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Theory of change: A valuable workforce development tool

An interview with Hilary Claire Frazer

We caught up with Hilary Claire Frazer of Mozen Consulting Ltd to talk about PtD's Theory of Change (ToC) in building human resources for supply chain management and how she thinks the tool can help users to improve their human resources (HR) practices.

An international organisation development director with an internal auditing and business-finance background, much of Hilary's career has focused on life sciences, financial and professional services, and bringing expertise and experience of transformation and change to low and middle-income countries, emerging markets and mature economies. She is also committed to corporate social responsibility as a non-executive director and a board-member.

Until recently she was a senior technical advisor contributing to Admas: a long-term human resources for supply chain transformation programme that began in March 2019, owned and led by the Ethiopian Pharmaceuticals Supply Agency (EPSA), with funding from the Bill & Melinda Gates Foundation and implemented by Pamela Steele Associates Ltd (PSA).   

Have you worked with or applied a theory of change in your work?

Prior to working on the Admas programme I'd never heard of a theory of change! Coming from the private sector, transformation and change programmes often follow methodologies – in-house or proprietary – to reach a pre-determined end state with specific targets in mind. Examples of this include a merger or acquisition, HR systems implementation or digital transformation to save x percent or deliver y return on investment within z number of years. 

Looking back, I see these attributes in theories of change. For instance, providing a common framework to bring various partners together to make a contribution, identifying the programme risks and measures needed to mitigate any impact and defining measures for performance and progress to completion.

Have you used the PtD Theory of Change?

Yes, I applied the PtD ToC as the framework to implement PSA's contribution to the Admas programme at the Ethiopian Pharmaceuticals Supply Agency (EPSA). The ToC enabled an international team of specialists to contribute their knowledge and experience to a multi-year transformation and change programme. Following the four pathways (staffing, skills, working conditions and motivation) enabled us to co-develop people-focused interventions to build capacity and improve EPSA's capabilities. The ToC also helped to provide continuity during a turbulent time at the agency with the COVID-19 pandemic, national unrest, a new ten-year plan and leadership changes all occurring at once.

How can users get the most out of the Theory of Change?

There are several ways users can benefit from the ToC. In my experience it is effective as a framework to bring together donor and/or client representatives, who may have very different perspectives and priorities, to adopt a consistent approach to understanding volatile, uncertain, chaotic and ambiguous environments and how they influence the client's context. The ToC can also help those planning and managing programmes to balance longer-term strategic change with shorter-term interventions to achieve incremental impact, as well as help diverse practitioners across and within teams to transfer knowledge and collaborate more effectively. Lastly users can use the ToC to prepare before, during and/or after going into the field. 

What do you think is the most useful aspect of the ToC?

Several aspects of the ToC are especially useful. Firstly it is well-structured with a logical flow – just like a good supply chain! The text is easy to read and explanations are relatively jargon-free while the design helps change practitioners work with the client organisation systematically by following the four pathways along various levels. For instance the ToC provides guidance around offering competitive salaries to recruit quality candidates, co-designing leadership programmes to build capacity, creating conditions to optimise workforce performance, raising motivation and optimising work performance overall. 

The indicators and interventions catalogue is comprehensive and focused on implementation with clear rationale statements, defining sources of data and intervention recommendations. All in all, the ToC supports the development of the supply chain profession, instilling a sense of pride and creating communities of practice to ultimately improve healthcare outcomes. 

What advice would you offer someone using the ToC to improve their HR practices?

From experience, the ToC is useful for looking at which critical assumptions apply as a diagnostic tool to assess the client's situation. Evaluating which pre-conditions are met and to what extent could also help to identify areas for intervention, the intended impact of changes, as well as the size and scale of a transformation programme. 

I think users should consider the ToC a particularly useful tool around which to frame conversations: it is a way to test an organisation's openness and readiness for change.

Human resources should be clearly defined from the outset and used to set the scope of any programme. Human resources can range from anything to do with people in an organisation to introducing HR best practices and applying international standards to improve HR processes, or specifically targeting professional development within the HR directorate itself.