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Formulating the goals is a key step in the development of a programme. A goal is the positive change that would come about as a result of successful implementation of the programme. It represents the ultimate outcome that we want to achieve. Multiple goals can be formulated to cover different parts of the programmes. Once the goals have been established, the inputs and activities required to reach these goals need to be determined. A theory of change or logic model can help in visualising the steps leading to the desired outcomes.

A simple diagram with an arrow indicating the transition from programme goals to operational SMART objectives.

A detailed flowchart outlining the pathway from inputs to impact in a school eye health program. Inputs include financing, local eye care providers, government ownership, trained personnel, material equipment, and health promotion activities. Activities involve partnerships, inclusion in insurance plans, detailed examinations, primary screening, and health promotion. Outputs include available clinics, detection of eye conditions, and provision of spectacles. Outcomes focus on access to quality eye care and children wearing their spectacles. The impact is improved quality of life, academic achievement, and life opportunities.

For each outcome, a SMART objective must be formulated: Specific, Measurable, Attainable, Relevant and Time-based. For example:

  • To screen XX children aged 7-15 years in one year;
  • To dispense XX spectacles to children, % of which will be ready-made spectacles;
  • To refer XX children to hospital for treatment (examples from CEHJ)

Assessing the gaps between the current situation and the ‘ideal’ situation can help formulate the objectives.

Potential barriers to the programme should also be considered and assessed when planning the programme.

Qualitative research such as focus groups or key informant interviews can be useful to identify local barriers if a lack of information or local contextual understanding exists.

A simple diagram showing the relationship between desired outcome and current situation, with the gap and objective represented further down the flowchart.

 

Example: Girls do not like wearing glasses. School nurses are overloaded.

Desired outcome Current situation Objective Potential barrier Possible solutions
All children wear their spectacles Only 30% of children wear their spectacles Obtain 70% spectacle wear rate at 6-month follow-up Girls don’t wear their spectacles because they are teased – Let the young girls choose their frames with a friend

– Targeted education campaign in schools