Systemic Approach

Systemic approach

The systemic approach is a methodology for tackling water, sanitation and hygiene (WASH) challenges in primary schools and health care facilities not connected to functional water supply systems. It combines technology, management, monitoring and behaviour change concepts into well-designed interventions oriented towards rethinking the entire WASH system and aimed at achieving systemic change.

The systemic approach is an output of the hands4health project. The development, implementation and impact evaluation of this approach will be carried out within the project implementation period. The main steps for the development of the systemic approach include the: 

  • review of existing tools, approaches and platforms, in order to identify current gaps and opportunities for synergies; 
  • development of the design brief for the systemic approach;
  • compilation of a catalogue of interventions;
  • identification of indicators supporting the choice of the most appropriate combination of interventions;  
  • development of the compendium and decision support tool.

The systemic approach takes into consideration the needs of users and implementers in a specific context, aiming at making WASH interventions more effective and sustainable. It guides the user through different existing tools. The latter, if used in a proper combination, enable the user to: (i) Identify the main challenges around the target system, (ii) Understand their root causes and (iii) Provide support/guidance to decision-making in different domains while improving sustainability.


So far, the systemic approach comprises 5 interconnected domains:

The development of the systemic approach is an ongoing process – the domains are being further shaped, as are the identified tools, their combination and the potential gaps. The systemic approach is also closely intertwined with the Theory of Change process (learn more about it here).

The concepts, methods and evidence will be shared to maximise the outreach and uptake. The plan is to publish them through an open knowledge-sharing platform, combining designs, methods, videos and tools under Creative Common Licences and sharing evidence and experiences from the cases. The platform is also meant for establishing new partnerships, and will be designed in a format that allows large numbers of users and developers to take advantage.

Do you already have experience in that? If you want to provide any suggestions and/or exchange on this topic, feel free to contact us.