Activity A: Setting the agenda of the workshop (4/7)
5. Adopt an ‘impact pathway’ approach to help formulate policy questions
The impact pathway model is a logical way to organise the various elements (inputs - activities - outputs - outcomes - impact). As shown in the animation below, the logical flow can be tested by moving from one element to the next. The relationship between two elements is based on underlying assumptions. For instance, the overall assumption is that if the multisectoral nutrition plan is well designed:
- the funding and human resources (inputs) are allocated as planned,
- the interventions are implemented (activity) with the desired quality,
- this would lead to adequate coverage of the target population (output),
- thus improving the intended behaviour (outcome, such as breastfeeding) which ultimately will lead to
- impact on the target nutrition indicator, for instance stunting).
It is important to test whether the data confirm that the relationship between two elements indeed exists, as well as the assumptions themselves.
Using the framework of the impact pathway will help to unpack broad policy questions, which are often related to impact, into sub-questions about the earlier elements in the impact pathway, which are more likely to be answerable with existing data. Indeed, following the impact pathway, policy-relevant questions and sub-questions can be formulated with respect to each individual element, the relationship between elements, or the underlying assumptions.
For instance, it is difficult to answer the following question: “Did the investments in nutrition-specific interventions in the Multi-sectoral Nutrition Policy and Plan of Action, phase II (MPPA-II), reduce stunting significantly over the same period?”
The question asks whether the inputs (investments) at the start of the pathway resulted in impact on a key nutrition indicator at the end of the pathway. Yet, there are so many different factors along the pathway which could have influenced the implementation of the MPPA that it is impossible to answer this question without a controlled research set-up and measuring all confounding factors. It is, however, possible to break down this broad question into a set of smaller questions pertaining to each step of the impact pathway, such as:
- Was the budget allocated and dispersed as planned in the MPPA?
- Were the interventions implemented as planned?
- Were the target populations reached by the interventions as planned?
Impact pathway models, or a theory of change already adopted by the country to monitor the MPPA, may provide a good basis for triggering the discussion on policy relevant questions and preparing this workshop exercise. These models will be particularly useful to identify the intervention logic of the MPPA and the existence (or gaps) of indicators.
In the absence of impact pathway models or a MPPA theory of change, impact pathways models of the REACH Compendium of Actions can serve as a good basis to start the exercise.