Design Decisions Guide

Levels of Change


Another important question to ask in addition to determining the types of problems you are seeking to solve, and the types of outputs or deliverables you should expect, is about what level of the system your project seeks to affect change? Is the work operating on the level of the individual, seeking to change attitudes, behaviors and social interactions around a certain issue? Or does it exist at the level of a community or service provider, where questions of power, cultural norms or organizational processes and services come into play? Or finally, does it exist at the societal level, seeking change in political trends, regulatory/policy frameworks or market dynamics to ensure more effective and equitable distribution of health care services? In many situations, you will likely find that your project does not fit easily within one of these areas alone; rather it may have one as the entry point for the work, but span across what is also often referred to as the micro, meso, and macro levels.

Three circles, each increasingly larger inside of each other labelled Mico: Involves change in behaviours and social interactions of individuals, households or very small groups. Meso: MESO Involves change within larger groups, communities, and institutions. . Macro: Involves change within societies at large, such as political trends, regulatory/policy frameworks or market dynamics.

At what level of the system are you looking to effect change?

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