Trainer Attachment 8C : The chain of causes
To help the participants get a better idea of the chain or network
of causes leading to a certain health outcome and actual chain can be formed.
Each time another cause is mentioned, a new link is added to the chain. Give
each participant a few links then each time a new cause is mentioned everyone
considers whether it is biological, physical, cultural, economic or political.
Whoever has the right link for a particular cause adds that link to the chain.
The chains can be made from cardboard and each link can be colored
differently to represent 5 kinds of causes. Symbol of Ibrahim, the family, and
the community should be made in such a way that they reflect the cultural
understanding of the society and the same goes for the symbol used for the
The chain of causes (A)
The chain of causes (B)
(Adapted from: Werner and Bower. Helping Health Workers