Most Significant Change - Monitoring empowerment for the right to health

7 Feb 2011


Stories from the DR Congo, Palestine, the Philippines and Latin America 

See also attachment below: 'Most Significant Change - Monitoring empowerment for the right to health'


Anyone who is involved in development work knows that monitoring and evaluation can be challenging. It is no easy matter to measure progress and to communicate achievements and results in formal reports, especially for organizations that are not investing in bricks and mortar, but in human and organizational capital.

There's one anecdote about monitoring and evaluation I'll never forget. A couple of years ago I was representing Belgian NGOs in the Philippines. One day I found myself on the island of Samar working overtime with our local partner organization to come up with indicators for our logical framework. It took us ages to find an indicator of poverty among the poor peasants we were working with. I had already tried every indicator I knew from training programmes and manuals but nothing seemed to be applicable, according to the director of the local partner organization.

On the verge of losing my patience, I finally asked her to tell me about a successful project area she had mentioned earlier during the break. How did they know that they had been able to improve the lives of the poor? She immediately started to enthusiastically tell me about their latest visit to the village and the many changes they had observed in the behaviour and living conditions of the local population. One of the most striking changes was that almost everyone was now using sugar and cooking oil.

There was my indicator. And I had learned my lesson: ask people to tell stories and you'll learn plenty of things that cannot be captured in indicators. Maybe it was also my first encounter with the Most Significant Change technique, long before I had even heard of it.

During the same period, I met a development consultant who had returned from a field visit for an ambitious evaluation project commissioned by the Belgian government. “You guys know what empowerment is,” he told me. I was flattered, of course, but also curious. How had he reached that conclusion? He had been interviewing farmers all over the Philippines, he explained, and most of them were very shy and hesitant when they were answering his questions. “When I interviewed farmer leaders in your partners' project areas, they stood up before they answered my questions and they looked me in the eye while they made their points,” he averred.

This observation never made it into the consultant's final report but now that I'm looking back on our initial experiences with the Most Significant Change technique, this anecdote seems very relevant. These kinds of stories and anecdotes often reveal most about the issues that really matter in our work: empowerment, health, well-being, rights, etc., and yet they hardly ever make it into our formal reports.

It was out of frustration that we decided to experiment with the Most Significant Change technique. We had been struggling hard these past few years to adopt results-based management techniques but often we had an uncomfortable feeling that something was missing. We hardly ever heard the stories from grassroots level any more - that wealth of quality information that shows what matters most for people – and for us.

When we read about the Most Significant Change technique, we thought it might provide an answer and we wanted to give it a try. We collected and selected stories with the help of our partners in the Philippines, Palestine, the Democratic Republic of Congo (DRC) and Latin America. Interestingly, in each of these regions the process was quite different. In the Philippines, a staff member from our local office worked closely with Gabriela, one of our partner organizations, to conduct a try-out of MSC with a regional Gabriela chapter. In Palestine, we had first-hand experience, as we collected and selected the stories ourselves, together with youth leaders in East Jerusalem. In the DRC, it was three interns who worked with the local partner to collect stories, and in Latin America, a local consultant assisted the local partner organization.

We consider the diversity in the methodology a strength, not a weakness. It provided us with a wealth of experience to learn from in a very short time. We want to share these experiences – the good as well as the bad with a broader audience involved in this kind of work and hope it will enable them to improve their work in the service of people's health and development.


Wim De Ceukelaire

Coordinator of the Policy and Partnership department

Third World Relief Fund (TWRF) / intal

Wim De Ceukelaire
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