A theory of change (TOC) defines the activities, outputs, outcomes, evidence and assumptions on the pathway to achieve a long-term goal. For the BID Initiative, this pathway is based on the principal hypothesis that better information plus better decisions will lead to the long-term goal of better health outcomes. The TOC describes in detail the types of activities the BID Initiative is conducting to bring about the outputs and outcomes depicted in the pathway.
The BID Initiative has four primary outcomes:
Improved overall immunization data quality at scale in two demonstration countries by 2017
Increased use of immunization data for decision making across all levels of the health system at scale in two demonstration countries by 2018.
Achieved implementation of relevant components of the BID solution at scale in two demonstration countries, and commitment toward implementation by 5-8 other country governments within Sub-Saharan Africa by 2018.
Significant additional resources are committed from donors, multilateral agencies, implementation organizations, or other innovative sources for financial and technical support to countries adopting and improving the BID solution by 2018.
There are a broad range of activities supporting the achievement of these outcomes, with the activities for primary outcomes 1 and 2 focused at the country level in Tanzania and Zambia (our two initial demonstration countries) and the activities for primary outcomes 3 and 4 focused mainly at the regional and global levels to expand and scale with additional resources. For this reason, we developed two separate but related TOCs – one for outcomes 1 and 2 and one for outcomes 3 and 4. In addition, there is a supporting document that summarizes a thorough review of the literature supporting the design of the BID Initiative activities and TOC related to outcomes 3 and 4.