Lessons Learned From the Use of the Most Significant Change Technique for Adaptive Management of Complex Health...

Area of Science:

• Global Health
• Monitoring and Evaluation
• Qualitative Research

Background:

• The Most Significant Change (MSC) technique is a recognized tool for adaptive management.
• Practical documentation of MSC for ongoing monitoring is limited.
• The Challenge Initiative (TCI) implements family planning (FP) and adolescent and youth sexual and reproductive health (AYSRH) interventions in 11 countries.

Purpose of the Study:

• To document TCI's application and adaptation of the MSC technique.
• To assess the added value of MSC in adaptive management, routine monitoring, and cross-learning.
• To share experiences and lessons learned from using MSC in a large-scale intervention.

Main Methods:

• A qualitative assessment was conducted in early 2021.
• Virtual focus group discussions and key informant interviews were employed.
• Participants included TCI staff involved in collecting and selecting MSC stories.

Main Results:

• TCI reported positive experiences using MSC to facilitate adaptive management across multiple countries.
• MSC use fostered learning opportunities, aiding the diffusion of evidence-based FP and AYSRH interventions.
• Key success factors included stakeholder buy-in, training, and dedicated staff management.

Conclusions:

• The MSC technique is an effective qualitative tool for strengthening routine monitoring and adaptive management.
• MSC allows for flexibility in implementation by project stakeholders.
• MSC is a valuable tool for global health practitioners, policymakers, and researchers working with complex interventions.