As with any health intervention, we start with the outcome we wish to achieve. Rather than adopt an abstract goal and quickly move on, this section advocates for a structured approach and dedicated time to arrive at a precise objective.
An objective shapes all of the work to come and significantly influences the ways in which we go about solving problems: the research we design, the challenges we focus on, the findings we prioritize and the indicators we select.
After answering this first question, you and your team will have a straightforward mandate to focus your work throughout the process.
Begin by identifying the group that requires your attention. Use available data to prioritize the people most in need of help. For example, an equity assessment may have recently revealed that a specific group is still persistently under-immunized. Making a specific population a priority prevents wasting time and resources on general activities directed to an unspecified population.
First describe the current or baseline state and then set measurable, achievable improvements.
Depending on your context, goals may be set at the national level , or you might have more flexibility in using local programme data to suggest feasible improvements in your immediate context.
Your programme objectives should be within the capacity for you and your team to influence. Set clear, measurable, attainable objectives that you can later evaluate.
First, identify the programme challenge in your area. Intended users fall into the following categories: (1) Makes full use of services and attends appointments on time (2) Irregularly uses services (3) Initially uses services and then stops or (4) Never uses services.
Second, ask why this challenge may be happening. What keeps users from acting or deciding in a way that is most beneficial for them? What do users need the system to do? What environmental factors contribute to the problem?
Finally, identify the biggest obstacles. The biggest obstacles are usually very human, meaning a bias, habit or conflicting priority stands between the user and the desired changed state.