Steps to Change – A phased approach to achieve change

Achieving change for Maternal and Newborn Health is a complex process that requires collaboration between multiple actors. Using our steps to change model, we support coalitions of advocates in Kenya and Nigeria as they work to achieve sustainable change in the quality of health services for mothers and babies.

What is it?

The Steps to Change model is a visual representation of how a root cause that contributes to a bigger health problem can be addressed. The model is adaptative, flexible, and can be applied in any context with the aim to achieve any desired change.

The Steps to Change maps guide advocacy coalitions (which sometimes include government and media) as they agree on how to get from ‘where they are today' to the change that they want to achieve. This model aims to: 

  • foster joint understanding and ownership of the advocacy goals and actions needed to achieve these. This is particularly important in case advocacy is driven by a disparate group of advocates from different sectors and backgrounds, who are working to achieve a common goal. 
  • facilitate an evidence-informed approach to developing an advocacy strategy, by considering available data and other evidence sources at every stage of the process.  
  • guide strategic advocacy by supporting the prioritization of goals and interventions that target advocacy issues 

By following the Steps to Change model, Civil Society Organizations (CSOs) and advocates are better able to design, coordinate and manage their advocacy strategies and activities. After they design their advocacy steps, CSOs build in periodic reviews during which they assess ‘what is going on’ around them, how it affects the possibility of achieving their change, and how they should adapt their advocacy in response.


How does it work?

This Steps to Change approach supports advocates to use data to identify the issue that is a priority to them and their communities and to agree on actions needed to resolve it. There are 5 key steps needed to map out we need to get from we are today to the change we want to achieve:

  1. Analyze the current context and identify what causes the issues that affect the health of mothers and children by using available data or other evidence.
  2. Agree on the desired change: advocates agree on the measurable desired change they want to achieve and see and track within an agreed timeframe.
  3. Identify the barriers to change: advocates brainstorm and identify the political, economic, institutional, or cultural barriers that prevent them from achieving of the desired change.
  4. Develop strategies to achieve change: agree on the steps that can be overtaken to overcome barriers to change. To do this,  advocates can create a visual pathway of what should happen between the context participants have validated, and the desired change you have articulated.
  5. Agree on next steps: once advocates have identified the strategic actions needed to bring about change, this now needs to be translated into a detailed action plan. 

The approach gives the advocates the power to establish their own priorities. If you wish to use this approach and adapt it to your context, a toolkit can be downloaded here.

A complementary tool to the Steps to Change is the E4A-MamaYe 6 Steps Approach to Advocacy, summarised in the E4A-MamaYe Advocacy Handbook which provides further guidance and tools for effective advocacy.

A few recommendations on using the tool - How to adapt the model to your needs?

  • Hold periodic and consistent reviews. Our experience shows that the process of implementation of the activities has been smoother after coalitions take full ownership of the tool and got into the habit of regularly updating the framework. Reviews also allow advocates to adapt their advocacy strategy to changes in context, or act on new learnings or insights.
  • Ensure the framework is used to inform the development of workplans, to translate the ‘steps’ into costed activities and detail who is responsible for delivering each step within a defined timeframe. This fosters accountability and informs mobilisation of resources to implement the plan. In addition, it is important to monitor and evaluate progress against each step.  
  • Finally, mapping ‘steps to change’ should be seen as a ‘routine’ starting point of any advocacy with the aim to build consensus around a joint goal, how to achieve these, identify gaps, contextual needs and opportunities as these arise.

For further information, support with using the tool or to hear directly from advocates about their experiences using Steps to Change, do not hesitate to contact our team!

The Steps to Change model helps us to keep track of what we are focused to achieve. It helps in identifying our key stakeholders: that is, who is responsible for what in the county health sector. The model also informs the goals we have attained, problems identified, like for example weak referrals, teenage pregnancies and low ANC visits.

RMNCAH Network Coalition member, Bungoma, Kenya.