Applied Systems Thinking for Health Systems Research: A Methodological Handbook

Patient safety in health systems has become more and more important as a theme in health research, and so it is not surprising to see a growing interest in applying systems thinking to healthcare. However there is a difficulty – health systems are very complex and constantly adapting to respond to core drivers and fit needs. How do you apply systems thinking in this situation, and what methods are available? National health authorities, international donors and research practitioners need to know the “how-to” of conducting health systems research from a systems thinking perspective. This book will fill this gap and provide a range of tools that give clear guidance of ways to carry out systems thinking in health, with real-world examples. These methodologies include: • System dynamics and causal loops • Network analysis • Outcome mapping • Soft systems methodology And many more. Written by an international team of experts in health research, this handbook will be essential reading for those working in or researching public health, health policy, health systems, global health, service improvement and innovation in practice.. “With this new book, health researchers have a detailed guide for applying system thinking tools in day-to-day operations to identify and solve issues related to health policy and systems.” Ghaffar Abdul, Executive Director of the Alliance for Health Policy and Systems Research, Switzerland “This book is the first to present practical options for applying systems thinking to understand complexity in health systems. The editors compile an essential collection of practical tools for understanding complex problems and framing research questions, as well as for determining and managing related solutions.” Ligia Paina, PhD, Assistant Professor, Bloomberg School of Public Health, Johns Hopkins University, USA “This keenly-awaited book offers a lucid and comprehensive discussion on how to research complex health systems. The book provides invaluable help in navigating this complexity and applying rigorous as well as pragmatic approaches to capturing dynamic interactions between system elements and causal loops.” Dina Balabanova, PhD, Associate Professor, Health Systems/Policy, London School of Hygiene & Tropical Medicine, UK “This book is timely to help equip individuals or researchers with practical tools that are expected to empower the field and facilitate greater and more relevant evidence production for better policy making in health.” George Gotsadze, Director, Curatio International Foundation “This methodological handbook includes variety of essential tools and provides excellent guidance for health system researchers and managers when investigating and resolving complex health systems problems.” Fadi El-Jardali, Professor of Health Policy and Systems, American University of Beirut, Lebanon

Table of Contents:
1.  Introduction – Scope, intended audience and how to use this handbook 2.  Systems approaches in health systems research – approaches for embedding research 3.  Boundary critique – approaches for framing methodological design 4.  Soft systems methodology – an approach for stakeholder and researcher reflection on a problem 5.  Cynefin – a tool for situating the problem in a sense-making framework 6.  Causal loop diagrams – a tool for visualizing emergent system behaviour   7.  Network analysis – a tool for understanding social network behaviour of a system 8.  Human systems dynamics – a tool for understanding self-organizing behaviour of actors in the system 9.  Process mapping – a tool for visualizing system processes from end-to-end 10. Systems dynamics – a tool for modelling and testing solutions 11. Scenario technique – a tool for simulating and reflecting on alternative solutions 12. Outcome mapping – a tool for planning, monitoring and evaluating complex interventions in systems 13. Conclusion – How these approaches and tools can fit together and be used