Social Analysis and Action Model

A SAA Peer Educator leads discussion on gender roles
A SAA Peer Educator leads discussion on gender roles



The purpose of the Social Analysis and Action Model (SAA) is to challenge negative norms and behavior around sexual and reproductive health (SRH) including family planning (FP).


According to the World Health Organization, “the most powerful causes of poor health are the social conditions in which people live and work, referred to as the social determinants of health. Evidence shows that most of the global burden of disease and the bulk of health inequalities are caused by social determinants.” Social Analysis and Action (SAA) seeks to address the social, economic and cultural factors that influence health. SAA is a model 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.

The process consists of five main phases:

  1. Transform staff capacity: This foundational step is intended to prepare staff to experiment  with the SAA approach. Strengthening the ability of staff to self-reflect, communicate and facilitate is, in fact, the beginning of the social transformation. Thus, CARE’s new addition to the program cycle reflects our commitment to stimulating personal change prior to doing so with communities
  2. Reflect with community: This is the first step in building trust with communities and engaging them in exploring how social factors influence their health needs, in encouraging their voice and agency, in engaging the most marginalized or vulnerable, and in redefining the community’s relationship with CARE or one of its partners as the outside facilitator.
  3. Plan for action: This step occurs when community members begin to consider how to actually address key social factors impacting their health, when they weigh both assets and challenges, manage conflict, and when they further exercise leadership by committing to address social realities and inequities.
  4. Implement plans: This occurs when CARE pools its resources with those of the community and continues to create space for dialogue, and when community members might initiate activities outside of the CARE project to address their needs.
  5. Evaluate: Evaluation takes place when CARE and the community use simple, effective and reflective methodologies to determine if transformation is taking place, when we look for anticipated and unanticipated social changes, and when CARE works with the community to readjust plans in light of emerging information and reflection.

In order to implement both awareness raising and SAA activities in an efficient and sustainable way, CARE Rwanda works through peer educators. Peer educators are community volunteers who are trained as trainers of facilitators. Often, they are VSL group members, which gives them an easy entry point in society. In all cases, peer educators are well-respected, responsible and confident members of society who continue to work to change norms and behavior in the long run which is necessary for achieving lasting change.

The model does not stand on its own but is complemented by other forms of support to the health sector, such as direct support to health centers of FP posts and advocacy.


The SAA Model is especially relevant in addressing rigid gender norms that lead to gender inequality in sexual reproductive health, including family planning. In CARE Rwanda’s experience, use of SAA has lead to higher adoption of modern FP method and joint decision making between husband and wife on SRH, but also a more equal division of household tasks, decreased gender based violence and joint decision making on health and use of money within the household. SAA thus addresses gender inequality and its underlying causes in relation to SRH and beyond.


SAA was developed by CARE International to help communities reflect on the relationship between social factors and health.


For more information on SAA, please refer to CARE SAA website. 

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Model Info

  • Date first used: 2011 July

  • Partners using model:

    CARE works with Religious Leaders and local health institutions in its Social Analysis and Action approach. 

  • Districts using model:
    • Gatsibo
    • Rulindo
    • Bugesera
    • Ruhango