Reproductive Health Stairway: the Dangerous Life of a Village Girl

The Reproductive Health Stairway is a Capacity-building Tool for Reproductive Health Workers in Pakistan.

The Reproductive Health Stairway helps planners and managers understand and plan effective activities. Each step down the Stairway indicates a risky event in the life of a village girl in Pakistan.

During a short workshop – not more than half a day – participants “walk” down the Stairway three times. The first walk leads them to understand Reproductive Health as they answer the question: “Why is this step a risk?” At step 1, for example, I ask, “Why is low birth weight a risk?” During a short discussion, participants discover that low birth weight is often a sign of under-nutrition before birth. Then we walk down to step 2 and so on. At step 13, some participants’ are shocked to discover that the risks are passed on to the next generation!

After the first walk, many participants – particularly men – are surprised to have learned so much, so quickly.

The second walk down the steps helps the group to plan Reproductive Health activities as they answer the question, “How can the risk at this step be reduced?” In step 1, for example, participants quickly discover that the key to preventing low birth weight is to ensure adequate food for the mother. During this walk, someone in the group may declare, “I like this stairway because it’s like a game where we try to change each downward step into an upward step leading to good health.”

During the third walk, the group develops action priorities by answering the question, “Which Reproductive Health activities can my organization implement? This third walk helps to ensure that the group will implement only what it can do well, rather than trying to implement every activity in the Reproductive Health concept. (To try to implement all the activities at one time might overwhelm or dilute the energies of an organization. For example, the training component would be enormous.)

By the end of the half-day workshop, participants have a clear understanding of Reproductive Health plus the outline of a plan of action.

Why is the Stairway effective? First, because it uses ordinary language instead of bio-medical terms and jargon that are only understood by health professionals. And, because it personalizes the complexities of female physiology, biochemistry and culture into the life story of one female – in other words, “a profile”. Participants learn quickly because they can visualize and empathize with the life of this one Pakistani girl.

Please feel free to use this Stairway, and to pass it on to others (they can download it from www.johndavies.com).