Network mapping, social network analyses, and process mapping involve a range of tools to illustrate and analyze connections between people, organizations, or processes in both qualitative and quantitative ways. In this supplement, Malik et al. The flow chart is one of the more common tools used to draw a process or a system. Innovation history or change management history is used to compile a history of key events, outcomes, issues that have cropped up along the way, and measures taken to address problems.
In this supplement, Zhang et al. Participatory Impact Pathways Analysis involves workshops and a combination of tools to clarify the logic of interventions and a mapping of the network [ 21 ].
Systems Thinking and Action for Nutrition
It is intended to enhance understanding through participation with beneficiaries, implementers, and other stakeholders in a project. Several papers in this supplement use similar approaches for a variety of situations, including to build leadership capacity for health systems in South Africa [ 32 ], to develop sustainable physical rehabilitation programs in Nepal and Somaliland [ 33 ], and to build sustainable maternal and child preventive health services in Northern Bangladesh [ 34 ].
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Agent based modeling takes advantage of a wide variety of theories, methods, and tools to build computer models that simulate the interaction of agents e. The models involve multiple individual agents that work at different scales, some decision-making rules e. In global health, we are concerned with both theory and practice, and are in need of models that match the complex conditions in which we work. A common thread of all these theories, methods, and tools is the idea that the behavior of systems is governed by common principles that can be discovered and expressed.
They are all helpful in trying to conceptualize the systems in place. Some are more focused on ways to change the system to produce better outcomes. It is to these uses that we now turn. In much of public health and medicine, we use research evidence on the efficacy of interventions to inform decisions with an expectation about their future effect.
Some systems thinking methods and tools, such as scenario planning, can also be used to explicitly forecast future events. However, even then, such methods are intended to be used for identifying possible outcomes to provide insights on how to prepare for them rather than fixing on any particular outcome. Most of these reasons are applicable to systems thinking more broadly. Many of these specific reasons relate to being able to explain how things work, and systems thinking is particularly useful to explaining how complex systems work. Many of models can be used for testing the viability of policy interventions in a safe and inexpensive way — agent based models, systems dynamics models, and scenario planning are particularly useful for these purposes.
In this journal supplement, for example, Bishai et al.
Systems Thinking and Action for Nutrition | SPRING
Systems thinking approaches can also provide guidance on where to collect more data, or to raise new questions and hypotheses. The methods and tools help us to make explicit our assumptions, identify and test hypotheses, and calibrate our models against real data. One of the frustrations of health planners and researchers has been the aspiration that interventions shown to be effective at small scale or in a research setting cannot be simply replicated at large scale or to reach populations that are most vulnerable.
Systems thinking methods and tools are increasingly being used to explain epidemics and to inform programmatic expansion efforts [ 5 , 6 ]. One of the more compelling reasons to use systems thinking approaches is to inspire a scientific habit of mind. And for those who value thinking and doing in global health, that can only be a good thing. Newman M: Networks: An Introduction.
Health Policy Plan. Paina L, Peters DH: Understanding pathways for scaling up health services through the lens of complex adaptive systems. San Francisco: Freeman Cooper, Schoemaker PJH: Multiple scenario developing: its conceptual and behavioral basis. Strat Manag J. Forrester JW: Principles of Systems. ILAC Brief 5. Uganda Health Res Pol Syst. Health Res Policy Syst. Blanchet K, Palmer J, Boggs D, Palanchoke R, Jama R, Girois S: Advancing the application of systems thinking in health: analysing the contextual and social network factors influencing the use of sustainability indicators in a health system - a comparative study in Nepal and Somaliland.
Epstein JM: Why model?
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I also appreciate the comments received from Josh Epstein. Correspondence to David H Peters. This article is published under license to BioMed Central Ltd. Reprints and Permissions.
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Peters, D. The application of systems thinking in health: why use systems thinking?. Health Res Policy Sys 12, 51 doi Download citation. Search all BMC articles Search. Abstract This paper explores the question of what systems thinking adds to the field of global health. Open Peer Review reports. Background In the rapidly changing field of global health, it is hard to know whether the recent attention to systems thinking is just another fad, or something more durable that offers usable insights for understanding and action.
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