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Systems Thinking
Bien Eli Nillos, MD, MHSS
Course on Social Determinants of Health
We remember in PHC
5/18/20122Inequalities and Inequities in Health
Primary health care is essential health care based on practical,
scientifically sound, and socially acceptable methods and technology
made universally accessible to individuals and families in the community
through their full participation and at a cost that the community and
country can afford to maintain at every stage of their development in the
spirit of self-reliance and self-determination.
Health as a Right
Social determinants of
Health
Community Participation
But it is not that simple…
Three types of complexities (Kahane)
• Dynamic
• Social
• Generative
Iceberg model
Interrelationship Digraph
Problem/Health Issue?
• EFFECT
Variable No. 1
Variable No. 2
Variable No. 3
Variable No. 4
Variable No. 5
Variable No. 6
• CAUSE
• EFFECT • CAUSE
Breakout rooms (30 minutes)
Let’s Discuss your Digraphs

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Systems thinking

  • 1. Systems Thinking Bien Eli Nillos, MD, MHSS Course on Social Determinants of Health
  • 2. We remember in PHC 5/18/20122Inequalities and Inequities in Health Primary health care is essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. Health as a Right Social determinants of Health Community Participation
  • 3. But it is not that simple…
  • 4. Three types of complexities (Kahane) • Dynamic • Social • Generative
  • 7. Problem/Health Issue? • EFFECT Variable No. 1 Variable No. 2 Variable No. 3 Variable No. 4 Variable No. 5 Variable No. 6 • CAUSE • EFFECT • CAUSE