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Theory of Change

For an organisation that has been active for almost a hundred years it is essential that we continue to ask ourselves how we can stay relevant in a rapidly changing world. With that in mind, last year we went through a reorientation process and made strategic choices about the role Simavi should play in the future to remain effective and sustainable. We mapped out how the world is changing and how these trends affect the development sector, and specifically Simavi’s work. We gathered input from our local partners in Asia and Africa and from other national and international stakeholders. Reflecting on all this information, we formulated a new strategy and Theory of Change to ensure we continue to maximise our impact towards our mission: A healthy life for all.


Simavi’s mission is A Healthy Life for All.

Good health goes hand in hand with personal, social and eco­nomic empowerment. It enables people to take control over their lives and pursue their rights. Health is a broad concept, so to be clear about the type of change that Simavi wants to make in people’s lives, it is important to define precisely what we mean by health. As Simavi contributes to more than physical health, we subscribe to the WHO definition: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’ To be able to measure our con­tribution to the health of the people we work for, we have defined six dimensions of health and wellbeing. Each of our programmes contributes to one or more of these dimensions:

  1. Experiencing physical and mental health
  2. Feeling confident and capable: feeling self-confident enough to have capacity for autonomous action, bottom-up advocacy
  3. Being self-aware and self-accepting: understanding your body, not being affected by community stigma
  4. Having control over one’s life and environment: decision-making in the family and on household expenditure, having access to services, not experiencing violence
  5. Having opportunities: success as education and economic empowerment, not being limited by child marriage or unwanted and early pregnancy
  6. Having the capacity for positive relationships with others – on a one-to-one, small group, family, community or societal level: having an inclusive social network and participating in community decision-making


Simavi strives for a world in which all women and girls are socially and economically empowered and able to pursue their rights to a healthy life, free from discrimination, coercion and violence.

In general, women and girls face greater challeng­es in achieving a healthy life than men and boys. That is why Simavi decided to invest primarily in improving the health of women and girls. In the communities we work in, women’s chances of living a healthy life are often limited by social and cultur­al norms, discrimination, coercion and violence. Empowering women, both socially and econom­ically, improves their ability to pursue their rights to a healthy life. Conversely, good health enables women to become more socially and econom­ically empowered. We believe that empowering women to pursue their rights to a healthy life will also improve the health of their families – includ­ing men and boys, and by extension their commu­nities as a whole – enabling a healthy life for all.

Outcomes and strategies

To achieve our mission, we have defined five outcomes and strategies that we apply in our programmes. Together these strategies contribute to our vision, our impact statement.

Outcome 1: Norms and practices are gender equitable and inclusive

Cultural and social norms define to a large extent how people behave and interact. For example, gender norms might restrict women’s ability to work or take part in decision-making. To create space for women to become more socially and economically empowered, to learn and practice new skills and to access services, it is important that norms and practices are supportive.
Strategy: Rather than directly challenging norms and practices, in our programmes we provide women, girls, men and boys with factual knowledge and skills. We also create space for dialogue and reflection on existing norms.

Outcome 2: Women have control over and the capacity to manage assets and resources

Having access to assets and resources – being economically empowered – is key to living a healthy life as it provides women with the opportunity to access services and products. In most households, men hold the decision-making power.
Strategy: By giving women and girls new knowledge and skills, we enable them to earn an income and to take part in decisions on the household income.

Outcome 3: Women voice their priorities and participate in decision-making

Men are often the main decision-makers in households and the communities we work in. This means for example that although women are the main users of water, they are often not involved in decisions about access to water. Women have different needs than men and it is important that these are included in decisions on both water, sanitation and hygiene (WASH) and sexual and reproductive health and rights (SRHR).
Strategy: Simavi empowers women as well as community stakeholders to ensure that women play an active part in decision-making.

Outcome 4: Women make use of sustainable SRHR and WASH services

Simavi works with public and private services providers to ensure that women and girls have access to services.
Strategy: We train service providers and empower communities to demand women-friendly services. In addition, we engage in partnerships to come up with innovative solutions that can increase the uptake of SRHR and WASH services.

Outcome 5: Women-friendly policies in place and implemented

To sustain our work, it is important that women-friendly policies are in place and implemented.
Strategy: We advocate with local and national governments to influence existing policies and encourage the development of new policies. When policies are in place, we work closely with local and national government stakeholders to support their implementation.

Local partners

In our programmes we work with local partner organisations that are rooted in and understand their communities and the national context. Together we strengthen the capacity of civil society organisations to represent the health needs and rights of communities at local, national and international levels. We do this by giving tailored support and technical assistance to boost our partners’ organisational capacity, their technical capacity and expertise, and their capacity for lobby and advocacy. This strengthens their ability to position themselves among and work with a wide range of relevant actors, including communities, grass-roots movements, civil society, governments and the public and private sectors. In doing so, we support civil society in its crucial role of making sustainable changes towards a healthy life for all.

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