Change Management in an HIVAIDS Research Project

Change Management in an HIV/AIDS Research Project
1
Change Management series 01
By
Joe Theu
Paper made in the Fulfilment of Capstone for the Masters’ degree in Business Administration
Aspen University
Supervisor
Prof. Kevin Chen
18 April 2016

2
Contents
Executive Summary....................................................................................................................................3
Acknowledgements .....................................................................................................................................6
Initial Problem/Opportunity Statement....................................................................................................7
Opportunity.................................................................................................................................................7
Scope issues..................................................................................................................................................8
High Level Overview of Deliverables to Sponsor or Project: .................................................................9
Anticipated Sponsor or Project Benefits...................................................................................................9
Introduction.................................................................................................................................................9
Research Question 1 .................................................................................................................................10
An analysis of the RP................................................................................................................................11
The External Environment ..................................................................................................................11
Threats ...............................................................................................................................................11
Opportunities: ...................................................................................................................................12
Stakeholder Analysis ................................................................................................................................13
Research Question 2 .................................................................................................................................15
Methodology..........................................................................................................................................15
Analysis..................................................................................................................................................15
Results....................................................................................................................................................15
Findings: ................................................................................................................................................17
Limitations.............................................................................................................................................20
Discussion ..............................................................................................................................................21
Recommendations.....................................................................................................................................22
Conclusion .................................................................................................................................................24
Proposed Change Implementation Plan .................................................................................................24
Lessons Learnt ..........................................................................................................................................26
References...................................................................................................................................................28
Appendix 1.................................................................................................................................................29

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Executive Summary
Introduction
Research in the era of the HIV/AIDS epidemic is ever dynamic. Scientists embarking on
a journey of a research topic that spans over a period of 3 years can anticipate numerous forces to
change their primary objectives along the way. We set out to analyze the effect of such forces on
a research project named here-in as RP designed to investigate effectiveness of a mixture of HIV
prevention strategies on reducing new infections in rural communities.
Methods
We used SWOT analysis and stakeholder analysis, questionnaires and group discussions
to analyze how these forces affect the RP strategy to change and how research employees
perceive the implementation of those changes.
Findings
We found several forces in the external environment of the RP that influence its strategy
of survival. The forces that threatened the RP were the emerging studies on HIV prevention and
care, the `new World Health Organization’s (WHO) recommendations on treatment and
prevention, new epidemics such as those of the Ebola and Zika viruses and the pressures from
the regulatory bodies such as the Data and Safety Monitoring Board(DSMB).
Research employees accepted (80%) and viewed the changes as necessary (90%). However,
research employees were split on how they perceived the introduction of the changes with half
agreeing with the process of introducing them while the other half not. Half the employees (50%)

4
felt that the changes directly affected them while 30% felt that the changes did not directly affect
them.
Several forms of resistance to change surfaced as described Hultman, K. (2016). Employees
made critical and fault finding statements at a rate (23.2%) when compared to (31.9%) positive
sentiments about the change. Critical statements included “the changes make staff look in-
efficient because of (management’s) poor planning”. Blaming and accusing statements were
made at a rate of 13% with statements such as “sometimes we change our plans, we are forced to
change our plans…we disappoint patients”. Ridiculing statements such as “work is increasing
the money is the same…” were made at a rate of 11.6%. Fear was demonstrated at a rate of
11.6% mainly pertaining to job insecurities. Sabotaging attitudes and those of withholding
suggestions and help were evident at the rate of 4.3% and 3% respectively.
Employee motivation remained almost the same before and after the changes. 60% of
employees remained very motivated before and after the changes while only 20% moved from
either being moderately motivated to being either being barely motivated or barely demotivated.
Recommendations
Research Projects need to analyze their external environment in-order to anticipate and to
respond to forces in their environment in-order to design and implement changes that are
necessary to make their research objectives viable. Research projects in the HIV/AIDS field such
as the RP need to avoid what Spector, B. (2013) calls “change implementation traps”.
Implementation traps are defined as “the application of appropriate change tools at inappropriate
points in the implementation process”. In general, Spector, B. (2013) cites the following steps in-
order to avoid implementation traps and to ensure effective change implementation:

5
Follow this order: “Shared Diagnosis 1-REDISIGN: roles, responsibilities relatioships.2. HELP:
training, mentoring, coaching. 3. PEOPLE CHANGE: assessment, promotion, replacement,
recruitment.4. SYSTEMS and STRUCTURES: reporting relationships, compensation,
information, measurement and control”.
Conclusion
The RP has several forces in its external environment which influence the viability of its
continued existence and ultimately alter its objectives in its quest to remain relevant. The RP
responds appropriately to these forces by implementing appropriate change. The RP has
successfully implemented its change process with an overall acceptance from its employees.
However, the RP has also fallen into “implementation traps” by implementing appropriate tools
of change at inappropriate stages. There are areas of improvement where the RP needs to work
on next time during implementation of change. These areas of improvement can be perhaps
addressed by following the recommendations suggested in this paper and the change
implementation plan also suggested in this paper. Lessons learnt from this survey can go a long
way in improving change management and acceptance in similar HIV research projects.

6
Acknowledgements
I would like to acknowledge all employees, the project coordinator for assisting me to
complete this paper. I also thank Onkgopotse Miller for endless support despite trying times.
Further thanks go to Yewo Theu for his unconditional support during this analysis. To you I say;
you are a Great son! To Vanessa Theu, my wife, I say; you gave me the encouragement to give it
a go at the MBA as you did on many other accomplishments. You are not here today to witness
this but I say all the glory be given to you. May your soul Rest in Peace!

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Initial Problem/Opportunity Statement
Background
The Research Project (RP) study is designed to test the hypothesis that applying
prevention measures in unison to neighborhoods will cost-effectively reduce new HIV
infections in those neighborhoods. This project is implemented by the Ministry of Health,
local partners and the international partners.
The Problem
The RP has implemented and continues to implement changes to its project so as
to align the project to the current developments in the field of HIV/AIDS management.
These changes have been to adopt the “test and treat” strategy that the World Health
Organization (WHO) is recommending for all countries. The outdated protocol which the
project currently uses relies on immunological staging (a form of differentiated criteria)
to determine the eligibility of HIV positive people on ART treatment. This call for change
has arisen upon the findings of the Temprano and most recently the START study that
found that delayed ART initiation led to more deaths compared to initiating ART at CD4
counts equal or greater than 500. It no longer makes sense to continue a research project
that uses the outdated protocol to pursue its research goals or questions. The findings of a
research of that kind would be irrelevant. This situation necessitates change.
Opportunity
While change is desired, it is not easy to implement large scale change to the
whole country without creating other problems. As a result of this realization, the RP
could be used as a pilot project to launch these changes in a “phased-out” approach rather
than in the “big-bang” approach. In a “big bang” approach, there is considerable risk

8
which the government could incur. Going through the “phased-out” approach through the
RP would minimize that risk. The risks arise in that some of these changes not only affect
the management of the epidemic but also the people managing the disease. When change
is introduced, a lot of things can be affected from patient care to staff management. “It is
not unusual for changes to raise project costs by 50% and sometimes even more”,
according to Stare, A. (2011). Cost, scope and schedule are usually affected during
change therefore, it is crucial to pay attention to how changes are implemented. An
opportunity exists within the RP to conduct an analysis of the change management
process that comes with this change introduction within the RP project. This will also
provide a better opportunity of learning to other HIV/AIDS organizations who are
affected by these inevitable changes that come as a result of external forces including the
evolving research world at large.
Scope issues –
In Scope
 The project will analyze the perception by employees of the processes so far used in
introduction of change in the RP organization.
 The impact on human resources such as acceptance or resistance to change, job
satisfaction or motivation.
Out of Scope
 The project will not analyze change in costs, scope, and schedule as this is beyond the
sponsor’s approval
 The project will not analyze in detail, the RP’s change plan.

9
High Level Overview of Deliverables to Sponsor or Project:
 Deliverable 1: Provide a report on changes in employee motivation.
 Deliverable 2: Provide a report on degree of acceptance or resistance, forms of resistance,
causes and possible steps and possible solutions to employee resistance.
 Deliverable 3: Produce a suggested change management template.
Sponsor Assistance Needed
1. Interview of employees and management
2. Access to non-confidential study documents
Anticipated Sponsor or Project Benefits
1. The sponsor will have an insight into the shortfalls and strengths from the way change is
implemented in the organization and possible ways on how change implementation could
be improved.
2. The sponsor will benefit from the lessons learnt that will be captured through this
project.
Introduction
In-order to examine change management at the RP, an internal and external analysis will
need to be conducted. We will conduct a qualitative analysis of the organization’s change
processes in response to the external environment. We will also conduct an internal and external
analysis of the organization broadly.
The focus will be specifically on how the RP responds to triggers of change and
implements change solutions to the organization. We specifically look at the employees’
perception of the steps taken to introduce change and therefore we will zone in at the reaction of

10
employees to those changes. This will therefore lead us to a focus on the acceptance or resistance
to the changes. Possible ways to mitigate the forms of resistance will be explored by searching
literature.
In-order to understand the root causes of this problems that will be elicited at the RP, we
will use group discussions, questionnaires and literature review.
Both qualitative and quantitative data analysis techniques will be utilized to fully understand the
issues around the introduction of change in the organization. In analyzing quantitative data,
statistical methods will be used to make meaning of the data. When analyzing data through the
use qualitative analysis, content analysis will be used to gain meaning of the themes that are
arising from the data.
Content analysis is as described by Libweb (2016) “a procedure for the categorization of
verbal or behavioral data, for purposes of classification, summarization and tabulation.” We will
analyze data at two levels using this method:
The basic level will be a description of the data in the way that it has been said without
making an attempt to create meaning. The second level of the analysis will be the higher level
where an interpretation of the responses will be gained through inference. This will be achieved
through coding and classification of data so as to elicit the significant messages.
Research Question 1
What are the forces that influence research projects to change their primary objectives?

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An analysis of the RP
The External Environment
Threats
The external environment of a project such as the RP that is an HIV/AIDS research
endeavor, is filled up with a lot of dynamic changes. The goal of a study that sets out at the
beginning may not be the same goal that the project pursues in the end. There are a lot of other
research projects taking place in the quest to curb the HIV/AIDS epidemic. The findings and
outcomes of each project has the potential to influence how any organization involved in the
prevention, treatment and care of the disease operates. This means that organizations working on
HIV/AIDS research themselves have a higher chance of being influenced by other studies. Such
is the situation for the RP. Below is an examination of the threats that the RP faces in its external
environment.
The Research Environment.
Emerging studies
The emerging studies in the field of research, in particular, the Temprano study, as cited
by WHO (2015) indicate that if people infected with HIV/AIDS are started on treatment sooner,
they survive more than their counter parts who are started on treatment only when their CD4
drops below 350. The other study, the START study, as cited by NIH (2015) also indicates that
when people are started on treatment early enough, the chance for them to spread the virus to
others is reduced. These emerging studies have affected this major strategy of the RP which was
among the preventative measures it is testing in combination with other lesser strategies. This
question is no longer useful as the other big studies have already proved this to be correct and
therefore, the need for the RP study’s existence is almost zero. This means that the RP needs to
change its primary goal if needs to exist. This is the major threat to the RP.

12
New World Health Organization (WHO) recommendations to “test and treat”
The World Health Organization (WHO) has recommended that countries embark on a
policy of “test and treat”. This means that patients should not wait for their immunity to go down
before they can be started on treatment. This is largely due to the findings from the other studies
which have shown that it is largely beneficial for people infected with HIV and their
communities if people infected with HIV are put on treatment universally. This has meant that
the issue of when people start treatment when they are infected with HIV is no longer a research
issue but is a policy one. This is a threat that the RP also needs to deal with.
New Epidemics
The emergence of new epidemics such as those of the Ebola virus and the Zika virus are
major threats that threaten the diversion of donor funds from initiatives combating the
HIV/AIDS epidemic. The RP needs to prove to donors that its continued existence adds more
value than when it is stopped.
The Data and Safety Monitoring Board
The Data and Safety Monitoring Board is a body which oversees all the health research
worldwide and monitors the relevance of research especially in terms of safety of the participants
and the viability of the data that comes out of the research. The board reserves the right to cancel
any study that it deems to be pursuing a cause that is no longer useful for the research
community and the health world. At any point, the RP could be stopped by this body.
Opportunities:
The HIV/AIDS Treatment Guidelines

13
The new HIV/AIDS Treatment Guidelines which emphasize immediate treatment of
people who tested positive. The RP is already conducting massive HIV testing campaigns in the
communities. This places the RP in the right position to be a leader from whom other
organizations can learn in implementing their own programs in working with large numbers of
people being put on treatment from RP study sites. This may make the policy makers to want to
maintain the RP to act as a lead in the introduction of this new treatment policy.
Renewed political commitment to the fight against HIV/AIDS
The political situation in the world at large as well as in the country under study
specifically has seen renewed vigor to the fight against HIV/AIDS since the advances made
towards curbing the epidemic have become apparent. A trend has become apparent that the
incidence of HIV is decreasing in the most hit countries as well as in the whole world at large.
As a result of this, there is a palpable general feeling among political leaders to do more in this
fight which at first seemed insurmountable. This presents the RP with the opportunity to get
financial support necessary for its continued existence.
In summary, the RP needs to modify its strategy and goals so as to be in line with the
trends in its environment. The trends in its environment present it with threats which it needs to
overcome using its internal strengths as well as capitalizing on the opportunities the external
environment present. These opportunities are the New HIV/AIDS guidelines and the renewed
political will in the fight against HIV/AIDS.
Stakeholder Analysis

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Liz Mac Dean Dan Coleman
Organization International
Partner
Local Partner Min of Health Sponsor partner Regulatory body
Role on project Project Lead
partner
Lead local partner Director General Lead sponsor regulator
Unique facts Very particular
with meeting
deadlines
Very open and mature
leadership, experienced
in the local health
system
Custodian of the
health system of the
country/well versed in
research statistics and
public health. Very
busy at this very high
position
Major stakeholder
very friendly and
excellent listening
skills
Very busy approves large
amounts of research work
and proposals in the
country/works with few
staff, has challenges
meeting deadlines
because of this
Level of interest Very high Very high Very high Very high low
Level of influence high medium Very high Very high Very high
Suggestions on managing
relationship
Must have weekly
meetings with her
Can have monthly
meetings with him
Must be updated
about the study
monthly
Do not have direct
contact but must go
through Lisa regularly
for close and regular
contact
Must have a cordial
relationship so that our
work can be prioritised on
his desk

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Research Question 2
How do employees perceive introduction of Change in HIV/AIDS Research Projects like the
RP?
Methodology
Thirteen conveniently selected employees were involved in the study. Ten of the thirteen
were given the questionnaires to provide responses. Three employees were requested to
participate in a group discussion using the questionnaire as a guide. The questionnaire had two
sections, one on acceptance and resistance of change and the other had questions on employee
motivation. Five of the questions required discreet answers of either Yes or No while the rest
could take any amount and form of text entries.
Analysis
The discreet responses were quantified using simple mathematics to calculate
percentages. The texts were coded into themes according to a table cited by Hultman, K (2016)
as representing forms of resistance and the number of texts falling into the categories of the
themes was quantified and calculated into percentages.
Results
Discreet questions on acceptance and resistance
Question Yes NO
Q1 8 0
Q4 9 0
Q5 5 5
Q6 4 4

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Q9 5 3
Responses to Questions on Motivation
Motivated Demotivated
Question Very moderately barely very moderately barely
Q4(After
change)
6 1 1 0 0 1
Q5(Before
change)
6 3 0 0 0 0
Theme analysis and coding adopted from Hultman, K (2016)
Theme Frequency Percentage
Critical/fault finding 16 23.2
Ridiculing 8 11.6
Using facts selectively 0 0
Appear to fear 8 11.6
Blaming/accusing 9 13.0
Distorting facts 0 0
Sabotaging 3 4.3
Intimidating /threatening 0 0
Starting rumor 0 0

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Arguing/raising objections 0 0
Agreeing only verbally 1 1.5
Failing to implement 0 0
Procrastinating 0 0
Feigning ignorance 0 0
Withholding information,
suggestions
2 3
Standing by watching things
fail
0 0
Positive attributes 22 31.9
Total 69 100
Findings:
Acceptance of Change
Majority of the employees (80%) welcomed the changes introduced in the project so far
while the 20% were non-committal in their responses. Employees accepted and embraced the
change which the saw as the right way-forward not only for the project but also as the right
approach towards the management of HIV/AIDS.
Necessity of Change
The majority of the participants (90%) believed that the changes were necessary with the
10% being non-committal.

18
Introduction of the Changes
The employees were split on how the perceived the introduction of the changes with 50%
believing that the changes were introduced in the right manner and the other 50% believing that
they were not.
Effect of the change on Employees
Half (50%) of the employees indicated that the changes directly involved them while
30% of employees believed that the changes did not directly affect them. 20% were non-
committal in their responses.
Description of Acceptance and Resistance to Change
The types of resistance described by Holman, K. (2016) listed in the table 1 below were
used as themes that emerged in the analysis. The following were the findings according to each
theme in each category.
Positive Attitudes towards Change
Overall, there were 31.9% positive reactions towards changes implemented in the project.
Such statements as “‘test and treat’ (the change theme) will bring in more lost patients” “test and
treat will make us earn more certificates because we will be trained”.
Critical and Fault Finding
Critical and fault finding themes emerged as the next highest category of reactions at
23.2%. The predominant statements were statements such as “the changes make staff look in-
efficient because of (management’s) poor planning”. Staff were critical of management’s
apparent lack of proper planning or sudden notices of changes or plans. Staff feel that at times,

19
they could not complete their tasks because of these frequent sudden changes. Staff complained
of not being involved in the process of change introduction and given not to have been given a
chance to contribute: “they were not done in the right manner, they are done fast, people were
not given a chance”.
Blaming and Accusing
At times staff were blaming or accusing (13%) in their reactions to change. They blamed
the management for putting them in awkward situations. “Sometimes we end up borrowing
money to go for abrupt workshops…they will just say I want you here in the morning”. Other
reactions were “the changes were harsh”. There was “too much movement of staff”. Sometimes
we change our plans, we are forced to change our plans…we disappoint patients (for example
those who come) for blood collection.
Ridiculing
There were some ridiculing reactions towards the changes at a rate of 11.6% with some
statements such as “do the public know about this (change) yet?” “Our posts are being
advertised…it is tea time to go”. “Work is increasing, the money is the same”.
Fear
Staff expressed fears at a rate of 11.6%. The fears were related to the loss of their jobs or
insecurities. They were not sure whether the project was going to continue for long or whether
their posts were going to be kept. They also feared that their workload was going to increase.
Some statements showing fear were “(we are) seeing other people losing their jobs…anytime it
is... time to go”. “These changes affect me because they affect my job…it may be decided (for
the project) to be stopped”.

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Sabotaging
Elements of sabotage (4.3%) were also present. Most of this represented looking for other
jobs and then quitting as soon as opportunity presents itself meaning that the project would go
with a vacant post. “If we find a stable position outside, we will quit”.
Withholding information/suggestions/help/support
The reaction of withholding either information, suggestions, help or support accounted
for 3% of the reactions. “We just do what you have been told to and (we) accommodate (it) but
we (only) meet their needs not our needs or patient’s needs”.
Employee Motivation
Employee motivation after the changes remained almost the same as before the change.
60% of the employees felt very motivated with their job before and after the change. However,
20% of the employees moved from either being very motivated or moderately motivated to being
either being barely motivated (10%) or barely demotivated (10%).
Limitations
The sample size may not be representative of the employees for two reasons: 1.The
sample size of 13 employees might not be representative of the full contingent of protocol 3
implementing staff. The convenient sampling method may cause bias in the findings. Statistical
tests of significance have not been used to examine the differences observed. The investigator is
part of the team and their bias cannot be eliminated both from the participants and from the
investigator’s perspectives.

21
Discussion
Spector, B. (2013) recommends four steps that start with shared diagnosis in
implementing change and cautions against what are called “implementation traps” in the
roadmap to change implementation. The “implementation traps” are defined as the application of
appropriate change tools at inappropriate points in the implementation process. Texts from the
findings such as “seeing our colleagues lose their jobs” and then “test and treat will make us earn
more certificates because we will be trained” suggest that structures were changed first and
positions lost before training was conducted which means structures were changed before
training for behavior change was effected. This has the problem of substituting refreezing with
unfreezing. Here, employees are still attached to the old social behaviors which may then cause
resistance.
By skipping the process of shared diagnosis, which as opportunity for building
commitment and harvesting from the knowledge that is rooted deeply and diversely within the
staffs, managers fall into another implementation trap and may be implementing out of touch
strategies. As advanced by Spector, B. (2013), retrenching employees as observed above without
giving them an opportunity to be trained on the new change processes may be seen as unfair,
arbitrary and may reduce trust as well as commitment.
In general, Spector, B. (2013) cites the following steps in-order to avoid implementation
traps and to ensure effective change implementation:
Follow this order: “Shared Diagnosis 1-REDISIGN: roles, responsibilities relatioships.2.
HELP: training, mentoring, coaching. 3. PEOPLE CHANGE: assessment, promotion,
replacement, recruitment.4. SYSTEMS and STRUCTURES: reporting relationships,
compensation, information, measurement and control”.

22
Recommendations
1. Employee of Engagement and Training
The lost opportunity of engagement should now be utilized by making sure employees
are engaged and trained about the changes. If possible, each training should be certified as the
employees seem to seek career advancement benefits from the change process. Employees want
to see these changes translate into visible benefits for patients. It would be useful to quantify the
impact of the changes on the quality of care of patients and communicate this to staff regularly.
Employees need to be involved when planning activities and further changes. They need
to be assured that interruptions in their work will not be accounted for in assessing their
efficiency. In-order to do this, care need to be taken to ensure that when events are planned,
employees are asked to specify how the change affects their work.
The stakeholders who are crucial in making sure that this recommendation is successful
are the training coordinators who are based at the international partner. These are under the
control of Liz according to the stakeholder analysis. Liz can influence the training coordinators
and make sure that they not only the employees but also issue them with meaningful certificates
which they can use to further their career prospects.
The hindering factor is that certifications require organization on the part of training
coordinators who need more time and resources to print certificates and to acquire accreditations.
However, it is possible that the international partner’s management could allocate the trainers
more resources and time to achieve this.
2. Improve Employee Welfare

23
When employees are called to attend meetings at places outside their work stations,
logistics need to be put in place to facilitate the ease with which they conduct their duties. This
will prevent them from blaming the job for the debts they at times incur for such arrangements.
These arrangements involve accommodation, transportation and food. The enabling factor for
this recommendation is the HR department of employees. The stakeholders that can influence
this are the PS of the Ministry of Health. The PS can ensure that policies are put in place
whereby every employee is well cared for during trainings outside their duty stations. This policy
can be made at the highest level and can be made as a requirement for all workers working in the
health field.
The hindering factors are the unavailability of funds. The mitigating factors are allowing
the communication plan described in the table above to be implemented.
3. Improve Clarity on job security
The process of retrenchment has to be explained explaining the criteria well in-advance if
there are to be retrenchments. A human face has to be seen handling the welfare of employees
who have been retrenched so that employees still on the job may be reassured that their welfare
is at the heart of the organization. This may not necessarily need monetary assistance. Activities
such as employee counseling and support and job references may help. Again the enabling factor
is the international partner’s management which can influence the HR department in
implementing this resolution.
4. Employee Involvement/ Install enablers of dialogue
The organizational silence that persists that candid feedback and open shared dialogue is
to be avoided in the organization should be removed. Some steps that can be followed to this are

24
installing enablers of dialogue such as doing away with executive parking and cafeteria tables,
putting the rest of the staff on the same payment scheme rather differentiating others, and using
casual communication such as use of first names.
The enabling factors of this are the use of the MOH PS to create such an environment which will
be act as an example for the other stakeholders.
Conclusion
The RP has several forces in its external environment which influence the viability of its
continued existence and ultimately alter its objectives in its quest to remain relevant. The RP
responds appropriately to these forces by implementing appropriate change. The RP has
successfully implemented its change process with an overall acceptance from its employees.
However, the RP has also fallen into “implementation traps” by implementing appropriate tools
of change at inappropriate stages. There are areas of improvement where the RP needs to work
on next time during implementation of change. These areas of improvement can be perhaps
addressed by following the recommendations suggested in this paper and the change
implementation plan also suggested in this paper. Lessons learnt from this survey can go a long
way in improving change management and acceptance in similar HIV research projects.
Proposed Change Implementation Plan
Month
1
Month
2
Month
3
Month
4
Month
5
Month
6
Leadership
alignment
Vision
worksho
ps
mission Change
agent
booklet
Change
agents
Alignment
workshop
Individu
al
coaching

25
Organizati
onal design
Process
definitio
n
Process
definition
Chart
finalization/r
oles specifics
Chart
finalization/r
oles specifics
Process
training/empl
oyee
mentoring
Transitio
n phase
Individual
developme
nt
Cultural
training
Cultural
training
Cultural
training
Role training
Cultural
identity
Mission,
vision
disseminat
ion
workshops
Communicat
ion program
Communicat
ion program
Communicati
on program
Team
building
Company
day
Team
objective
workshops
High
performance
teams
workshops
Global Team
workshops
Global
Team
worksho
ps
Employee
motivation
Employ
ee
satisfacti
on
survey
Project
member
recognitio
n
Project
member
recognition
Employee
satisfaction
survey
Individual
Cafeteria
program
Satisfact
ion
survey

26
Lessons Learnt
Focus area Low
1 2 3 4
High
5
Successes shortcomings Recommended
solutions
Change
Introduction
x Changes
necessary
Manner abrupt-
non-engaging
Shared
diagnosis(unfreeze)
Change
implementation
x Implementation
steps not in-
order
Follow this order
1-REDISIGN
roles,
responsibilities
relatioships.2.
HELP training,
mentoring,
coaching. 3.
PEOPLE
CHANGE
assessment,
promotion,
replacement,
recruitment.4.
SYSTEMS and

27
STRUCTURES,
reporting
relationships
,compensation,
information
,measurement and
control
Employee
Welfare
x Work hygiene
factors not
conducive
Attend to hygiene
factors of job
security, work
environment and
work conditions
Employee
Motivation
x Motivation
maintained
No specific
program for
employee
motivation
Address employee
motivational
factors-recognition
and mastery,
reward routine
non-cognition jobs
with appropriate
financial
compensation

28
References
Spector, B. (2013). Implementing Organizational Change. 3rd edition. Pearson. Boston
Christensen et al (2016). Research Methods, Design and Analysis. 3rd Edition. Pearson. Boston.
RP (2016). The CP Protocol. Unpublished Notes
Stare, A. (2011). Reducing Negative Impact of Project Changes with Risk and Change
Management. Retrieved from
http://search.proquest.com/pqcentral/docview/913401431/3398DAC60FC84E23PQ/6?ac
countid=34574
Hultman, K. (2003). Managing Resistance to Change. Retrieved from
http://www.academia.edu/595772/Managing_Resistance_to_Change
Sundaram, A. (2015). Resistance and types of resistance to change. Retrieved from
http://www.slideshare.net/AjithSundaram1/resistance-and-types-of-resistance-to-change
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Management. Retrieved from
http://search.proquest.com/pqcentral/docview/913401431/3398DAC60FC84E23PQ/6?ac
countid=34574

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UNAIDS (2015). Implications of the start study data questions and answers. Retrieved from
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_study_data_en.pdf
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Appendix 1
Questionnaire on change
1. Do you welcome the changes that have been introduced into the project?
2. Which changes do you particularly like?
3. Which changes do you not like?
4. Do you believe that the changes were necessary?
5. Do you believe that the changes were introduced in the right manner?

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6. Are you having any concerns about how the changes were introduced?
7. How did you respond to the changes you did not like?
8. How do you plan to keep responding to these changes?
9. Do the changes directly affect you?
10. How do you think these changes affect you
Questionnaire on Employee Motivation
1. What do you like about your job with the CP?
2. What is it that stands in your way to do your job perfectly?
3. Has anything changed with your job that motivates or demotivates you to perform your
duties?
4. How do you feel about your job?
1. Very motivated. 2. Moderately motivated. 3. Barely motivated. 4. Very Demotivated.
6. Moderately demotivated. 7. Barely demotivated.

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5. How did you feel about your job before the changes you mentioned above?
1. Very motivated. 2. Moderately motivated. 3. Barely motivated. 4. Very Demotivated.
6. Moderately demotivated. 7. Barely demotivated.

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