Don’t create parallel systems Facilitating the stewardship function of govt Identify linkages with non-health actors Continuous stakeholder engagement at all levels (beneficiaries, health workers, local and national govt)
https://www.researchgate.net/figure/Causal-loop-diagrams-showing-the-demand-for-neonatal-and-maternal-health-service_fig3_264644772 Causal loop diagram showing the demand for neonatal and maternal health service.
Eg For a training programme to be effective, you may need to work on leadership/governance, health financing as well as health information systems
how we use theories of change to keep in mind the bigger picture even when our mandate/scope is limited
Systems Thinking: Bridging theory & practice
Bridging theory & practice
Health Systems Research Symposium 2018
Why systems thinking is important for our work?
‘We need new ways of thinking and of working in order to
accommodate the complexity of the challenges in and urgent need
for health system innovation and change.’ Herbert & Best, 2011
Provides an approach to problem identification and solution finding in
a way that recognises the nature of complex systems and dynamics
Static thinking Dynamic thinking
Tree-by-tree thinking Forest thinking
Linear thinking Loop thinking
What does this mean in practice?
Common applications of systems thinking in our
Political Economy Analysis
Embedded technical assistance
Linear reporting mechanisms Complex and messy reality
Short time-frame of programme
Limited scope of programme
timeline for systems changeProject timeline
How we address these challenges?
We use Theories of Change to:
illustrate the pathways of change
identify the ‘missing middle’
explore how and why change comes about
Reflect on the bigger picture beyond the scope of the programme
Increased donor recognition of the
Participatory approaches (eg HCD)