is to tag on sessions to existing meetings. MSH has produced a calendar of events which identifies opportunities to undertake these tag on sessions.

Skill building workshops were undertaken in Kenya in November 2007 and early 2008 by FHI and Jhpiego, in Mali by Macro International, Pakistan by USAID and Ethiopia by the IBP Secretariat in 2008. CARE also plan to undertook workshops in their country of operations. 

Training materials were prepared by MSH in collaboration with the IBP Secretariat and members of the Task Team.

Since 2007 training in the management of change based on the Guide for Fostering Change has been provided in all workshops, conferences and meetings supported by the IBP Secretariat and IBP partners.