TOOLS: The Problem Pentagon

The Problem Pentagon


Is there a problem? What do you observe that tells you so?


Good response

We don't have good clinic records.

Not-so good response

Providers are lazy.


 For further analysis, ask:

 Probe further to identify problem, ask:


What's wrong with the records? Are they not filled out? Are they incomplete? Be more specific.

What are they not doing? Can you be specific? What does that look like (can you describe it?)


How will you know when the problem is solved? What will be different?


Good response

 Obstetric emergencies will decrease by X%.
 Incidence of post-partum hemorrhage will decrease by X%.
 First visits by pregnant women in their first trimester will increase by X %.

Not-so good response

 Providers will be more effective.

 Probe further to identify problem, ask:

 What do you mean by more effective? What is it that makes them ineffective? What will it look like?

How general is the problem?

  1. Where does it occur? (region, department)
  2. Is it restricted to a specific place/area?
  3. Is it the only place that it occurs?
  4. Where does it not occur?

When is it a problem?

  1. When does it occur? (every day, each instance, every 3 clients)
  2. Does it always occur at the same time?
  3. Is that the only time it occurs?
  4. When does it not occur?
  5. How long has it been happening?

Who is the performer in question?

  1. Is it a group of performers?
  2. What is the desired performance?
  3. What specifically is the performer doing wrong?
  4. What are other performers doing?
  5. Can you identify a performer that does it correctly? (desired performance)

Good response

Desired Performance
Answers client's questions or refers client to doctor.

Actual Performance
Does not answer client's questions.

Not-so good response

Desired Performance
Makes clients feel good.

Actual Performance
Has poor attitude towards client.

 Probe: What do these statements mean?


Is this problem important?

  1. Does the problem affect:
    • Quality?
    • Cost?
    • Timeliness?
    • Quantity?
  2. How does the outcome compare with other organizations?
    • Is the 'poor performance' similar across the region? Sector?
    • When compared with other countries or organizations, does it still stand out as a problem?
  3. Is it worth the cost of 'fixing it'?
    • How much does it cost the organization? In money? In lives?
    • Are there other problems that, when fixed, can reap greater benefit?

This question must be answered by the key stakeholders:

Is this problem worth pursuing?