Pivoting from systems “thinking” to systems “doing” in health systems—Documenting stakeholder perspectives from Southeast Asia

Abstract

Applications of systems thinking in the context of Health Policy and Systems Research have been scarce, particularly in Low- and Middle-Income Countries (LMICs). Given the urgent need for addressing implementation challenges, the WHO Alliance for Health Policy and Systems Research, in collaboration with partners across five global regions, recently initiated a global community of practice for applied systems thinking in policy and practice contexts within LMICs. Individual one on one calls were conducted with 56 researchers, practitioners & decision-makers across 9 countries in Southeast Asia to elucidate key barriers and opportunities for applying systems thinking in individual country settings. Consultations presented the potential for collaboration and co-production of knowledge across diverse stakeholders to strengthen opportunities by applying systems thinking tools in practice. While regional nuances warrant further exploration, there is a clear indication that policy documentation relevant to health systems will be instrumental in advancing a shared vision and interest in strengthening capacities for applied systems thinking in health systems across Southeast Asia.

The Application of Systems Thinking to the Prevention and Control of Sexually Transmissible Infections among Adolescents and Adults: A Scoping Review

“…It is possible that the English-language focus of this scoping review contributed to the low number of studies identified from non-Anglophone countries, and it is recommended that future reviews are conducted to identify literature in other languages. A recent study on stakeholder perspectives of systems thinking in Southeast Asia found that some participants believed that "the nomenclature of systems thinking, and interrelated concepts were all in English and predominantly adopted a Western approach to implementation, which could have (in part) served as an impediment to wide-scale adoption" in that region [105]. Collating more examples in which systems thinking has been applied in non-Anglophone regions may assist in overcoming the perception that it is a Western construct with little application to other global contexts.…”

Human Factors in Leveraging Systems Science to Shape Public Policy for Obesity: A Usability Study

“…In the case of systems thinking for public health, there has been a disconnect between the practices of model developers and the needs of end users for tangible assistance [19]. On one side, modelers have invested considerable energy in thorough inventories of the factors and relationships that create a complex system.…”

“…The intention was to provide policymakers with comprehensive tools that support systems thinking approaches. Little was known about how policymakers engaged with systems thinking [19]; hence, assumptions were made and occasionally became problematic. Specifically, the laudable aim that policymakers should be provided with very comprehensive maps of causes and interrelationships implicitly assumed that they wanted such maps and would be able to use them effectively via existing software.…”

“…As a result of this disconnect, scholars have noted that applications of systems thinking in policymaking and practice have been scarce [19,28], despite a broad consensus on its importance [28] and its increasing presence as a discussion topic in public health [29]. To address this gap, our study evaluates the usability of a software that seeks to support policymakers in using a systems map of obesity.…”