Theory of Change
Our Purpose
Making safe surgery possible, so kids can
make anything possible
Every child deserves the chance to live life to the full. To go to school, to play with their friends, to grow up and take their best shot at making their dreams come true.
But for too many children around the world, that’s not the reality. A broken leg can mean a lifetime of disability. A hernia can make a child’s life a misery. A blocked gut can kill a newborn baby.
The answer is safe and timely surgery, but in many countries that’s just not an option. Hospitals don’t have enough space, or the right equipment. Surgeons have to operate by torchlight, in crumbling buildings, with adultsized tools. Too often they can’t get the right training to carry out the specialised operations children need.
Surgery for children is an essential part of a health system that works. But it hasn’t had the recognition or funding it needs. That’s why we’re here – to fill this gap.
By supporting local surgical teams, wherever they need us, we can help change this for good. We can stop children from dying needlessly and having their childhoods stolen by treatable conditions.
Investing in children’s surgery is an investment in the future. Children’s futures. Communities’ futures. Countries’ futures. It’s a cost-effective way to make a truly remarkable impact.
All over the world, surgical teams are working in unbelievably tough conditions to save and change lives. We can support them to make safe surgery possible, so kids can make anything possible.
Our Value Proposition
→ We are the only organisation focused entirely on strengthening local surgical care for children.
→ We are experts at doing this sustainably: empowering local professionals and strengthening health systems for the long-term.
→ Building surgical services in the world’s most challenging environments is difficult. We are trusted to do this on time & within budget in many countries & hospitals. We have an unrivalled track record of success.
→ We create sector-leading returns on investment for donors.
The Problem
Globally, most children can’t get an operation when they need it. These children die preventable deaths or live with lifelong disability.
Our Mission
Our mission is to make safe surgery possible for every child.
Our Vision
Our vision is that every child gets the chance to grow up and live their life to the full.
Theory of Change
Our work is grounded in a robust theory of change and model of how our work drives the change that is needed to make safe surgery possible for every child.
The Need The Work The Results
The Problem We Face
Globally most children can’t get an operation when they need it. These children die preventable deaths or live with lifelong disability.
The People We Help
We help children in lowresource settings access high quality care.
The Reason We Exist
Every child deserves a chance in life, to go to school, to play with friends, to realise their potential.
Surgery makes this possible.
Our Mission
Make safe surgery possible for every child.
Our Big Idea
Train and equip local teams to care for their nation’s children.
What We Need
We need funding to make this possible.
What We do
Build & equip state-of-the-art, solar powered operating rooms.
Fund training for local surgical teams.
Support local engineers to maintain the equipment.
Advocate for children’s right to safe surgery.
Who We Work With
Ministries of Health to direct resources.
Local hospitals & clinicians to run the units.
Local Surgical Colleges to deliver training.
Academic Institutions to monitor & evaluate.
What Will Happen
Transformative growth to build on proven success.
What We Will Measure
No. of operating rooms opened. No. of solar systems installed. No. of trainings supported. Engagement level in policy activities.
Short-Term Outcome
We aim to have increased capacity for high quality care by 70,000 operations a year by the end of 2027.
Long-Term Outcomes
We aim to have increased capacity for high quality care to reach a global target of 500,000 operations a year by 2030.
10-Year Target
By 2035, we aim to have created annual capacity for one million children to access high quality, sustainable and safe surgery around the world.
Our Vision
Our vision is that every child gets the chance to grow up and live their life to the full.
Our Model to Deliver
We have built an operating model which ensures every member of our team is engaged in a virtuous cycle to deliver this life saving work. Our operating model is underpinned by the core requirements of a well run organisation.
Our Operating Model
Our measures
We have identified the outputs and outcomes that we expect should result from the work that we do, and we have identified measures to help us measure progress in achieving these.
The work that we do
The Outputs of this work
Build & equip state of the art solar powered operating rooms
• Infrastructure installations
• Solar Installations
Fund training for local surgical teams
• Scholars trained
• Up to date materials in online training tools
• Clinicians using online training tools
• DHTP programme events
• Locally relevant training initiatives and courses
• Increased capacity for safe surgery
• More facilities have trained staff
Support local engineers to maintain the equipment
• Trained engineers
• Toolkits provided to each site
Advocate for children’s right to safe surgery
The Outcomes that will result
Measures / Evidence
• Increased capacity for safe surgery
• More children in reach of surgical facilities
• Less disruption to surgery from power outages
• Safer surgery
• Number of ORs / Solar
• % in budget / time
• Capacity created
• Impact stories
• Geographical access mapping
• Demographic / clinical data from hospitals
• Safer surgery
• Volume increases
• Increased ability to conduct complex surgery
• Increased applicants to paediatric surgical fellowships
• Improved quality of training
• Number of training opportunities
• No of graduates
• % sites with paediatric surgeon
• No of PAPSEP users
• % graduates retained in country
• Capacity created
• Impact Stories
• Increased capacity for safe surgery
• Improvements in surgical safety
• Longevity of impact
• Reduced downtime for equipment
• Advocacy campaigns
• Publications and other written outputs
• Stakeholder engagements
• Parliamentary Group
• More decision makers fund children’s surgery
• Governments prioritise funding children’s surgery reducing dependence on aid
• Trust & credibility
• Wider networks
• Number of biomeds trained
• % Sites with biomed resource
• % Sites surveyed each year
• Maintenance backlog
• Maintenance visits
• Volume metrics e.g. MP contacts / champions / publications
• Campaign statistics
• Number of invitations to submit evidence
• Number of situational analyses and policy briefs
• Number of successful grant applications
Ripple effects
Surgery saves kids’ lives. It also gets them back to school, back on the football pitch, back with their friends, back on track for their unique future. A future where anything is possible.
The impact of supporting paediatric surgery has a powerful ripple effect. It doesn’t just help the child; the benefits are felt by the entire family, community, and country.
When a child recovers swiftly, parents aren’t forced out of work for extended periods. Siblings don’t have to be taken out of school to take on household duties, ensuring their own education continues. The family avoids the financial ruin and potential ostracisation that crippling illness can bring.
Investing in children’s surgery is one of the most costeffective healthcare interventions, protecting their economic future and building stronger communities.
The investment in children’s surgery represents far more than immediate health gains. For countries, it is a crucial driver of economic growth and societal stability. By saving and transforming children’s lives, we protect decades of potential economic productivity.
It’s an investment in the future, a truly remarkable impact.
