Leading Transformational Change: A Framework for PEPFAR Teams

Change is a constant state of being for PEPFAR teams. Changes may be large, such as a major shift in policy direction from Washington, or they may be small, such the integration of new team members into the TWG. Regardless of the scope of change, transitions can be particularly tricky to lead in the difficult environments in which PEPFAR teams often operate.

Kotter’s model offers valuable insights for PEPFAR teams dealing with change. We are not suggesting that transformational change becomes easy or automatic when using Kotter’s framework. Instead, we hope that change in your country will be facilitated by applying some of the lessons presented in a hypothetical account of one PEPFAR team’s use of the Kotter model.

In Abeona, PEPFAR teams had always operated as the main agents of change. Yet they were now being told to shift the ownership of their programming in a fundamental way. Although the change was mandated, like all transitions, it was risky and encountered resistance. So how can a PEPFAR coordinator faced with a policy change from DC help her/his team achieve success? Let’s turn back to Abeona and see how they used the model.

To help guide successful change, noted Harvard Business School professor and practitioner John Kotter has developed an eight-step model for leading transformation in organizations. His model emphasizes a strategic approach to integrating changes into an existing system. He also stresses the need for accomplishing the critical first four steps of change sequentially, before moving on to the second half of the process.

Step I: Create a Sense of Urgency

Examine realities and identify and discuss potential crises or major opportunities
Appeal to the hearts and minds of your team

Since everyone in Abeona knew that local staff comprised the backbone of the team’s institutional memory, and that they possessed unparalleled connections with local government officials, the PEPFAR coordinator highlighted the benefits that the program would enjoy by giving more control to local staff. By tangibly illustrating how the program would profit from the change, the coordinator helped to build a sense of urgency among the team.

A parallel strategy the PEPFAR coordinator also used was to demonstrate the harm that would befall the program if the mandated change didn’t occur. In Abeona, local staff formed a significant portion of the team’s composition, but had come to feel increasingly disgruntled by their lack of authority. It was clear that both program outcomes and overall job satisfaction would suffer without immediate change. Logic alone, however, wasn’t enough to establish a sense of urgency in Abeona. Key team members also needed to connect what mattered most to them with the need for change; they needed to feel at an emotional level that the change was consistent with their values. Thus, in Abeona, the PEPFAR coordinator showed how the change would promote one of the basic principles of development: sustainability. By appealing to both the hearts and minds of the team, the PEPFAR coordinator helped cement a fundamental agreement among her colleagues regarding the need for a different kind of approach.

Step II: Form a Guiding Coalition

Assemble a well-functioning team with the power, commitment, knowledge, and credibility to champion the change

In Abeona, agency heads from USAID, CDC, DOD and the Peace Corps were prepared to assume leadership responsibilities for transforming the program from USG to local ownership. Both as individuals and as a group, the coalition had the right mix of knowledge, power, and authority to sway their respective agencies back home, as well as their own staff on the ground, about the specific merits of the proposed change. Agency heads, in turn, identified local senior staff who could be a part of the coalition; while local staff didn’t have official decision-making power yet, they did hold great informal influence and would be largely responsible for implementing the change effort. Finally, given the scope of the change and its impact on relations between Embassy and local government officials, mission leadership – in the form of the DCM – also agreed to participate in the guiding coalition.

Individually, each member of the nascent coalition had the motivation, subject matter expertise, and influence to succeed. Yet it was also vital that this diverse group of agency heads, local senior staff, and the Ambassador and DCM work well as a group. Mutual trust and effective communication are essential foundations for any team, but the smooth functioning of the PEPFAR guiding coalition in Abeona was especially important because it would demonstrate to others – both inside and outside the USG – how cooperation was necessary for the larger effort to work. So, the coordinator invested in trust-building activities, such as casual get-togethers and candid discussions at team meetings. She also lowered barriers to effective collaboration by developing meeting agendas and coordinating follow-through tasks, which went a long way to ensuring the smooth functioning of the guiding coalition.

Step III: Establish a Vision for the Change Process

Craft a vision that instills inspiration and reminds stakeholders that the change is positive, worthwhile, and consistent with the overall effort
Make your vision easy to understand, so that it can serve as a lens through which decisions and actions are taken

When the Abeona coalition asked itself “what is the better tomorrow that our change will provide, and how will that be accomplished?” they determined that the vision would be “to optimize contributions of the local staff in pursuit of country ownership and sustainability.”

Such a statement had an element of realistic aspiration – it was attainable, but it also caused the group to creatively stretch to achieve the change. In the past, local staff hadn’t been well-utilized when it came to creating ongoing, sustainable dialog with local government; in order to achieve the vision, systems and processes would need to be drastically changed. While this was a stretch, the capacity and experience of the local senior leaders made it well within reach.

The vision was also effective because it struck at fundamental beliefs that were central to the change. Specifically, the vision reflected the Abeona team value that human resources were the most valuable asset in the county (particularly in service of building partnerships with local government), and that local staff would make the best decisions regarding the dispersal of USG resources.

Step IV: Communicate the Vision

Continuously and persuasively communicate the vision to the relevant external and internal stakeholders
Openly address team members’ concerns about the change process – the most effective strategies are a product of collaborative dialogue

In transitioning to greater local ownership of HIV/AIDS programs, our PEPFAR team strove to convey its goal of increased local ownership at every opportunity. The coalition knew that other responsibilities and distractions were competing with the message they wanted to send team members, so every chance they got – in PEPFAR country team meetings, agency staff meetings, and technical working groups – they repeated the vision. Agency leads reached out to their home offices to tell them about the goal, and the appropriate staff communicated the vision to local government partners, implementing partners, and beneficiaries.

In addition to affirmatively presenting the vision, coalition leaders took time to listen to and answer questions from other members of the team. Change always evokes anxiety, and leadership recognized that honest consideration of each member’s fears could serve as a check on the realism of the goal while also helping to increase buy-in. By knowing what people are thinking and feeling, the guiding coalition ensured that their message capitalized on team members’ hopes while getting to the heart of any emotional obstacles.

Important Note: Systematically building support for institutional change – as in Steps I through IV above – is often the most difficult part of the transformation process and in the rush to action these steps can be easily overlooked. Skipping or rushing through these steps seriously obstructs the change process. A stalled change effort may be revived if the teams returns to and properly addresses these steps. If not addressed the change process is quite likely to fail. Thus it is imperative that the first four steps get the strategic and systematic attention required for success. Even after a coalition of support has been established around a joint vision, that vision must still be implemented using the last four of Kotter’s organizational steps, outlined below.

Step V: Empower Others on the Team to Act

Remove obstacles to change by creating structures that enable the team’s movement toward its goal
Encourage risk-taking, and ensure that people are recognized and rewarded for their achievements

Elevating the TWG to become a true center of decision making helped give local staff primary responsibility for program prioritization and resource allocation. While ceding power and accountability to those not previously tasked with such responsibilities presented a risk, the guiding coalition encouraged the team as a whole to make such moves in order to achieve a departure from their former ways of operating. Committed to continuous learning and professional growth the coordinator arranged for collaboration skills-building interventions to occur in order to position the local staff for optimal success. Those sessions focused on strengthening communication, decision-making, conflict management, problem solving, strategic thinking, etc. At the end of each session the staff developed learning application learning plans and established buddy support partnerships. During this stage, the PEPFAR coordinator and leadership also made sure to publicly emphasize positive public feedback and reward change for teamwork and individual accomplishments.

Step VI: Create Short-Term Wins

Plan for systematic, targeted, unambiguous victories to build on credibility and momentum

In Abeona, not only was the TWG led by local staff, this group was praised both internally and publically for their success in setting program budgets and undertaking broad-based stakeholder consultations. Externally, local staff presented materials and program proposals to local government officials, and negotiated plans with implementing partners – a signal to both the internal team and to outsiders that the new approach was working. By actively looking for ways to publicly demonstrate the merits of the new approach, the guiding coalition built credibility and enthusiasm for the change.

Step VII: Build on the Momentum Created by the Change

Drive change deeper into your organization
Evaluate progress during every stage of change so that you can continue to improve your approach

Despite team Abeona’s considerable achievements in the first six steps of Kotter’s model, continued success meant not declaring victory early. The group continued to consider bureaucratic mechanisms to support local staff in assuming increased responsibility, and they also determined how local staff might better leverage existing relationships with government officials to achieve a transfer to local ownership. The team kept up the urgency, was flexible, and was constantly on the lookout for ways to reinvigorate the transformation process. Recognizing the value of documenting lessons learned the TWG periodically paused to assess and document their progress, identify areas for improvement and creatively formulate strategies for making those improvements.

Step VIII: Institutionalize New Approaches

Make change stick by anchoring it in your team’s culture
Allow victories to become part of your story by repeating what you did, and how it made an impact
Document lessons learned

PEPFAR leaders in Abeona talked internally and externally about how the team changed as a result of their efforts to transfer the HIV/AIDS fight to local ownership. The role of the guiding coalition was included in the team operations manual, which was used in orienting new staff. In addition, as expat staff members transferred out of the country and new staff joined the team, remaining members of the guiding coalition repeated stories that reflected how the team had achieved what they did – and why it mattered. In this way, the successful transformation became a part of the organization’s history and culture, framing future efforts to deal with new challenges.

Conclusion

Change is a constant challenge in large organizations. Too frequently, teams adopt hasty and unplanned approaches to change that produce confusion at best, and significant organizational setbacks at worst. To successfully integrate change into existing processes, PEPFAR teams must thoughtfully address the human dynamics of the change process and creatively lead major transformations as the positive and productive force they can be.

The Kotter model offers a framework for an intentional approach to change. As is often the case with frameworks, the model itself is not difficult to comprehend. Instead, the challenge is to apply the model to real-work situations and begin to practice its approaches in pursuing transformational change.

How can PEPFAR teams do this? By paying continuous attention to communicating in a manner that is clear and inspirational. Remember that people are at the center of any change process: to secure their acceptance and alignment you must first reach their hearts. Help them feel, see and touch the better future that the change is designed to produce. By achieving the delicate balancing act of keeping your feet in today – and your eyes on tomorrow – you will transform not only the way your team works, but the lives you strive to improve.

Footnotes

This resource is a part of a series of articles created under the USAID-funded AIDSTAR project. The principles in these resources can be widely applied to a variety of contexts where different groups work together closely on a shared initiative or different teams within an organization need to work together more effectively.