#### Table of Contents
- [[#Developing a Theory of Change|Developing a Theory of Change]]
- [[#Identifying Indicators|Identifying Indicators]]
- [[#Collecting Data|Collecting Data]]
- [[#Monitoring and Evaluation|Monitoring and Evaluation]]
- [[#Analysis and Reporting|Analysis and Reporting]]
- [[#Learning and Adaptation|Learning and Adaptation]]
How do impact organisations measure impact? After working for various impact firms, and also being involved in setting up an impact-organisation of my own, I've realised how crucial the 'Theory of Change' framework is, when it comes to measuring if the impact firm is indeed making an impact.
The term impact comes with a lot of baggage, and that needs to be dealt with the right amount of scrutiny.
For example, for my work at [[Noora Health]], for the expectant mothers, we provide health education training with the hope that in the long run, it might lead to a reduction in the infant mortality rate, as well as maternal mortality rate.
According to the World Bank's latest data, here are the statistics for the infant mortality rate (IMR) and maternal mortality ratio (MMR) in India, Bangladesh, and Indonesia:
| India | Indonesia | Bangladesh |
| IMR: 29.1 deaths per 1,000 live births (2019) | IMR: 21.3 deaths per 1,000 live births (2019) | IMR: 24.2 deaths per 1,000 live births (2019) |
| MMR: 113 deaths per 100,000 live births (2017) | MMR: 126 deaths per 100,000 live births (2017) | MMR: 173 deaths per 100,000 live births (2017) |
Although the distal outcome we are aiming for is: Reduction in IMR and MMR, we would find it difficult to not only measure, but evaluate the causation of our efforts and its relations with IMR, MMR. How much of the intended effect is a causation, and not correlation?
However, there are certain indicators which would come under the proximal outcomes which help us evaluate our impact, and to check if we are indeed headed in the right direction. The framework of **Theory of Change** is usually adopted consisting of the following steps:
## Developing a Theory of Change
The organization starts by developing a comprehensive Theory of Change that outlines the desired long-term outcomes and the pathways to achieve them. This involves identifying the inputs, activities, outputs, and outcomes involved in their work.
## Identifying Indicators
The organization then identifies specific indicators that can measure the progress towards each outcome. These indicators should be measurable, specific, and relevant to the organization's goals.
Some possible indicators for Noora Health while intervening in ANC (Antenatal Care) could be:
* Increased ANC visits.
* Increased knowledge and health seeking behaviours.
* Increasesd knowledge and practice of behaviours like taking antenatal medicines, following recommended nutrition, etc.
* Increased knowledge and practice of early initiation of breast feeding.
* Increased knowledge on identification of danger signs in new-born
* Increased Knowledge and practice of immunization.
* Increased knowledge on planning of safe delivery.
* Reduction in preventable complications during pregnancy
* Reduction in hospital complications during delivery.
* Overall reduction in NMR and MMR.
These indicators helps Noora Health measure its progress towards improving maternal health outcomes through their interventions during ANC sessions.
## Collecting Data
Once the indicators are identified, data collection methods are determined. This may involve surveys, interviews, focus groups, or other means to collect quantitative and qualitative data.
## Monitoring and Evaluation
The organization establishes a monitoring and evaluation system to track progress against the identified indicators over time. This involves regular data collection and analysis to assess whether the activities are contributing to the desired outcomes.
## Analysis and Reporting
The collected data is analyzed to determine if there is evidence of impact or if adjustments need to be made in the organization's approach. Reports are generated highlighting the findings and recommendations for improvement.
## Learning and Adaptation
Based on the analysis and findings, impact organizations learn from their monitoring and evaluation efforts and make adaptations as necessary to continuously improve their programs or initiatives.
By following these steps, impact organizations can effectively measure their impact using Theory of Change, ensuring they stay accountable for achieving their desired outcomes.