Document Type

Journal Article

Publication Date



Journal of Health Diplomacy






The current picture of global health diplomacy (GHD) is one of increasing complexity, with multiple actors striving for multiple objectives, using a multitude of strategies and activities. Analysis and documentation of GHD practice is urgently needed to help identify the opportunities GHD provides for jointly improving global health and international relations, as well as possible unintended consequences. Systematic analysis of GHD practice is challenging without a conceptual framework. We identified a Theory of Change approach as one way to conceptualize GHD practice and potential impacts that could also depict its complexity and identify relationships and pathways for measuring success. We hypothesized that an implicit ToC underlying GHD practice existed, that could be identified and made explicit. In this paper, we develop a template ToC for GHD based on existing literature. We discuss the concepts and methods used to develop this “implicit” ToC template for GHD, and use the case of US-Myanmar relations to test the ToC against an example of real practice. We conclude with a discussion of how a ToC approach can: provide clarity on the complex relationships in GHD; help articulate desired outcomes for GHD; and, systematically capture contextual factors, stakeholder motivations, and contributions to GHD objectives. We argue that this single case of making an explicit ToC for GHD demonstrates the potential for developing a more generally relevant ToC for future GHD efforts. Finally, we propose three immediate ways in which the ToC approach could contribute to future GHD practice and assessment.


Reproduced with permission of GHD-NET. Journal of Health Diplomacy.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Open Access