We believe that systems thinking and complexity science can be transformational in global health by increasing local capacity and shared learning, and minimizing unintended consequences.
The discussions this week at the Health Impact Assessment Conference got me thinking, once again, about health as a social movement. I remember well first reading the words “health systems activism.” I was an intern, during my neurosurgery rotation. Perhaps I was reading McCoy, et al’s article “Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa: Avoiding the Pitfalls and Dangers, Capitalizing on the Opportunities” to escape the tedious, never-ending neurosurgical rounds. In any case, I was immediately sold: health systems strengthening needs the same passion and social mobilization as human rights movements and political campaigns.
The virtues of health systems strengthening have always seemed self-evident to me. It’s obvious, after all, that patients don’t go to clinics with diagnosed diseases, they go with symptoms, suffering. I recognized that health depends on multiple relationships between individuals and institutions, companies and organizations. A health system is a complex, connected network that must be treated as such in order to produce health effectively, efficiently, and equitably.
A health system is much more than a way to respond to biological challenges. A health system reflects society; it is a social institution. The way that health systems are structured and funded are based on societal values (through action or inaction). In addition, the health system is full of human interactions and responses that are explained by behaviors based on social reasons as opposed to rational data. Mothers decide to bring children to a clinic based on socially-reinforced perceptions and assumptions. Politicians and caregivers make decisions based on social reasons as well.
As such, health systems strengthening could learn something from social movements. We need charismatic leaders, committed, passionate, volunteer followers, and an organized strategy. What do you think about HSS as a social movement? I’ll start by tweeting. My name is “HSStrengthening”