[Change management: An analysis of actors; perceptions about technical assistance in the Democratic Republic of...

Technical assistance (TA) is a common component of health system strengthening interventions. This type of intervention is too often designed and evaluated according to a logic that fails to take into account social complexity. Actors' perceptions are one element of this complexity. This article presents a study conducted in the Democratic Republic of Congo designed to identify perceptions concerning two types of technical support providers for health system strengthening: long-term technical assistants (agents of development agencies) and provincial technical advisors (agents of the Ministry of Health).

Interviews were conducted with an innovative tool inspired by the principles of systems thinking. Interviewees were actors involved in a TA intervention in the province of Bandundu. Their expectations regarding TA providers were identified in terms of personal characteristics (knowledge, know-how and interpersonal skills), roles, and styles of interaction for capacity building ("interventionist/ prescriptive axes").

Interviewees emphasized the importance of mutual learning and the quality of interactions, which depends on TA provider's interpersonal skills and mutual willingness. Perceptions of TA provider's characteristics tend to be similar, but several differences were observed concerning the expectations about the roles of TAs, and the style that should be adopted for capacity building. Ignoring these differences in expectations may be a threat to the effectiveness of TA.