Bandali Sarah, Style Sarah, Thiam Lamine, Omar Omar Ahmed, Sabino Alice, Hukin Eleanor
Options Consultancy Services Ltd, London, UK.
Women's Integrated Sexual Health Programme, Options Consultancy Service, Abuja, Nigeria.
Glob Public Health. 2022 Mar;17(3):457-468. doi: 10.1080/17441692.2020.1868016. Epub 2021 Jan 6.
Traditional approaches to development programming with fixed targets and outcomes do not fit complex problems where the pathway to achieve results differs in each context and evolves constantly. Adaptive programming improves responses to complex problems by identifying which solutions bring change. This paper reviews the theory behind adaptive programming approaches and introduces the 'Pathways of Change' tool for achieving sustainability results, developed for the multi-country Women's Integrated Sexual Health programme. Qualitative data, using semi-structured interviews and group discussions from teams in over 17 countries in Africa and South Asia, are presented which examine the application of the Pathways of Change (PoC) tool focusing on successes and challenges across different intervention areas. The PoC responds to the need for a more practical adaptive programming tool that can be tailored to support flexibility in global health programme implementation while meeting donor requirements. Findings suggest that the PoC tool provides a flexible yet robust alternative to traditional monitoring frameworks and is able to facilitate adaptive, contextualised planning and monitoring for multi-country programmes. The PoC tool offers a solution to realise the ambitions of implementing adaptive programming within global health programmes and potentially beyond.
传统的以固定目标和成果进行发展规划的方法并不适用于复杂问题，因为在每种情况下实现结果的途径都不同且不断演变。适应性规划通过确定哪些解决方案能带来改变来改善对复杂问题的应对。本文回顾了适应性规划方法背后的理论，并介绍了为多国妇女综合性健康项目开发的用于实现可持续性成果的“变革途径”工具。文中呈现了定性数据，这些数据来自非洲和南亚17个以上国家的团队通过半结构化访谈和小组讨论得出，考察了“变革途径”（PoC）工具在不同干预领域的应用，重点关注其成功之处和面临的挑战。“变革途径”工具满足了对一种更实用的适应性规划工具的需求，这种工具可以进行定制，以支持全球卫生项目实施中的灵活性，同时满足捐助方的要求。研究结果表明，“变革途径”工具为传统监测框架提供了一种灵活而强大的替代方案，能够促进多国项目的适应性、因地制宜的规划和监测。“变革途径”工具为在全球卫生项目及可能更广泛的范围内实现实施适应性规划的目标提供了一种解决方案。
