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Libby Kalucy, PHC RIS
The chaos engulfing Haiti in the aftermath of the earthquake illustrates painfully the importance of systems to deliver the basic necessities of life. This report looks at ways of strengthening health systems, by understanding their strengths and weaknesses, and how any intervention will affect the whole system. I found it refreshing to read a report in good plain English, which uses many visual devices to illustrate its messages. Firmly grounded on previous work from the World Health Organization (WHO), it is designed to be practical and workable in contrast to some publications on complexity which leave this reader thinking ‘it’s all too hard’. The complexity of systems can’t be used as an excuse for inaction, nor can it be ignored to make life easier.
In its Ten Steps to Systems Thinking, this Report shows how we can better capture the wisdom of diverse stakeholders in designing solutions to system problems. It suggests ways to more realistically forecast how health systems might respond to strengthening interventions, while also exploring potential synergies and dangers among those interventions. Lastly, it shows how better evaluations of health system strengthening initiatives can yield valuable lessons about what works, how it works and for whom.
To quote from the report: "Systems thinking is not a panacea. Its application does not mean that resolving problems and weaknesses will come easily or naturally or without overcoming the inertia of the established way of doing things. But it will identify, with more precision, where some of the true blockages and challenges lie. It will help to:
- explore these problems from a systems perspective;
- show potentials of solutions that work across sub-systems;
- promote dynamic networks of diverse stakeholders;
- inspire learning; and
- foster more system-wide planning, evaluation and research."
This report is available from the WHO website: <www.who.int/alliance-hpsr/resources/9789241563895/en/index.html>
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