Systems Thinking for Capacity in Health
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.
Thematic Sub-Group of SHaPeS on Complexity Science and System Thinking
Introduction
SHaPeS, the “Social Science Approaches for Research and Engagement in Health Policy & Systems” working group for Health Systems Global, has recently approved the formation of a thematic sub-group on Complexity Science and System Thinking. We hope you’ll consider joining us! See below for details. Email Joe Varghese – vakkan2000 (at) yahoo (dot) com – if you’d like to join the group.
Theme
Health systems are complex. They are embedded in social and biological systems that involve multiple actors and entities which are interconnected by mutually influencing interactions.
Systems Thinking (ST) is a promising and potentially transformational way of looking at health and health systems. ST applies the idea that component parts, when viewed together as interactive elements, help us to understand a problem better than when viewing each part in isolation. For example, we must consider each part of a community, such as its’ economic, political, and social factors in order to best understand the source of a problem. Therefore, all participants influencing health must come together to develop a shared vision to enact change in the community.
Why do we need a thematic sub-group?
The dominant knowledge base of current public health practice and research are confined to a positivist paradigm that limits our ability to understand the complexity involved. Positivist conceptualization often fails to generate evidence in the context of complexity. For example practitioners and health system researchers, when using conventional positivist approaches, find it challenging to explain why public health functions are delivered more efficiently in some contexts compared to others.
Focusing on one aspect of health in isolation without understanding its complexity could lead to unintended consequences, such as dependency and inequities among recipients. For example, obesity is complex because it has a number of diverse causes and possible interventions and the ideal way forward depends on local context and may change over time.
Therefore, a thematic a subgroup that focuses on complexity and help in application advancing and strengthening of the ST approaches within health system research and practice is proposed. This would be complimentary and synergetic to the objectives of SHaPeS. While the ST involves several methodological approaches, the focus of this thematic sub-group will be to strengthen the social science approaches within ST paradigm in line with the mandate of SHaPeS.
Strategic focuses of the group
1. Reach out to wider audience – involving the current practitioners and inviting new members
2. Counter reductionism
3. Providing a platform for new ideas, learning and partnership
4. Developing a Community of Practitioners (CoP)
5. Building trans-disciplinary collaborations
Activities proposed
1. Initiating a platform for online based CoP. CoP will provide opportunity for the professionals share and discuss experiences in their practice through email conversations, blog posts, and online discussion groups. The people involved in the other theme areas of Health Systems Global (HSG), but interested in ST will be invited. Systems Thinkers from sectors other than health can also be invited to join – The main online platform can be the present SHaPeS List serv. But additional online groups on platforms such as Linkedln or Yammer may be considered (to be able to closely connect with serious practitioners of ST)
2. Circulating materials for propagating the concepts of ST and for inviting new members to be part of SHaPeS. These materials will elaborate basic concepts of ST approaches and examples of its applications.
3. Besides the open discussions and postings by all members, knowledge sharing within the CoP online platform will be optimized by organising specific questions for in-depth exploration within the on-line community and collecting and compiling the information for future use — 2 discussions per year modelled on UN solutions exchange approach (set out 1-2 questions for each discussions to the entire group – leave open for 1 month, debate, synthesize, compile responses and publish summary doc/blogpost)
4. Two webinars on ST per year most relevant to SHaPeS group (done through Google hang-out or other free platforms).
5. Creating a repository of resource materials including bibliography of published articles, mythological tools and training materials- repository can be held within the Health Systems Global website
6. Monthly literature updates – by developing an automated search in pubmed and other databases and the results will be filtered by the coordinators by scanning the abstracts and full texts
Coordination
Joe Varghese and Raman VR (Public health foundation of India)
Joe Varghese, MPH, PhD is associated with Public Health Foundation of India. He has over 12 years of involvement in public health in India as a trainer, health system researcher and policy expert. His research and publications are related to local self-governance and health sector, public health ethics and analytical frameworks for public health policies & programmes. His doctoral thesis is on complexity of public health governance and his manuscript based on the application of CAS framework is part of the papers identified by the WHO Alliance for the second special journal supplement on ST.
Raman VR is Principal Fellow of the Health Governance Hub, PHFI’s interdisciplinary programme of research on critical aspects of health governance in low-income contexts, linked to capacity building and advocacy. He is a public health and development practitioner with over two decades of experience in health policy-planning, research, advocacy, training, community mobilisation and organization-building towards strengthening public health systems in several states of India. He has earlier served as Technical Advisor to the Planning Commission’s High Level Expert Group on Universal Health Coverage.
Ligia Paina (Johns Hopkins University Bloomberg School of Public Health)
Ligia Paina is an Assistant Scientist in the International Health Department of the Johns Hopkins University Bloomberg School of Public Health (JHSPH). Her research interests include health workforce policy, complex adaptive systems, and research and organizational capacity development in low and middle income countries. Ligia’s experience in global health is focused on health systems strengthening and health systems research. As a Research Assistant at Johns Hopkins University, she has contributed to the design, management, and analysis of qualitative, quantitative, and mixed methods research studies. Prior to joining Johns Hopkins, Ligia worked as Health System Advisor in the Office of Health, Infectious Diseases, and Nutrition at the U. S. Agency for International Development. Ligia holds a PhD and a MHS in International Health – Health Systems from the Johns Hopkins University Bloomberg School of Public Health.
R Chad Swanson (Brigham Young University Department of Health Sciences)
Chad Swanson, DO, MPH is a community emergency physician in Provo, Utah, USA with a passion for applying “systems thinking” concepts, approaches, and methods to transform health systems. After medical training, he received a Masters Degree in Public Health from the Johns Hopkins Bloomberg School of Public Health. Dr. Swanson currently teaches international health and health systems at Brigham Young University, and has published in journals such as the Lancet and PLoS Medicine on topics related to health systems strengthening and global health. He is the founding co-chair of the American Public Health Association’s working group on systems sciences and health, and is interested in high-impact activities that cross disciplines, mobilize stakeholders, and transform systems. Dr. Swanson was the primary organizer of a high-level conference at the Rockefeller Foundation’s Bellagio Center in August 2012 that focused on increasing organizational capacity in low-income countries to strengthen health systems.
Systems Thinking for Capacity in Health 
This is a good initiative and it sure will be a great platform for helping health and development practitioners to expand their knowledge base as well as develop the skills and competence in systems thinking perspectives with health as focus.