History, complexity and health systems research

Bloom, Gerald

doi:10.1016/j.socscimed.2014.07.048

Cited by 9 publications

(5 citation statements)

References 7 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As Berridge (2011) points out, the processes and power relations that have shaped the current policies can be illuminated by historical studies [ 28 ]. Knowledge of history is increasingly recommended in health systems research to alert policy formation and formulation to historically affected dynamics [ 29 ]. This case study mainly focused on the policy formation of DHN in Iran as a developing country with distinct political, cultural, social and economic conditions to help understanding the specific conditions in which the policy was formed.…”

Section: Methodsmentioning

confidence: 99%

District health network policy in Iran: the role of ideas, interests, and institutions (3i framework) in a nutshell

2021

View full text Add to dashboard Cite

Background District Health Network (DHN), one of Iran’s most successful health reforms, was launched in 1985 to provide primary health care (PHC), in response to health inequities in Iran. The present study aims to use interrelated elements of the 3i framework: ideas (e.g., beliefs and values, culture, knowledge, research evidence and solutions), interests (e.g., civil servants, pressure groups, elected parties, academians and researchers, and policy entrepreneurs), and institutions (e.g., rules, precedents, and organizational, government structures, policy network, and policy legacies) to explain retrospectively how (DHN) policy in Iran, as a developing country, was initiated and formed. Methods A historical narrative approach with a case study perspective was employed to focus on the formation and framing process of DHN. For this purpose, the 3i framework was used as a guideline for data analysis. This study mainly searched and extracted secondary sources, including online news, reports, books, dissertations, and published articles in the scientific databases. Primary interviews as a supplementary source were also carried out to meet cross-validation of the data. Data were analyzed using a deductive and inductive approach. Results According to the 3i framework, the following factors contributed to the formation of DHN policy in Iran: previous national efforts (for instance Rezaieh plan) and international events aiming to provide public health services for peripheral regions; dominant social discourses and values at the beginning of the Iranian revolution such as addressing the needs of disadvantaged and marginalized groups, which were embedded in the goals of DHN policy aiming to provide basic health services for deprived people especially living in rural and remote areas. Besides, the remarkable social cohesion and solidarity among people reinforced by the Iran-Iraq war were among other factors which contributed to the formation of participatory plans such as DHN (ideas). Main policy entrepreneurs including Minister of Health, his public health deputy and two planners of DHN with similar and rich background in the public health field and sharing the same beliefs (interests) which subsequently led to creation of tight-knit policy community network between them (institutions) also accelerated the creation of DHN in Iran to great extent. Political support of parliamentary representatives (interests), and formal laws such as principles of Iran Constitution (institutions) were also influential in passing the DHN in Iran. Conclusions The 3i framework constituents would be insightful in explaining the creation of public health policies. This framework showed that the alignment of laws, structures, and interests of the main actors of the policy with the dominant ideas and beliefs in the society, opened the opportunity to form DHN in Iran.

show abstract

Section: Methodsmentioning

confidence: 99%

District health network policy in Iran: the role of ideas, interests, and institutions (3i framework) in a nutshell

2021

View full text Add to dashboard Cite

show abstract

“…Although systems thinking gained currency with the dissemination of the World Health Organization (2007) systems strengthening framework 89,90 apart from a few examples, systems strengthening trials remain rare in Asia and Africa 37,73,91 because of the high cost, complexity, and organizational challenges of systems research. 92 In all 3 cases, investment in innovation incurred incremental costs. Establishing cost compatibility with host agency budgets and generating host agency knowledge of these costs was important to deliberations on the utilization of results.…”

Section: System Relevancementioning

confidence: 99%

Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research

Phillips

MacLeod

Kachur

2021

Glob Health Sci Pract

View full text Add to dashboard Cite

Implementation research often fails to have its intended impact on what programs actually do. Embedding research within target organizational systems is an effective response to this problem. We present case examples from Bangladesh, Ghana, and Tanzania that demonstrate challenges associated with embedded science. We propose “agile science” as a means of sustaining scientific rigor while simultaneously catalyzing evidence utilization.

show abstract

“…45 The fact that in some contexts neoliberal reforms are adopted, while in others they are roundly rejected, can be explained not only by the unpredictability of complex systems' responses to new stimuli, but also by the fact that, in complex systems, history matters. 90,104,107,112 The likelihood of adopting neoliberal reforms depends not only on present conditions, but also on historical conditions.…”

Section: Offering An Initial Explanatory Theory: Social Value As An Ementioning

confidence: 99%

Towards an Explanation of the Social Value of Health Systems: An Interpretive Synthesis

Whyle

Olivier

2020

Int J Health Policy Manag

View full text Add to dashboard Cite

Background: Health systems are complex social systems, and values constitute a central dimension of their complexity. Values are commonly understood as key drivers of health system change, operating across all health systems components and functions. Moreover, health systems are understood to influence and generate social values, presenting an opportunity to harness health systems to build stronger, more cohesive societies. However, there is little investigation (theoretical, conceptual, or empirical) on social values in health policy and systems research (HPSR), particularly regarding the capacity of health systems to influence and generate social values. This study develops an explanatory theory for the ‘social value of health systems.’ Methods: We present the results of an interpretive synthesis of HPSR literature on social values, drawing on a qualitative systematic review, focusing on claims about the relationship between ‘health systems’ and ‘social values.’ We combined relational claims extracted from the literature under a common framework in order to generate new explanatory theory. Results: We identify four mechanisms by which health systems are considered to contribute social value to society: Health systems can: (1) offer a unifying national ideal and build social cohesion, (2) influence and legitimise popular attitudes about rights and entitlements with regard to healthcare and inform citizen’s understanding of state responsibilities, (3) strengthen trust in the state and legitimise state authority, and (4) communicate the extent to which the state values various population groups. Conclusion: We conclude that, using a systems-thinking and complex adaptive systems perspective, the above mechanisms can be explained as emergent properties of the dynamic network of values-based connections operating within health systems. We also demonstrate that this theory accounts for how HPSR authors write about the relationship between health systems and social values. Finally, we offer lessons for researchers and policy-makers seeking to bring about values-based change in health systems.

show abstract

History, complexity and health systems research

Cited by 9 publications

References 7 publications

District health network policy in Iran: the role of ideas, interests, and institutions (3i framework) in a nutshell

District health network policy in Iran: the role of ideas, interests, and institutions (3i framework) in a nutshell

Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research

Towards an Explanation of the Social Value of Health Systems: An Interpretive Synthesis

Contact Info

Product

Resources

About