From Idea to Impact - A Manual on Activity and Project Management by International Federation of Medical Students' Associations

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IFMSA Imprint Collaborators Hana Lučev - Croatia Caroline Arnbjerg - Denmark Pelle Harris Krog - Denmark Marie My Warborg - Denmark Christian Sommerdahl - Denmark Nina Maria Madsen - Denmark

Layout Design Victor Leal Garcia - Brazil

The International Federation of Medical Students’ Associations (IFMSA) is a non-profit, non-governmental organization representing associations of medical students worldwide. IFMSA was founded in 1951 and currently maintains 136 National Member Organizations from 127 countries across six continents, representing a network of 1.3 million medical students. IFMSA envisions a world in which medical students unite for global health and are equipped with the knowledge, skills and values to take on health leadership roles locally and globally, so to shape a sustainable and healthy future. IFMSA is recognized as a nongovernmental organization within the United Nations’ system and the World Health Organization; and works in collaboration with the World Medical Association.

Publisher International Federation of Medical Students’ Associations (IFMSA)

This is an IFMSA Publication

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International Secretariat: c/o Academic Medical Center Meibergdreef 15, J0-208

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From idea to impact: A Manual on Activity and Project Management

Contents

Introduction Page 4

What is an Activity? Page 5

The Project Cycle Page 5

How to get started Page 6

The Problem Tree Page 6

The Objective Tree Page 9

A Stakeholder Analysis

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Page 10

Formulating Your Activity Page 13

Formulating Your Activity Proposal Page 9

Monitoring and Evaluation Page 16

Tools for Monitoring and Evaluation Page 17

Strategic Actions - How to TOWS Page 21

IFMSA Programs Page 22

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Introduction

MSA brings people together to exchange, discuss and initiate activities to create a healthier world. But what is an activity really? And how do we run an activity in the best way? How can we create the change that we want to see in our communities?

Failing to plan is planning to fail. IFMSA NMO members wrote this manual for IFMSA NMOs members. Its purpose is to empower members to run successful activities, thus increasing the impact of IFMSA in our local communities. Planning enables us to know what should be done when—Without proper planning, activities may be implemented at the wrong time or in the wrong manner and result in poor outcomes. Planning ensures smoother implementation— There will always be unexpected situations in activities. However, a proper planning exercise helps reduce the likelihood of these and prepares the team for dealing with them when they occur. The planning process should also involve assessing risks and assumptions and thinking through possible unintended consequences of the actions being planned. Planning improves focus on priorities and leads to more efficient use of time, money and other resources—Having a clear plan or roadmap helps focus limited resources on priority actions, that is, the ones most likely to bring about the desired change. Without a plan, many competing demands often distract people. Similarly, activities will often go off track and become ineffective and inefficient. Planning helps determine what success will look like—A proper plan helps determine whether the results achieved are those that were intended and to assess any discrepancies. Of course, this requires effective monitoring and evaluation of what was planned. For this reason, good planning includes a clear strategy for monitoring and evaluation and use of the information from these processes.

Source: UNDP Handbook on planning, monitoring and evaluating for development results

From idea to impact: A Manual on Activity and Project Management

What is an Activity? What is an Activity? We in IFMSA define an activity as: A unique set of planned interventions designed and implemented to achieve certain specific objectives – within a given budget and a specified period of time. This definition corresponds to a definition of a project.

The Project Cycle This model illustrates the different phases in a project or an activity and how they are interlinked. Normally an activity starts with a planning-phase progressing to a monitoringphase when the activity is or has been implemented. A activity ends by an evaluation aiming to provide learning-points and recommendations, which can be used to plan a new activity and set a new vision and goals.

Source: UNDP Handbook on planning, monitoring and evaluating for development results

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How to get Started How to get started In the very beginning of an activity-making-process, it is essential to allow a broad range of ideas to be discussed. This is the time where creativity should be encouraged. Two easy tools to start with are the “Problem Tree and Objective Tree” followed by a “stakeholder analysis”. After making these three exercises, it should be easier for you to formulate and write a great activity or campaign. It is essential for the whole activity period and outcome that as many people/ members of your activity team are involved in the planning phase. This is to ensure the best possible engagement to the activity as well as obtaining as many inputs and ideas as possible. We recommend that you set a plan for how to monitor and evaluate your activity before you start your activity, in order to ensure the success.

The Problem Tree The problem tree is a central workshop-method to use in the planning of an activity, but can also be used in later stages of the project cycle. The problem tree allows you to discover the underlying causes of the problem you are trying to solve, thereby enabling you to create objectives that tackle the true cause(s) of the problem, instead of simply planning your activity to target the immediately apparent causes. The method should be used as a group exercise in your activity group, but it can also be beneficial to create a problem tree with your target group or key stakeholders – this gives you the broadest insight into the problem you wish to tackle, so you can plan for the activity that will have the highest possible impact. The first step in creating a problem tree is to discuss and agree the problem or issue to be analysed. Do not worry if it seems like a broad topic, because the problem tree will help to break it down and make it more concrete. During this first stage, it is important that as many possible options are examined. Here, the aim is to establish an overview of the situation (e.g. Cholera in Kingstown). Later in the process, the perspective will be narrowed and deepened in order to prepare an activity design.

From idea to impact: A Manual on Activity and Project Management

The Problem Tree

Example of a problem tree focused on the health issue of Cholera in a given area

Step 1 – Formulate problems Brainstorm suggestions to identify a focal problem that the your activity will focus on (e.g. Cholera in Kingstown). Each identified problem is written down on a separate card or Post-It. The wording of your suggestions does not need to be exact as the roots and branches will further define it, but it should describe an actual issue that everyone feels passionately about to change it. What is a ‘problem’? A problem is not the absence of a solution but an existing negative state: ‘High prevalence of bacterial infections’ is a problem; ‘No antibiotics are available’ is not.

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The Problem Tree Step 2 – Identify the central problem Discuss your suggested problems – are they related, and if so, in what way? Through your discussions, identify the central problem. If agreement cannot be reached, then: • Arrange the proposed problems in a problem tree according to the causal relationships between them; • Try again to agree on the focal problem on the basis of the overview achieved in this way. If no consensus can be achieved: • Try further brainstorming; • Select the best decision, e.g. by awarding points; or decide temporarily on one, continue your work but return at a later stage to discuss the other options. • Decide whether this really is the problem you want to tackle. One of the most important things in teamwork is to all be passionate and motivated to work on it.

Step 3 – Develop your problem tree Once you have identified your central problem, the cards or post-its can be moved so that the immediate and direct causes of the focal problem are placed in parallel (see example above), and draw connecting lines to indicate the means-ends relationships. • Beneath it; the immediate and direct effects of the focal problem are placed in parallel • Above it: causes and effects are further developed along the same principle to form the problem tree. The problem analysis can be concluded when your group agrees that all essential information has been included that explains the main cause and effect relationships characterizing the problem. The heart of the exercise is the discussion; debate and dialogue that is generated as factors are arranged and re-arranged, often forming sub-dividing roots and branches (like a Mind map). Take time to allow people to explain their feelings and reasoning, and record related ideas and points that come up on separate flip chart papers under titles such as solutions, concerns and decisions.

From idea to impact: A Manual on Activity and Project Management

The Objective Tree Creating an objective tree will help you find best solutions to the problems you want to focus on in your activity. Once completed, the objective tree provides a summary picture of the desired future situation, including the means by which ends can be achieved. While developing, a problem tree will provide your activity group with great insight into the issue at hand. The real strength of the method is to use your problem tree to develop an objective tree. Having broken down your issue into separate problems (a central problem and its causes and effects) in the problem tree, you can now reformulate each of the problems in your tree to a solution, or a desired scenario.

Step 1

Reformulate all the elements in your problem tree into positive desirable conditions.

Step 2

Review the resulting means-ends relationships to assure the validity and completeness of the objective tree.

Step 3

If required, revise statements; delete objectives that appear unrealistic or unnecessary; add new objectives where required. Select one or more conditions that you want to change with your activity. Choose realistic goals; goals that are set too high, are meant to fail and knock down all the motivation.

Example of an objective tree focused on the health issue of Cholera in a given area.

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A stakeholder analysis What is a stakeholder? A stakeholder can be both individuals or organizations and institutions who your activity is influenced by or your activity being able to exert influence on – both positively and negatively, directly or indirectly. For example, a stakeholder of your activity can be the target group, activity team, partner organizations, donors, decision makers and politicians. One way to divide stakeholders is by categorizing them as allies, neutrals and opponents.

Why is it important to identify stakeholders? vIn general, a stakeholder analysis is crucial for the activity in terms of support, engagement and ownership. Furthermore, a stakeholder analysis can be helpful for your activity group by identifying needs and opportunities that you may not have been aware of before. For the activity itself finding its stakeholders often results in greater success and impact, as well as securing its relevance and sustainability.

Important questions to ask and answer during the analysis: • Who are the different stakeholders? • What is their need/interest in the activity? • How can they influence the activity? • How close are they to the activity and how important are they?

From idea to impact: A Manual on Activity and Project Management

A stakeholder analysis Method to be used Different analysis methods exist. A common approach is to map the influence and interest or influence of each stakeholder group on a matrix. You may now have a long list of people and organizations that are affected by your work. Some of these may have the power either to block your work or to advance it. Some may be interested in what you are doing; others may not care at all. Some stakeholders only need to be kept informed, while other needs to be managed closely depending on their power on your activity. For example, your dean is likely to have high power over your activity and high interest. Your family may have high interest, but are unlikely to hold power over it. • High power - interested people, institutions or organizations: these are the people you must fully engage and make the greatest efforts to satisfy. • High power - less interested people, institutions or organizations: put enough work in these stakeholders to keep them satisfied, but not so much that they become bored with your message. • Low power - interested people, institutions or organizations: keep these people adequately informed, and talk to them to ensure that no major issues are arising. These stakeholders can be very helpful with the detail of your activity. • Low power - less interested people, institutions or organizations: again, monitor these ones, but do not bore them with (excessive) communication.

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A stakeholder analysis Understand your stakeholders When you have identified and prioritized your stakeholders, it is crucial that you learn more about them and try to understand them and their motivation. Moreover, you need to determine what they need from you and what you need from them to move your activity forward. A very good way of answering these questions is to talk to your stakeholders directly – people are often quite open about their views, and asking people’s opinions is often the first step in building a successful relationship with them, by showing you’re interested in them.

From idea to impact: A Manual on Activity and Project Management

Formulating your Activity We have made a matrix that illustrates the different components of an activity. The example uses the story of the Lion King. We call it Scar’s Matrix. Below we explain to you how to write a long-term goal, immediate objectives, outputs, indicators and means of verification.

Long-term goal and immediate objectives At the end of the activity-planning-phase you have insight into the issue at hand, and you are ready to decide what the long-term goal for your activity should be. Your longterm goal (or overall objective) describes why your activity is being done – it is a vision based on insight into context and society. It should characterize the future and overall situation that the activity is expected to contribute to achieving – often in the long term. As students volunteering, with often limited time or access to funding, we can never achieve our long-term goals by ourselves. However, our activity will contribute to achieving this goal. Your immediate objective(s) describe the change you are looking for within your activity group – a change that you are able to influence. Your immediate objectives will often feed directly into the outputs/outcome of your activity.

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Formulating your Activity Outputs or results The outputs are defined as the results that can be guaranteed by the activity as a consequence of its actions. The outputs are the concrete results that you plan your actions to produce or deliver to achieve the immediate objective. The outputs are meant to be produced during different stages in the activity. The outcomes should be what “comes out” of the actions and something that is within your control of your activity. It is recommended to keep the amount of outputs limited to 2-5, in order to ensure the overview of the activity design and to keep realistic goals. However, be aware of including all necessary outputs required to achieve the immediate objective. Finally remember to keep your outputs precise and verifiable.

Indicators or success criteria Indicators or success criteria are important as they provide a basis for monitoring and evaluation. They are intended to indicate the extent to which objectives and results have been achieved. They should indicate a concrete ambition level – i.e. a “certain percentage of” or number – not just “more” or “increased”; they should be SMART.

SMART Criteria SMART is an acronym representing five points that your indicators should follow: • • • • •

Specific – target a specific area for improvement. Measurable – quantify -or at least suggest- an indicator of progress. Assignable – specify who will do it. Realistic – state what results can realistically be achieved, given available resources. Time-related – specify when the result(s) can/will be achieved.

Means of verifications Tells us where and how we will find our answers/data, tells us who will do it and for most of us, must be reasonable in terms of costs and other resources required.

From idea to impact: A Manual on Activity and Project Management

Formulating your Activity Proposal Formulating your activity proposal When you have a well-designed activity with clear objectives and success criteria, it is easy to present it to outsiders - this includes potential donors or sponsors. Donors will often receive applications for funding from many different organizations. Therefore, it is important to be able to describe your activity in a short end precise manner, with a focus on what results you are looking to achieve, or in other words: what impact on society will the donor get for their money, if they choose to support your activity? When fundraising it is very important that you recognise the potential donor as a stakeholder in your activity. You should always be aware of the funding criteria that a donor has, and adjust your application to match. Fundraising and donor management goes beyond this manual, and we advise you to seek out other resources on the topic, or contact relevant IFMSA NMOs members.

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Monitoring and evaluation Monitoring and evaluation (M&E) of an activity is important to steer and improve an activity, to maintain high activity standards, encourage reassessment and continual improvement for future activities and determine the extent to which the activity has met expectations. A good M&E plan is therefore essential for a good activity. The indicators of the activity, e.g. in terms of SMART indicator, are the heart of the monitoring and the activities indicators will be used as measures for both monitoring and evaluation. To make it easier to measure a potential change it can be useful to start the activity period with creation of a baseline. Many donors make stringent demands for documentation that the activity implemented does in fact produce the benefits that were promised when the funds were applied for. Furthermore, a good M&E will increase the possibilities of obtaining funds for new interventions.

Monitoring: Monitoring can be defined as an on-going and systematic check upon the actions and outputs. Monitoring is something that should be done during the whole activity period and not just in the end. In order to facilitate monitoring and avoid overlooking something, it can be helpful to create a monitoring plan. In this process the team should consider the following: • Have our indicators been formulated with sufficient accuracy, or is there a need for further definition? • What is our baseline? • How and from where should data be gathered? • How often do we monitor?

Evaluation: Evaluation can be defined as a systematic examination of an activity’s achievements compared to its planned objectives and expected outputs. An evaluation is done at the end of the activity. A good evaluation could include the following criteria: • Relevance: The extent to which the objective of an activity conforms to the target group’s needs, as well as to national and stakeholder’s strategies. • Efficiency: A measure of the extent to which optimal value for money has been obtained in the spending of activity funds. • Effectiveness: The degree to which the activity has succeeded in meeting its objectives. • Impact: The lasting changes – positive as well as negative, planned as well as unplanned – arising from the activity.

From idea to impact: A Manual on Activity and Project Management

Tools for monitoring and Evaluation How to SWOT When you have a activity running or a planned activity, but need a structured tool to monitor or evaluate a SWOT and a TOWS framework can be used. SWOT is an abbreviation for Strength, Weaknesses, Opportunities, and Threats. It collects internal and external factors relating to the activity, that the team members should know about, and use in a strategic fashion. Throughout the text it is assumed that the SWOT is used for activity evaluation, but it can easily be used to evaluate an organization, a program or a campaign as well. SWOT is only a snapshot of the organization and its surroundings. It is recommended that the SWOT is revisited and updated frequently.

The roadmap The easiest way to eat an elephant is one bite at a time. Using this analogy, you should focus on the subparts of the SWOT. The roadmap for a successful SWOT analysis;

1. Internal factors, using the “objective-resource-matrix” a. Strength b. Weaknesses 2.

External factors, using PESTLE and Impact-Grid a. Opportunities b. Threats

3. Setup the SWOT framework 4.

Do the TOWS analysis

Even though there seem to be an endless number of elements, you will find that only a limited few are really important to the activity. The aim is to identify these limited few.

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Tools for monitoring and Evaluation Internal strengths and weaknesses We start by defining: -

A Strength is a resource necessary to reach one or more objectives A Weakness is the lack of a resource necessary to reach one or more objectives

Resources include all assets, capabilities, processes, information, knowledge etc. controlled by the activity team or organization, necessary to carry out the activity. One possible way of identifying Strengths and Weaknesses is by using a “resource-objectivematrix”. From your activity locate a series of operational objectives necessary to reach the main objective. Next identify what internal resources are necessary to meet that objective. It is helpful to illustrate it graphically in the following way:

In the above example the activity lacks resource 3, which is crucial for reaching all stated objectives. This constitutes a weakness to the organization. On the other hand, resource 2 is crucial for all objectives, and it is thus strength to the organization that it holds this resource.

External opportunities and threats Turning to the external factors we again start by defining; -

An Opportunity is an external factor that might help reaching one or more objectives A Threat is an external factor that might prevent reaching one or more objectives

These definitions can easily be used on the stakeholder analysis presented above, but to extend beyond stakeholders and scan the environment in an analytical fashion, it can be advantageous to use the PESTLE framework. This also helps to ensure that everything has been considered.

From idea to impact: A Manual on Activity and Project Management

Tools for monitoring and Evaluation PESTLE PESTLE is a mnemonic of elements, which constitutes broad sources of opportunities, and threats that should be considered. The elements are

P E S T L E

olitical factors

conomic factors ocial factors echnological factors

egal factors nvironmental factors

Once these factors have been considered, use an impact grid to identify those external factors that should be included in the SWOT framework. An impact grid evaluates factors along two dimensions, (1) the probability that the event which might affect the activity actually realizes, and (2) the impact of the event on the activity. The model is a bi-matrix which can be illustrated as follows:

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Tools for monitoring and Evaluation

Only those events ending up in the “take-action” cell should be included in the SWOT framework. Bear in mind those possible opportunities and threats should be evaluated in separate grids Now you have all the elements, and are ready to fill in the SWOT matrix. Below is an example of a graphical representation of a SWOT framework.

From idea to impact: A Manual on Activity and Project Management

Strategic actions – How to TOWS By doing a SWOT analysis you have identified internal and external factors that influence your activity in advantageous and disadvantageous ways. But how do you move on from here? How do you utilize your new knowledge? The answer is the TOWS. It takes the SWOT and turns it upside down, and forces one to make combinations and come up with strategic actions to use in the activity.

This framework allows you to combine the elements of the SWOT in a way that fosters strategic actions, and help the organization in succeeding or mitigating imminent threats. SO-Actions: are combinations of the internal strengths with the external opportunities. They represent some low hanging fruits to the organization,that should be utilized. WO – Actions: are suggestions to how the organization uses the opportunities that is sees to mitigate or strengthen the internal structure. ST – Actions: these are the risk management actions, where the organization finds a way to use its internal strength to eliminate threats. This is really the “take-action” part from the impact grid. WT – Actions: these are more monitoring actions, in which the organization makes sure that its internal weaknesses does not create any external threats to them or the activity. Again it is important to state that since TOWS is based on SWOT, it too is context specific and a snapshot. Whenever the SWOT changes, so should the TOWS.

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IFMSA Programs All of the activities, apart from changing our local and national perspectives, belong to the international family of initiatives - aiming to fulfill the “Think globally act locally” vision of IFMSA. That is why Programs have been created - in order to bring all of us our goals, expectations, successes and passion together, in order to make them even greater and to see, how big of an impact we, as the Federation, have on the world. IFMSA Programs address problems within a specific field that we as medical students and global health advocates stand up for while connecting local, national and international activities and opportunities that contribute to the final outcome. More about Programs you can learn in the Programs Toolkit. Things to help you while enrolling your activity into Programs:

• Don’t forget to be “SMART” for the objectives. • Target groups and Beneficiaries (examples). • Always prepare a good evaluation method first, including “pre activity” questions if possible. • Make a strong problem statement based on evidence when possible. • Get to know your Program, use manuals, contact the Program Coordinator. • Don’t forget to report your activities after the enrollment. • After evaluation and enrolling process share your feedbacks and improve your activity with your PC • Contact the activity coordinators of similar activities in different NMOs through your Program Coordinator or Activities Database.

From idea to impact: A Manual on Activity and Project Management

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