Dr. Andri Jatikusumah, coordinator for the Asia Partnership on Emerging Infectious Diseases Research (APEIR), gave a presentation on outcome mapping as part of HSRI Academic Conference. The presentation inaugurates the first in a series of the English conferences at HSRI.

Outcome mapping is described as a participatory planning, monitoring and evaluation tool developed by the International Development Research Center (IDRC) in Canada in the early 1990s to evaluate many of its projects conducted alongside other actors, stakeholders, experts, and development agencies.

Most research projects are conducted with the goal of positively affecting the well-being of the population and the environment. Many factors have an impact on a research project: economic factors, cultural factors and political factors. Due to the sheer complexity of these factors, outcome mapping helps prioritize what is important.

Outcome mapping can be viewed as a results chain, starting from inputs to activities, outputs, outcomes, and impact. The main focus is on outcome, specifically behavioral change—a broad term encompassing individuals’ change in attitude and action.

Outcome mapping requires the thinking that everything and everyone are interconnected. It recognizes and embraces changes that may be continuous, non-linear, complex, multi-directional or non-controllable. It allows individuals to learn by engaging in the process. And it is conducted under the concept that humans individually cannot change the world.

When developing a project, researchers should think ahead to the beneficiaries. They may be farmers, consumers, or the overall population. A project proposal must include activities which, over the following one-five years, will lead to outputs that make a positive impact on the quality of life of these beneficiaries.

A project usually concludes with a report of results and recommendations. In most cases, there are no follow-up studies to measure and evaluate the long-term impacts on the target population. Even when project evaluators observe an impact, they are often unable to discern who is being impacted, and what aspect of the project is causing the impact. This is due to a significant number of interrelated factors.

Moreover, most projects cannot make a significant impact within the short timeframe.  As a result, outputs are often in the report, but not the impact.

With outcome mapping, it is possible to map the influence one group has over another. The sphere of control is the operational environment where researchers have control over inputs, activities and outputs. The sphere of influence is where relationship and interactions occur for the desired outcome, which in this case is behavioral change.

Limitations caused by both internal and external factors mean the research team has to refocus their efforts on the behavior of the boundary partners instead of the beneficiaries. The belief is that changing the behavior of boundary partners will lead to positive impacts on the beneficiaries, in the sphere of interest, through changes in the social, economical and environmental trends. 

In short, outcome mapping asks the research team to serve their immediate boundary partners. These partners are those whose behavior the interventions aim to influence for a maximum impact on the society. They act as liaisons between the research team and the target population. When choosing boundary partners, researchers should choose those who can make a discernible impact in their community. 

During the research timeline, the project’s influence will decrease over time as local partner ownership increases. The intersection of a program’s influence and local partner ownership should ideally be at the point where behavioral change occurs. It is hoped that the boundary partners will continue the interventions started by the research team.

Dr. Jatikusumah illustrated this concept by using his own project on rabies vaccination as an example. Knowing that his project had a two-year time frame, he decided to focus on boundary partners to maximize his project’s effects on the overall population.  He utilized the stakeholder analysis to identify the individuals with the most influence in the community to be partners, namely religious leaders, education leaders, and village leaders. He hoped that after the project was over, these leaders would uphold the project’s vision by influencing their constituents to change their behavior.

Outcome mapping is thus a participatory planning, monitoring and evaluation tool to effect a behavioral change in the research’s boundary partners. These partners act as the agents of change on the true beneficiaries long after the project’s conclusion. Limitations to outcome mapping are the substantial amount of time and money required to carry out this procedure and the difficulty in measuring the project’s impact on society. The tool is also more suited to action and operational research than clinical research.