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SP 2026-2031
Theory of Change
SP Teoria del cambio
  • The overarching Theory of Change (ToC) for the PAHO Strategic Plan 2026–2031 offers a strategic vision of how the Organization will contribute to improving health and well-being throughout the Region of the Americas. It reflects how the actions of PASB, in collaboration with Member States and partners, are interlinked and mutually reinforcing in their pursuit of health outcomes. Anchored in results-based management principles, the ToC connects the Organization’s core functions with the broader goal of achieving the highest attainable standard of health for all.
  • A clear reflection of the health-related challenges facing the Region, the problem to be addressed underpins the ToC. Persistent structural barriers, combined with slow progress in transforming health systems, and the intersection of social, environmental, epidemiological, and demographic factors, have left many populations in situations of vulnerability and health gains at risk. Meanwhile, new health threats continue to emerge, often compounding long-standing health challenges and unfinished health agendas.
  • In response, PASB contributes to the collective achievement of outcomes and impacts, through the delivery of outputs—driven by accelerators (see section above)—to enable, catalyze, and influence the joint action of Member States and partners in achieving targeted results. These represent the Organization’s pathway of change, carried out through its six core functions. Through these channels, PASB acts as a convener, technical health leader, and catalyst, strengthening Member States’ ability to address both immediate health priorities and longer-term system transformations.
  • Achieving the ambitious targets of the Strategic Plan requires strong and sustained commitment from Member States and partners. This includes Member States’ commitment to and upholding of internationally agreed health-related mandates and resolutions, according to national contexts and laws, including this Plan, and integrating these commitments into national frameworks, strategies, laws, and plans. The sustained allocation of adequate resources by both Member States and partners as well as the fostering of cross-sectoral collaboration and meaningful engagement with civil society and communities in shaping and delivering public health interventions are key.
  • The 10 outcomes within Strategic Objectives 1 to 4, which represent the medium-term results that define the Strategic Plan’s success, are interdependent. They reflect a comprehensive and integrated approach to addressing the Region’s most pressing public health needs. Across all strategic objectives, achieving health for all serves as the guiding principle, ensuring it is systematically embedded in policies, programs, and services.
  • To effectively deliver on this vision, PASB must also reinforce its internal systems and institutional capabilities (reflected under Strategic Objective 5). Key enablers include strengthening the capacity at the country and regional level, securing sustainable and flexible financing, and leveraging modernization, digital transformation, and innovation to enhance decision-making and operational efficiency. Building an organizational culture that values respect, and promoting a strong ethic of efficiency, transparency, and accountability, are equally essential for driving impact and maintaining PAHO’s credibility as a trusted partner in health.
  • The achievement of these targeted results rests on a set of critical assumptions, external factors or conditions, which can impact the achievement of the outcomes and impact results in the SP26–31. Member States and partners must remain committed to internationally and regionally agreed targets, while demonstrating readiness and willingness to adopt the policies, institutional reforms, and operational adjustments needed to advance the acceleration agenda. Sufficient and sustained resources must be available to address health priorities, and major unforeseen events must not cause significant structural or operational disruptions, taking focus away from long-term health priorities.