Publication Date
Publication Date: 
December 1, 2007

This manual describes the experience of CARE staff and partners in using an approach called Social Analysis and Action (SAA) to identify and address the social, economic, and cultural factors that influence reproductive health. SAA is an approach for working with communities through regularly recurring dialogue to address how their social conditions perpetuate their health challenges. In this way, SAA seeks to enable communities to identify linkages between social factors and health and then determine how to address them. As a first step in this process, SAA encourages CARE staff to deeply question their own biases and behaviours that might contribute to or reduce social stigma, discrimination, and social conditions. In this way, SAA suggests that for developmental change to take place, change must sometimes begin with the development worker.

This document has been titled an "ideas and action" book to reflect the experimental nature of SAA, which is exploratory and based on the personal experiences of people in the project sites. CARE's aim with this book is not simply to contribute to a growing body of knowledge about social determinants of health, but to spark readers' creativity to explore with project stakeholders the social issues that affect people's health status. This publication explains SAA at both a conceptual and practical level. The sections include:

  • Process: What is SAA? This section further describes the concept of SAA and walks the reader through each stage of its potential implementation within a programme cycle.
  • Case studies: Explores CARE's experience been with SAA, presenting brief case studies. For example, in Sierra Leone, the SAA process helped the team to tailor its activities to meet the specific sexual and reproductive health (SRH) needs of youth and to address deeply held cultural traditions that impact them.
  • Tools: This section provides practical methodologies for integrating SAA into different stages of the project cycle.
  • Personal reflections: Two personal reflection essays written by CARE staff members who have been leaders in SAA experimentation. Questions are offered to stimulate readers' own reflection.

Click here for the 120-page resource in English in PDF format.
Click here for the 120-page resource in Spanish in PDF format.
Click here for the 120-page resource in French in PDF format.

In addition, 3 videos are available (see below) that are associated with this resource: two "how-to" videos on SAA and a longer video on integrating SAA into an economic development project in Rwanda.


English, French, Spanish

Number of Pages: 



Emails from Luis Ortiz-Echevarría to The Communication Initiative on May 25 2012, June 5 2012, and June 7 2012.