Clement L. Rasul
© copyright 2009
If you intend to use any portion of this article in your training program, permission can be granted by writing the author. The illustration below of the problem tree is based on an actual problem analysis work undertaken by the author. It has been abridged by the author for teaching purposes.
What is a Problem Tree?
A problem tree is a problem analysis tool that illustrates the cause and effect relationship of problems using a hierarchical tree diagram. It is illustrated by arranging the problem statements in hierarchical order and depicting the problem statements in a boxed article. The cause and effect relationship of the problems are illustrated by an arrow-less line connected to the boxed article.
This tool is similar to the Fishbone (Ishikawa) diagram used in quality management circles and the Stream Analysis diagram used in organizational development (OD) diagnosis.
A Health Sector Example
What does the above diagram mean? The diagram means that the focus of analysis is "High Infant Deaths". In the problem tree, this is known as the "Starter Problem", "Focal Problem", or the "Core Problem". This is usually the main symptom of a series of problems that you want to investigate.
From the above-mentioned problem statement, you will have to ask the question: What are the causes for high infant deaths? The answer to this will bring to the second level problem statements. In the illustration, there are five (5) causes. These are:
• Too young mothers, defined as mothers below 18 years old;
• Close spacing of births, defined as successive births occurring to mothers of less than 2 years;
• Too many births, defined as the total number of births to mothers in excess of 5 children;
• High risk births arriving too late in the hospital, these are births by mothers who are considered of greater risk of having birthing problems due to hypertension, fetal presentation, and the like ; and
• High incidence of sepsis, defined as acute infection
For each of the 5 causes of "High Infant Deaths", you will further ask the question:
• What are the causes of too young mothers giving birth;
• What are the causes of very close spacing of births;
• What are the causes of too many births;
• What are the causes of high risk births arriving too late in the hospital; and
• What are the causes of high incidence of sepsis;
The answers to each of the above-mentioned questions will bring you to the third level problem statements.
In the case of too young mothers giving birth, the causes are: (i) Pregnancy due to rape; and (ii) children (girls) are living on the streets.
In the case of very close spacing of births, the causes are: (i) Intermittent use of family planning methods; and (ii) short breastfeeding practice.
Moreover, in the case of too many births, there are 3 causes:
• Intermittent use of family planning methods;
• Short breastfeeding practice; and
• Non-use of family planning methods;
For high risk births arriving too late in the hospital, the causes are: (i) Mothers are living in far-flung areas; and (ii) mothers do not know that their pregnancy is considered high risk.
Then, for high incidence of sepsis, the cause is that births are handled by hilots (traditional birth attendants) who do non-aseptic birthing practices.
If there are still reasons for the stated problems, you will again ask the question: "What are the causes for ...?" and you will continue on until you have identified all the causes. In the process, the identified problems will form a hierarchical diagram of "effect and causes".
In the above illustration, most of the problem branches end at the third level hierarchy. Except for non use of family planning methods, which still has a cause identified as religious belief forbidding the use of family planning methods.
The terminal or root cause identified are called the "leaves" of the problem tree. In problem analysis, the most important are the "leaves" as these will be the sources of your strategies in solving the problem.
Some Thoughts ...
If we are making an analogy between the problem tree diagram and the actual tree, we might as well call the problem tree a "root diagram". The focus of analysis are the roots that branches from the "starter problem". And the "leaves" of the problem tree might as well be called "terminal roots" or "root ends". In diagramming though, any diagram that involves branching are often called a tree diagram.