Together We Decide: A Game for Building Health and Harmony Within Families

"Having conversations and making decisions together is another important way to build harmony in your household, but it can be hard to find a good way to start the conversation."

"Together We Decide" is an interactive game that is designed to create a safe space for participants to learn and discuss how to build health and harmony within their families. Developed for Breakthrough ACTION South Sudan, it was adapted from a game designed by ideas42 and IntraHealth for use in Uganda. The game allows players to experience the diverse consequences of childbearing decisions, improve their knowledge of family planning, and develop familiarity and comfort with discussing family planning and related topics with their spouses or partners, other family members, and community health workers. The game encourages players to consider how different family planning methods can help them achieve their reproductive intentions and goals as individuals and with their spouses or partners.

In particular, the objectives of the game are to: 
 

• Provide accurate health information on family planning to men and women;
• Redefine roles and norms around decision-making and participation;
• Demonstrate equitable communication and decision-making around family planning; and
• Encourage couples to seek advice on family planning from healthcare providers.

The game is designed to be implemented in communities and facilitated by community health workers, also known as Boma Health Workers in South Sudan. Depending on what is most relevant and appropriate for the setting and context, the game can be played with mixed-gender groups (e.g., couples) or single-gender groups (e.g., women-only groups, men-only groups). Playing the game with couples creates more opportunities for joint reflection, discussion, and problem solving. 

To play the game, individual players form teams known as "households", and each one receives a starting number of children. Their goal is to work together as a household to achieve harmony, as represented by beads gained or lost throughout the game. Players can gain harmony points in diverse ways, including the following: building wealth; improving health, safety, and security; discussing important topics and issues as a family; being knowledgeable about family priorities and needs; and supporting family happiness and well-being. Players can lose harmony points due to life events or decisions made by household members.

The game consists of 2 components and is accompanied by an implementation guide for facilitators: 

1. Together We Decide Implementation Guide [PDF, 12 pages] - This guide is a resource for the game facilitator, who will walk the participants through the game and lead discussion. The guide includes instructions for each section of the game and a script to read aloud to participants.

2. Game Cards [PDF, 132 pages] - The cards in the game include:
 

• Quiz Cards: Players learn about family planning and test and demonstrate their knowledge through quiz cards. Households win harmony points for answering correctly. These cards build players' knowledge about family planning and their familiarity and comfort with this subject.
• Life Event Cards: Players draw cards reflecting relatable life events. Some cards present choices about childbirth spacing and family planning methods that can result in "harmony" gains or losses, allowing players to experience the consequences of their decisions.
• Discussion Cards: Players gain harmony points by discussing prompts related to childbirth spacing with other household members. These cards allow players to practice informed discussions about family planning and their individual and family priorities, intentions, and goals, modeling couple communication and joint decision making.

3. Child Spacing Planning Card [PDF, 2 pages] - The child spacing planning card is a physical cue for couples to have conversations about childbirth spacing and family planning. It models how couples can approach these conversations and prompts them to visit a health facility together to seek out family planning information, services, and methods. The card also includes a picture of the full range of family planning methods, which prompts couples to review and consider each method. The community health worker or designated facilitator distributes the card to all players after completing the game and reviews and discusses card content with them, responding to questions and comments as needed.