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Module 3: Optimize Potential Impact
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Inner Context
Outer Context
How do complex interventions interact
Examples of context and change
Features of Inner Context
Features of Outer Context
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Outer context

Outer context includes the structural and cultural features outside an organization that could affect planning, implementation, evaluation and sustainability of changed or new programs and policies. It can directly or indirectly, positively or negatively influence strategies. If your multiple intervention program is aimed at community, regional, national or international levels, the outer context can be critical. The table below highlights features of outer contexts.

Features of outer context

Questions to consider about outer context

1. Inter-organizational networks & collaboration
This includes:

  • Informal networks or links outside of the organization
  • Formal networks or links outside of the organization

Informal and  formal communication and relationships outside of an organization and  similar changes in other organizations increase the chance a new program being adopted  (Greenhalgh et al., 2004).

  • Are other organizations making similar changes or adopting similar programs?
  • Is there a positive attitude for collaboration among  disciplines, sectors, or jurisdictions?
  • Do you have influential contacts outside of the organization?
  • Are these networks stronger horizontally (across sectors, departments) or vertically (between system layers)?
  • Are there various multi-disciplinary players committed to change?
  • Are there processes in place to communicate and share knowledge with contacts outside the organization?
  • Are there strategies for collaboration outside the organization?
  • Does the network function effectively?

2. Socio-political climate
This includes:

  • Laws
  • Government regulations
  • Policy documents
  • Political & policy-making environment

Timing a change or new program to relate to a policy “window” can influence your success (Greenhalgh et al., 2004).

  • Are there policy priorities or urgent public policy issues to tie your change to?
  • Does your plan align with regional, national, or international activities and momentum?
  • Will your proposal help solve a policy problem?
  • Are there policy documents that will support your intervention?
  • Do you anticipate a policy window opening after the intervention is launched, which will increase the likelihood of a regulatory change?

3. External incentives and  mandates
This includes:

  • Political ‘must-dos’

Mandatory change increases the motivation to act but does not necessarily increase the capacity to do so (Greenhalgh et al., 2004).

  • Is the change or program voluntary or part of an external mandate?
  • Is there dedicated funding, governmental or otherwise, for your program?

4. Prevailing norms
This includes:

  • Public opinion
  • Media

Mass media may create awareness of the need for changes and contribute to success. Public opinion can provide support for change.

  • Is there public support for change?
  • How are the media portraying the issue?

Last Updated on Wednesday, 16 September 2009 18:30