How can a Theory of Change framework be applied to short-term international volunteering?

Abstract

Short-term international volunteering has become enormously popular among individuals from high-income countries who travel to low-income countries to offer support on initiatives often related to health and development. However, their impact on global development is questionable, particularly when volunteer skills are not matched to local needs, or when teams operate outside the local health system. Furthermore, the impact of these volunteer programs is rarely evaluated. Theory of Change is a framework for program design meant to facilitate measurable social change. We propose that a Theory of Change framework, appropriately deployed in the design and conduct of short-term international volunteerism, could help improve volunteer efforts by identifying problems and clearly defining goals, designing and implementing effective strategies, and evaluating the real impacts these have on identified concerns.

Developing world, Global development, Global health, Short-term volunteer, Theory of Change, Voluntourism

Short-term international volunteering has become enormously popular among individuals from high-income countries who travel to low-income countries to offer support on health and development initiatives.¹ Increasing participation in volunteer abroad experiences has prompted scrutiny around the impacts this phenomenon has on host communities visited by these groups.

La Romana, Dominican Republic, attracts scores of short-term international volunteers each year. Many visiting volunteers participate in activities that aim to improve the quality of life for individuals living in bateyes (i.e. marginalized residential communities inhabited by sugarcane workers).² Our study examining the perceptions of local hosts, international volunteers and local community members on the impacts of short-term volunteerism in La Romana found that respondents generally had positive views on the phenomenon.² However, careful analysis revealed diverse and sometimes opposing perspectives among stakeholders regarding the approach and perceived impacts of short-term volunteerism, and also highlighted the need for improved design, implementation and evaluation.²

‘Theory of Change’ (TOC) is a methodology that defines long-term goals and works backwards to identify initiatives that work towards accomplishing them.³ It has been used in international health and development for strategic planning of organizations, monitoring and evaluation of programming, and as a tool to understand what interventions lead to change.⁴ TOCs best reflect the change process when employed together with social science theory and research-based evidence, such that the messy complexities of real-world settings are accounted for.⁴

To address the concerns raised around international volunteerism, we suggest that the application of a TOC framework could help guide planning, evaluation and optimization of the intended impact. We propose a TOC model for short-term volunteerism in the context observed in La Romana, following the framework published by the W.K. Kellog Foundation for measuring programmatic outcomes.⁵

TOC models start by defining the problem: while concerns around poverty and poor health in the bateyes of La Romana has attracted many international volunteers, it remains unclear how necessary, sufficient or effective their involvement is (Figure 1: box 1). Working from this problem statement, the following steps provide a framework for change.

Figure 1.

Theory of Change model for short-term volunteerism in La Romana, Dominican Republic.

Document community needs and assets

(Figure 1: box 2) The needs of the community (local host and community members) should be paramount, but the potentially erroneous assumption is that international volunteers are interested in and able to effectively identify and address those needs. In contrast, an underutilized asset may be the existing interest among the La Romana community to address local priorities and needs. Many of the staff of relevant health and clinical organizations working in this space have formerly lived in bateyes; it follows then, that they should be involved in decision making. If existing partnerships have the capacity to develop local programs, and that visiting volunteer teams have a keen interest in meaningfully addressing the needs of batey communities, a comprehensive understanding of those needs is essential to encourage shifts in planning and programming.

Identify desired results

(Figure 1: box 3) Our research participants identified many perceived benefits to the community from international volunteers,² but it was not evident whether these addressed desired, meaningful community impacts. Given the service focus of most volunteer activities, the assumption in this model is that one desired result would be improved conditions and services in batey communities. Expanding on this desired result, the inclusion of foreign teams within established, long-term programs could better and more sustainably address health and social needs of batey communities.⁶

Identify influential factors

(Figure 1: box 4) Factors that would influence the success of achieving desired results include the presence of multiple uncoordinated volunteer groups on the ground, differing philosophies between these groups (e.g. political or religious ideologies), and complex inter-relationships between the government, private sector (e.g. sugar cane industry) and community, and broad social policy considerations, such as legislation affecting healthcare, education and housing. The accommodating nature of local partner organizations that welcome foreign visitors may additionally shift attention away from an overall objective of community improvement, and local host perceptions of what constitutes community benefit may be at odds with desired results.² Finally, the presence of volunteer teams also represents a tenuous funding mechanism and revenue stream.⁷ An in-depth review of the desired results and a clear plan to address these potential contextual barriers is necessary, as some factors may be more easily addressed (e.g. enhancing collaboration between volunteer teams) than others (e.g. legislation).

Identify plausible strategies

(Figure 1: box 5) Once influences and desires are considered, the next step is to identify approaches that might achieve a resolution to current challenges facing short-term volunteer work. Simple strategies, such as encouraging collaboration and coordination between different volunteer teams, are key.² More complex ideas, such as creating a culture of accountability to ensure fulfillment of predetermined goals and ethical conduct, need time, effort and incentives to build. For example, one could potentially construct a funding escalator scheme dependent on outcomes and evidence, with larger roles for local funding sources. Efforts to empower local partners, especially local community members in the bateyes, could direct program goals and standards of practice. Strategies should also target greater awareness among volunteers of potential harms to community, and encourage self-reflection and compliance with ethical codes. Finally, data on the incidence and prevalence of specific health conditions in batey communities would help support analyses of the impact of volunteer efforts that can be evaluated prospectively.

Account for assumptions

(Figure 1: box 6) The inclusion of assumptions in a TOC framework is meant to account for potential contextual factors that may directly, or by being changed, result in impacts to strategic implementation. At present, the major assumption in this work is that there is continuing interest to build upon existing partnerships between local and visiting actors, as subjectively demonstrated in the responses analyzed.² However, ideas to the contrary may have been self-censored given that the research team themselves were visitors. Ideally, the other assumption is that local partners are behaving ethically, especially when marginalized populations are involved, and are willing to engage in programs that improve health outcomes and minimize costs and inefficiencies. With respect to the volunteers, we assume they are adequately trained and working within their scope of practice, and behaving ethically, unbiased by religion or culture. These key assumptions at present suggest that appropriately targeted change has the potential to succeed.

Development of a TOC is an iterative process; TOCs are meant to evolve as experience and knowledge expands.^8,9 The model we have developed represents a plan for change that is reasonable, doable and testable. The knowledge gleaned from its implementation may provide those involved in the design, conduct and evaluation of short-term volunteer trips in La Romana with key insight on how change for the better may be achieved. Given the growing concerns around the ethics and impact of short-term volunteerism globally,^7,10,11 the TOC may be relevant to other contexts that similarly contend with a large influx of short-term volunteers but have no current mechanism to evaluate their impact.

Authors’ contributions: All authors conceived, wrote, read and approved the final paper. HD is guarantor of the paper.

Funding: The research team was supported by a grant from the University of Toronto Dean's International Initiative Fund.

Competing interests: None declared.

Ethical approval: Not required.