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.
This is a preliminary draft, and is posted only to give reviewers an idea where this is headed. It should not be disseminated or quoted. Comments are appreciated.
A strong health system:
1. Improves and maintains health in the most efficient manner possible.
a. The structure should match the need. For example, community/household level interventions for child survival.
b. The research and funding focus matches the need.
c. Practice is evidence based, whenever possible.
d. Duplication should be avoided.
e. Financial management is inefficient when funds are unpredictable and sporadic.
2. Develops human and institutional capacity long-term.
a. New public health challenges like emerging infections, drug resistance, environmental changes, etc. are most efficiently addressed by trained locals.
b. Behavior change and institutional development take many years. Programs should consider this when planning time-lines.
c. Development and maintenance of effective leaders is crucial.
d. Quality assurance is a cyclic, iterative, gradual process that must be planned for.
3. Recognizes that ill health is at least as much a social problem as it is a biomedical one.
a. Public health successes often require social mobilization and change.
b. Health systems should be accountable to the population that they serve.
c. Earns the trust and respect of the community.
4. Is equitable.