Whole-System-in-the-Room (WSR) Multi-Stakeholder Workshop Report: Jharkhand, India

This 100-page report explores - through a concrete example - how the planning methodology called Whole-System-in-the-Room (WSR) works in practice. WSR is one step of a 5-step management process called SCALE (System-wide Collaborative Action for Livelihoods and the Environment). This report describes how WSR was applied in practice during a July 2009 workshop held in Jamshedpur, Jharkhand, India, to address the multifaceted issue of youth health and fertility. Captured in the report is the process, dialogue, and synergy that emerges when a broad range of stakeholders from different sectors come together for 3 days to explore the strategy of healthy timing and spacing of pregnancies (HTSP) within the context of free and informed choice - and to work together to find solutions.

The gathering was organised by Communication for Change (C-Change), which is a programme of the United States Agency for International Development (USAID) being implemented in India by the Academy for Educational Development (AED). The gathering was hosted by the Jharkhand Department of Health and Family Welfare and facilitated by New Concept. This WSR workshop culminated the first phase of the implementation of the SCALE® approach in Jharkhand under the C-Change project. SCALE® is a process for catalysing large-scale change by bringing together multiple stakeholders - both those using conventional and other approaches - to adopt a common vision, network among themselves, and take action to produce system-wide change in a short period.

The report begins by explaining why HTSP is a critical intervention in Jharkhand, and presents key findings from 6 global research studies that USAID sponsored in order to assess the effects of pregnancy spacing on maternal and newborn health outcomes.

As detailed here, the WSR involves a carefully laid-out sequence of participatory tasks that are designed to allow participants to share their experiences and ideas. Here is a summary of how the process worked in the Jharkhand experience:

Day 1: An opening ceremony was held with young girls from indigenous groups providing a traditional welcome to the nearly 90 participants from all the districts of Jharkhand and from 7 stakeholder groups (government, corporate, civil society, youth, academia, donor partners, and culture and sports). New Concept's team leader launched the workshop. One member of the "Change Group" then recounted the process that led to the workshop. (This small group of participants worked for several months to map and engage stakeholders, explore SCALE®, plan the WSR workshop, etc. This entire planning process is described in detail beginning on page 8 of the report). The facilitators then introduced themselves, the WSR methodology, and the 6 principles upon which it is based (see Appendix 1 of the report for visual representations - drawings - of these principles).

The participants began the day working in small mixed groups with representation from many sectors. The first task was to establish a common history and an understanding that all participants, no matter how diverse, live in the same world. This was accomplished by creating 3 timelines (covering the past 2 decades) on the walls: one timeline for key personal events, one for events in Jharkhand, and one for global events. After exploring the past and determining their common context, participants explored the present by mapping trends that currently impact youth health and fertility in Jharkhand. The result was a "Mind Map" (see Appendix 2 for the list of trends - e.g., increase in positive perspective toward women - decrease in dowry and increase in self-selection of spouse).

Day 2: Participants spent time on the Mind Map. The participants then broke into their stakeholder groups, and were asked to come up with 3 achievements and challenges in addressing youth health and fertility. The facilitators then asked participants to imagine it was the year 2020 and to use the materials provided to demonstrate the changes they would like to see in youth health and fertility. The groups used art, skits, mock TV interviews, and other methods to communicate their dreams. The participants worked in small groups to reflect on "what they wanted to work on toward the common future". They came up with 2 lists of ideas - those that everyone in their group agreed with and those that not everyone agreed with - pasting their lists on the wall under 2 labels.

Day 3 Participants were asked to reflect on the common ground issues. "Initially reluctant until one participant challenged them, they engaged in vigorous discussion and debate". Having agreed on 5 broad issues as common ground, 6 interest groups were formed to work on the 5 issues (health was divided between 2 groups). These are, in sum, the priority action plans that participants considered necessary to address HTSP and youth health and fertility; one or more selected communication-related examples are provided for each.

1. Advocacy and policy: Example: Carry out evidence-based training, research, advocacy, and networking with students and non-governmental organisations (NGOs).
2. Livelihood and youth: Examples: Make vulnerable populations aware of the consequences of migration (HIV/AIDS, health hazards) and provide counselling on healthy behaviour. Implement information, education, and communication (IEC) and behaviour change communication (BCC) activities. Conduct training and capacity building (police, judiciary, NGO, media, government).
   
3. Youth reproductive health (community and youth engagement): Examples: To foster awareness and education, campaign at village, community, school, and college levels through use of multimedia. Conduct capacity building and peer education with service providers, school teachers, and others
4. Youth reproductive health (policy and advocacy): Examples: Foster increased knowledge about HTSP, in part through life-skills education (curriculum in high schools). Carry out awareness services and communication - IEC, BCC, social mobilisation (SM). Conduct social marketing and IEC to foster demand for contraceptives. Create advocacy campaigns in schools and colleges.
5. Women's empowerment: Example: Initiate dialogue process with young boys by establishing boys' groups (Kishor) along with girls' groups (Kishori).
6. Education: Example: Build and develop a model school with spiritual and values education.

In closing remarks, the New Concept director congratulated the participants for their participation, energy, and commitment, saying, "[t]his was clearly a workshop by and for the participants!"