Skip to content

Increase font size Decrease font size Default font size default color orange color green color
You are here: Home Modules Module 3: Optimize Potential Impact Context - Inner Context
Context - Inner Context Print E-mail
Module 3: Optimize Potential Impact
Article Index
Inner Context
Outer Context
How do complex interventions interact
Examples of context and change
Features of Inner Context
Features of Outer Context
All Pages

Inner and outer context

Greenhalgh et al. (2004) describe two broad areas of context, inner and outer.

Inner context

Inner context includes the structural and cultural features in an organization that could affect planning, implementation, evaluation and sustainability of changes to programs and policies. Inner context is important for multiple intervention programs that involve partners or policies, such as schools and school boards; non-government organizations; workplace polices; or health-care facilities. The table below highlights features of inner context.

Features of inner context

Questions to consider about inner context

1. Structure of the organization
This includes:

  • Maturity and size of the organization (may be related to the amount of resources available)
  • Complexity/Differentiation (parts can work independently)
  • Decentralization
  • Slack resources (available human & financial resources)

Organizations that are large, have specialized units that operate fairly independently, have decentralized decision-making, and have resources that can be channelled are more able to make changes or adopt new programs (Greenhalgh et al., 2004).

  • How long has the organization existed?
  • Are there different units or different areas of specialization in the organization?
  • Does the organization have the skills mix, competencies or capacities required to implement the intervention strategies?
  • Are there differentiated or multi-disciplinary areas of professional knowledge?
  • Are the decision-making processes dispersed or concentrated in the organization?
  • Does the organization have the requisite resources to maintain operations while introducing a new program (including financial and human)?

2. Absorptive capacity for new knowledge
This includes:

  • Knowledge that already exists
  • The ability to develop or gain, combine, interpret, spread or share, and use new knowledge

Organizations that are able to systematically identify, capture, interpret, share, re-frame and re-codify knowledge, link it to what they know already and put it to proper use are more able to make changes or adopt new programs (Greenhalgh et al., 2004).

Do those within the organization:

  • Have access to knowledge?
  • Have the ability to gather data quickly and efficiently?
  • Know how to make sense of the data?
  • Have the means to share knowledge internally and externally?
  • Have the ability to evaluate and use the data?

3. Receptive context for change
This includes:

  • Leadership and vision
  • Managerial relations
  • Risk-taking climate
  • Goals and priorities
  • Ability to capture high quality data

An organization that has strong leadership, a clear strategic vision, a climate supportive of risk-taking and the ability to capture data is better able to make changes or adopt new programs (Greenhalgh et al., 2004).

  • Does the program support the overall vision for the organization?
  • Is there strong leadership?
  • Are there visionary staff in pivotal positions?
  • Are there positive managerial relations?
  • Does the organizational climate favour experimentation or risk-taking?
  • Are there effective data-capture systems?

4. System readiness
This includes:

  • Tension for change
  • Fit between the system and program/policy goals
  • Balance between supporters and opponents
  • Assessment of the implications
  • Dedicated time/resources

System readiness is necessary for successful changes or the adoption of new programs (Greenhalgh et al., 2004).

  • Are staff supportive and in favour of change?
  • Are there supporters or champions for the intervention program?
  • Does the intervention program fit with existing goals, values, norms and strategies?
  • Are there competing demands or priorities?
  • Have the implications of change to or the addition of a new program been considered?
  • Have a budget-line and human resources been committed to the program?

Last Updated on Wednesday, 16 September 2009 18:30