Development of the Systems Thinking for Health Actions framework: a literature review and a case study.

Journal: BMJ global health

Volume: 8

Issue: 3

Year of Publication: 2023

Affiliated Institutions:  Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland. Public Health, Child Advocacy International, Islamabad, Pakistan. Public Health, Institute of Development Management, Gaborone, Botswana. Alliance for Health Policy and Systems Research, World Health Organization, Geneve, Switzerland. Monitoring Evaluation and Quality Assurance, Ministry of Health Botswana, Gaborone, Botswana. Department of Obstetrics and Gynecology, Fazaia Medical College, Islamabad, Pakistan. Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland daniel.cobos@swisstph.ch.

Abstract summary 

Systems thinking is an approach that views systems with a holistic lens, focusing on how components of systems are interconnected. Specifically, the application of systems thinking has proven to be beneficial when applied to health systems. Although there is plenty of theory surrounding systems thinking, there is a gap between the theoretical use of systems thinking and its actual application to tackle health challenges. This study aimed to create a framework to expose systems thinking characteristics in the design and implementation of actions to improve health.A systematised literature review was conducted and a Taxonomy of Systems Thinking Objectives was adapted to develop the new 'Systems Thinking for Health Actions' (STHA) framework. The applicability of the framework was tested using the COVID-19 response in Pakistan as a case study.The framework identifies six key characteristics of systems thinking: (1) recognising and understanding interconnections and system structure, (2) identifying and understanding feedback, (3) identifying leverage points, (4) understanding dynamic behaviour, (5) using mental models to suggest possible solutions to a problem and (6) creating simulation models to test policies. The STHA framework proved beneficial in identifying systems thinking characteristics in the COVID-19 national health response in Pakistan.The proposed framework can provide support for those aiming to applying systems thinking while developing and implementing health actions. We also envision this framework as a retrospective tool that can help assess if systems thinking was applied in health actions.

Authors & Co-authors:  Thelen Sant Fruchtman Bilal Gabaake Iqbal Keakabetse Kwamie Mokalake Mupara Seitio-Kgokgwe Zafar Cobos Muñoz

Study Outcome 

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Statistics
Citations :  Pype P, Mertens F, Helewaut F, et al. . Healthcare teams as complex adaptive systems: understanding team behaviour through team members’ perception of interpersonal interaction. BMC Health Serv Res 2018;18:570. 10.1186/s12913-018-3392-3
Authors :  12
Identifiers
Doi : e010191
SSN : 2059-7908
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
COVID-19;Health systems;Qualitative study
Study Design
Case Study
Study Approach
Country of Study
Publication Country
England