Once all the outcomes and their relations have been identified, you can reflect on what activities, approaches or interventions are needed to achieve each outcome. At this stage it is more about the type of activity or intervention; there is no need to go into detailed planning of interventions yet.
However it is important to get to clearly defined outcomes at this stage:
This process will give you a first version of a diagram or map with the outcomes, activities and their relations. As explained before you’ll have to go through several cycles of refinement, revision and adaptation with different stakeholders to get to a final version.
In the ToC example above, the contribution of the organisation to the overall change process is marked with the thick black arrows. In the middle, the main intervention strategies are in the boxes with the thick edges: 'Continuous training of medical staff' and 'Continuous management' training respectively. The main assumption here is 'Good political management' which will have to reduce political meddling in nominations of doctors and other medical staff and create a real motivation to work on infrastructure, fight corruption and so on. This assumption must be elaborated and clarified in the next step.
The main purpose of this diagram is that it provides a good and understandable overview of your Theory of Change. You can use all kinds of visual aids (colours, pictograms, arrows…) to accomplish this. And yes, in some cases your ToC will resemble a certain figure and you can emphasise this and release your inner creative person. But don’t force it, don’t make the message secondary to the artwork and don’t simplify too much or modify the content to fit into your beautiful artwork.
In your narrative document, it’s important to explain the rationale of your ToC: why are the different outcomes needed to achieve the overall goal and why will the different interventions lead to the achievement of the outcomes and final goal(s)?