Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics.

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  • Additional Information
    • Affiliation:
      Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK
      Grand Challenges Canada / Grands Défis Canada at the Sandra Rotman Centre, MaRS Centre South Tower, 101 College Street, Suite 406, M5G 1L7, Toronto, ON, Canada
      Center for Accelerating Innovation and Impact, United StatesNorwegian Agency for International Development (USAID) Cooperation, 1300 Pennsylvania Ave. NW, Washington DC, USA
      Center for Accelerating Innovation and Impact, Bureau for Global Health, United States Agency for International Development (USAID), 1300 Pennsylvania Ave. NW, Washington DC, USA
      Maternal and Child Health Division, Bureau for Global Health, United States Agency for International Development (USAID), 1300 Pennsylvania Ave., NW, Washington DC, USA
      Department for Global Health, Education and Research, Norwegian Agency for Development Cooperation, Ruseløkkveien 26, 0251, Oslo, Norway
      Health Team, Research and Evidence Division, Department for International Development, 22 Whitehall, SW1A 2EG, London, UK
      Discovery and Translational Sciences, Bill and Melinda Gates Foundation, 5th Avenue, 98119, Seattle, WA, USA
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Background: Grand Challenges for international health and development initiatives have received substantial funding to tackle unsolved problems; however, evidence of their effectiveness in achieving change is lacking. A theory of change may provide a useful tool to track progress towards desired outcomes. The Saving Lives at Birth partnership aims to address inequities in maternal-newborn survival through the provision of strategic investments for the development, testing and transition-to-scale of ground-breaking prevention and treatment approaches with the potential to leapfrog conventional healthcare approaches in low resource settings. We aimed to develop a theory of change and impact framework with prioritised metrics to map the initiative's contribution towards overall goals, and to measure progress towards improved outcomes around the time of birth.Methods: A theory of change and impact framework was developed retrospectively, drawing on expertise across the partnership and stakeholders. This included a document and literature review, and wide consultation, with feedback from stakeholders at all stages. Possible indicators were reviewed from global maternal-newborn health-related partner initiatives, priority indicator lists, and project indicators from current innovators. These indicators were scored across five domains to prioritise those most relevant and feasible for Saving Lives at Birth. These results informed the identification of the prioritised metrics for the initiative.Results: The pathway to scale through Saving Lives at Birth is articulated through a theory of change and impact framework, which also highlight the roles of different actors involved in the programme. A prioritised metrics toolkit, including ten core impact indicators and five additional process indicators, complement the theory of change. The retrospective nature of this development enabled structured reflection of the program mechanics, allowing for inclusion of learning from the first four rounds of the program to inform implementation of subsequent rounds.Conclusions: While theories of change are more traditionally developed before program implementation, retrospective development can still be a useful exercise for multi-round programs like Saving Lives at Birth, where outputs from the development can be used to strengthen subsequent rounds. However, identifying a uniform set of prioritised metrics for use across the portfolio proved more challenging. Lessons learnt from this exercise will be relevant to the development of pathways to change across other Grand Challenges and global health platforms.
    • Journal Subset:
      Biomedical; Europe; UK & Ireland
    • Instrumentation:
      Health-Related Hardiness Scale (HRHS)
    • ISSN:
      1744-8603
    • MEDLINE Info:
      PMID: NLM29378667 NLM UID: 101245734
    • Publication Date:
      In Process
    • Publication Date:
      20190106
    • DOI:
      10.1186/s12992-018-0327-z
    • Accession Number:
      127711961
  • Citations
    • ABNT:
      LALLI, M. et al. Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics. Globalization & Health, [s. l.], v. 14, p. 1–N.PAG, 2018. DOI 10.1186/s12992-018-0327-z. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=127711961. Acesso em: 31 out. 2020.
    • AMA:
      Lalli M, Ruysen H, Blencowe H, et al. Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics. Globalization & Health. 2018;14:1-N.PAG. doi:10.1186/s12992-018-0327-z
    • APA:
      Lalli, M., Ruysen, H., Blencowe, H., Yee, K., Clune, K., DeSilva, M., Leffler, M., Hillman, E., El-Noush, H., Mulligan, J., Murray, J. C., Silver, K., & Lawn, J. E. (2018). Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics. Globalization & Health, 14, 1–N.PAG. https://doi.org/10.1186/s12992-018-0327-z
    • Chicago/Turabian: Author-Date:
      Lalli, Marek, Harriet Ruysen, Hannah Blencowe, Kristen Yee, Karen Clune, Mary DeSilva, Marissa Leffler, et al. 2018. “Saving Lives at Birth; Development of a Retrospective Theory of Change, Impact Framework and Prioritised Metrics.” Globalization & Health 14 (January): 1–N.PAG. doi:10.1186/s12992-018-0327-z.
    • Harvard:
      Lalli, M. et al. (2018) ‘Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics’, Globalization & Health, 14, p. 1–N.PAG. doi: 10.1186/s12992-018-0327-z.
    • Harvard: Australian:
      Lalli, M, Ruysen, H, Blencowe, H, Yee, K, Clune, K, DeSilva, M, Leffler, M, Hillman, E, El-Noush, H, Mulligan, J, Murray, JC, Silver, K & Lawn, JE 2018, ‘Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics’, Globalization & Health, vol. 14, p. 1–N.PAG, viewed 31 October 2020, .
    • MLA:
      Lalli, Marek, et al. “Saving Lives at Birth; Development of a Retrospective Theory of Change, Impact Framework and Prioritised Metrics.” Globalization & Health, vol. 14, Jan. 2018, p. 1–N.PAG. EBSCOhost, doi:10.1186/s12992-018-0327-z.
    • Chicago/Turabian: Humanities:
      Lalli, Marek, Harriet Ruysen, Hannah Blencowe, Kristen Yee, Karen Clune, Mary DeSilva, Marissa Leffler, et al. “Saving Lives at Birth; Development of a Retrospective Theory of Change, Impact Framework and Prioritised Metrics.” Globalization & Health 14 (January 29, 2018): 1–N.PAG. doi:10.1186/s12992-018-0327-z.
    • Vancouver/ICMJE:
      Lalli M, Ruysen H, Blencowe H, Yee K, Clune K, DeSilva M, et al. Saving Lives at Birth; development of a retrospective theory of change, impact framework and prioritised metrics. Globalization & Health [Internet]. 2018 Jan 29 [cited 2020 Oct 31];14:1–N.PAG. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=127711961