Long Read

Theory of Change

WASH and SRHR related health problems can’t be solved by individuals or groups working alone: they require sustainable long-term solutions that allow systems to be changed and stakeholders to be in regular communication with each other. We developed this Theory of Change to ensure we can deliver sustainable, long lasting improvement of basic health. To reach this goal we simultaneously work on three integrated pillars.

Pillar 1: Empowered communities

We empower communities to ensure they will demand quality services and engage in healthy behaviour.

How does it work?

  • Set up and train community groups to raise awareness on WASH and SRHR issues.
  • Make communities aware of their rights, the importance of health and how to prevent the spread of diseases.
  • Make sure that the ‘voice of the community’ is heard and the interests of all community members are represented.

What is the outcome?

  • Communities can understand and monitor the health situation in their villages better.
  • People take better care of their health – by for instance knowing the value of washing hands or requesting skilled midwifes to attend birth deliveries.
  • Communities are stimulated to partner with local stakeholders to demand adequate and sustainable services.


Pillar 2: Enabling Environment

We create an environment where everybody from the local communities to the private sector to local, regional and national government level is actively involved in a community’s health situation.

How does it work?

  • Build the capacity of governmental health and WASH providers to make them aware of national laws and regulations and their roles and responsibilities.
  • Train local craftsmen and entrepreneurs to ensure sustainable production of WASH & SHRH related products and services that meet the demands of the community.
  • Increase communication channels between local communities and healthcare providers to provide more effective, efficient and relevant services.
  • Gather local data and evidence to share with influential (inter)national stakeholders

What is the outcome?

  • Stakeholders are aware it is their responsibility to deliver quality health services in line with the needs of the community.
  • The local economy is boosted by work being done within the community.
  • Community and local and national government stakeholders have platforms where they collaborate and discuss issues such as budget allocation for WASH facilities, or the presence of skilled health providers in health clinics.
  • Development of health policies with sufficient budget allocation for WASH and SRHR.


Pillar 3: Sustainable services

We ensure that good quality WASH and SRHR services are available, affordable, sustainable and accessed by the people who need them.

How does it work?

  • Set every service up according to our five sustainability principles, FIETS: financial, institutional, environmental, technical and social sustainability.
  • Train WASH and SRHR service providers, amongst others, in organisational and financial management.

What is the outcome?

  • Improvement in the sustainability, quality, affordability and availability of health services.
  • Significant growth in the effective and sustainable use of WASH and SHRH services.
  • Tangible improvement in a community’s basic health.

Simavi Theory of Change This factsheet provides an elaborate description of our Theory of Change.

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