1. Root Cause Analysis
Identifying critical campaign challenges and diagnosing bottlenecks

2. Root Cause Analysis Agenda Introduction to Root Cause Analysis (RCA)
Keys steps for conducting root cause analyses
Assessing potential impact and actionability of addressing root causes
ROOT CAUSE ANALYSIS TOOLKIT

3. Introduction to Root Cause Analysis
ROOT CAUSE ANALYSIS TOOLKIT

4. What is Root Cause Analysis?
A problem-solving method to identify underlying causes of key process challenges
A tool for learning from observed bottlenecks and mitigating them in the future & learning from successes and promoting best practices
A learning process to determine what happened, why it happened, and what should be done to improve it
An iterative approach – both hypothesis generating and confirming
Root causes
Causal factors
Key Challenge
Why?
Why?
Why?
ROOT CAUSE ANALYSIS TOOLKIT

5. Learning objectives
By the end of this module, users should be able to:
Understand and describe a common approach to identifying challenges or bottlenecks that may be limiting to the effectiveness of a campaign.
Perform a root cause analysis to determine what’s causing the challenge or bottleneck.
Assess and prioritize root cause(s) that are actionable.
ROOT CAUSE ANALYSIS TOOLKIT

6. Root Cause Analysis Key Steps
ROOT CAUSE ANALYSIS TOOLKIT

7. Overview of the key RCA steps
Step 1: Identify issues or bottlenecks
Step 2: Define the key problem or challenge (or success)
Step 3: Chart the RCA diagram
Step 4: Validate the RCA through iterative and participatory processes
Step 5: Identify the most impactful and actionable root causes
ROOT CAUSE ANALYSIS TOOLKIT

8. STEP 01 | Identify campaign issues or bottlenecks
Brainstorm observed challenges, issues, or bottlenecks
Categorize identified challenges into domains to help recognize where challenges are concentrated
Draw on multiple sources of data:
Planning
Funding
Routine and non-routine sources
Human resources
Observations from supervision visits
Disease/epidemiological context
Document review
Logistics management
Key informant interviews and/or focus groups
Data/monitoring and evaluation
Leadership, management, and coordination
Intervention characteristics/design
Population and patient characteristics
Advocacy and social mobilization
Contextual factors
Social determinants
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9. STEP 02 | Define the key problem or challenge (or success)
Examine your list of challenges – which one is most closely related to the desired outcome or impact? For example:
If measles outbreaks continue to occur after a measles campaign...
Potential challenge statement: Measles outbreaks continue to occur
If campaign coverage is lower than expected...
Potential challenge statement: Low coverage
Tips and Considerations
Use plain language to ensure clear articulation and understanding of the challenge (or success) by the evaluation team and other relevant stakeholders
If multiple challenge statements are identified, some will likely fall along the causal pathway between root cause and overall challenge
Where there are multiple challenges, consider which are most actionable to address
Although challenges are most often the focus of RCA, examining successes as well can facilitate learning and sharing of best practices
ROOT CAUSE ANALYSIS TOOLKIT

10. STEP 03 | Chart the RCA diagram
RCA usually involves a visual schematic to document assumed causal chains; flow charts work well
Probes such as ‘Who, What, Where, When, and How’ questions help in assessing challenges
Who were the stakeholders involved?
What information was available to key stakeholders?
Where did the challenge or problem happen?
How widespread is the challenge or problem? How well were procedures carried out?
‘5 Whys’ technique for getting at the root cause
Tips and Considerations
Work backwards from the prioritized challenge through assumed causal factors to arrive at most likely root cause
RCA often performed as a group exercise; drawing on diverse perspectives strengthens the RCA
Charting the RCA helps identify evidence gaps and where additional validation is needed
Put everything down on paper first, then investigate and iterate further. Messy is okay!
Transfer draft RCA to PowerPoint for sharing digitally; use for further iteration and development
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11. EXAMPLE RCA: Human African Trypanosomiasis Elimination Initiative
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12. STEP 04 | Validate the RCA through iterative and participatory processes
RCA benefits from iteration – update and refine your RCA as additional data is collected and analyzed
A participatory process helps confirm assumptions and linkages in the RCA, causal factors, and the key challenges
A participatory workshop is a low-cost, efficient approach to RCA validation
Engage a variety of stakeholders with diverse perspectives, such as: Ministry of Health officials, district health planners, program managers, implementers, technical partners, and donors
Reaching consensus on root cause(s) is critical before moving onto designing solutions/interventions
Tips and Considerations
Are there other types of data that need to be collected? Identify gaps and make plans for additional data collection
Consider what contextual and/or environmental factors may be affecting the causal chain
Design choices such as color-coded boxes and solid vs. dotted lines can help convey relationships
Developing a draft RCA prior to the stakeholder workshop helps validate the evaluation team’s analyses with stakeholders and uncover additional supporting information
See Participatory Workshop Design Considerations in RCA Toolkit for guidance on carrying out the workshop
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13. STEP 05 | Identify most impactful and actionable root causes
Identifying actionable and impactful root causes is a critical step prior to intervention design
Common considerations for assessing actionability and impact are summarized
Feedback on actionability and impact can also be gathered through a participatory workshop
Use a 2x2 table to organize which root causes are most actionable, and if addressed, likely to drive the most impact
Root causes
Low potential impact
High potential impact
Low actionability
High actionability
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14. Assessing potential impact and actionability of addressing root causes
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15. Considerations to assess potential impact and actionability of addressing root causes
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16. ROOT CAUSE ANALYSIS TOOLKIT

17. Determinants of RCA usefulness
Strong engagement with stakeholders – key actions must be bought into the RCA causal pathway
RCA strikes the right tone in framing challenges and successes
A policy or program window exists within which changes can be enacted and adopted
RCA is accompanied by actionable recommendations to help frame further discussion on intervention design
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18. Thank you!