ArticleInternational journal of health policy and management2014
Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries.
Article in International journal of health policy and management, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- What the policy and stewardship landscape of a national health research system looks like in a developing country like Iran: a qualitative study.Health research policy and systems · 2022Pooled it
- Development of the Systems Thinking for Health Actions framework: a literature review and a case study.BMJ global health · 2023Review
- Accelerating systems thinking in health: Perspectives from the region of the Americas.Frontiers in public health · 2023Article
- The Palestinian health research system: who orchestrates the system, how and based on what? A qualitative assessment.Health research policy and systems · 2018Article
- Assessing policy-makers', academics' and experts' satisfaction with the performance of the Palestinian health research system: a qualitative study.Health research policy and systems · 2018Article
- Understanding the concept and importance of the health research system in Palestine: a qualitative study.Health research policy and systems · 2018Article
- Stakeholders' perspectives on facilitators of and barriers to the utilisation of and access to maternal health services in Eritrea: a qualitative study.BMC pregnancy and childbirth · 2018Article
- Qualitative analysis of the health system effects of a community-based malaria elimination program in Rwanda.Research and reports in tropical medicine · 2018Article
- A Systems Approach to Evaluate One Health Initiatives.Frontiers in veterinary science · 2018Article
- Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.Health research policy and systems · 2017Article
- Exploring the dynamics of food-related policymaking processes and evidence use in Fiji using systems thinking.Health research policy and systems · 2017Article
- Factors affecting evidence-use in food policy-making processes in health and agriculture in Fiji.BMC public health · 2017Article
- Taking the Concept of Citizenship in Mental Health across Countries. Reflections on Transferring Principles and Practice to Different Sociocultural Contexts.Frontiers in psychology · 2017Article
- Understanding the dynamics of the Seguro Popular de Salud policy implementation in Mexico from a complex adaptive systems perspective.Implementation science : IS · 2016Article
- Time to shift from systems thinking-talking to systems thinking-action: Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".International journal of health policy and management · 2015Article
- Application of systems thinking in health: opportunities for translating theory into practice Comment on "Constraints to applying systems thinking concepts in health systems: a regional perspective from surveying stakeholders in Eastern Mediterranean countries".International journal of health policy and management · 2015Article
- Thinking shift on health systems: from blueprint health programmes towards resilience of health systems Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".International journal of health policy and management · 2015Article
- "Wood already touched by fire is not hard to set alight": Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".International journal of health policy and management · 2015Article
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Abstract
backgroundSystems Thinking (ST) has recently been promoted as an important approach to health systems strengthening. However, ST is not common practice, particularly in Low- and Middle-Income Countries (LMICs). This paper seeks to explore the barriers that may hinder its application in the Eastern Mediterranean Region (EMR) and possible strategies to mitigate them.
methodsA survey consisting of open-ended questions was conducted with a purposive sample of health policy-makers such as senior officials from the Ministry of Health (MoH), researchers, and other stakeholders such as civil society groups and professional associations from ten countries in the region. A total of 62 respondents participated in the study. Thematic analysis was conducted.
resultsThere was strong recognition of the relevance and usefulness of ST to health systems policy-making and research, although misconceptions about what ST means were also identified. Experience with applying ST was very limited. Approaches to designing health policies in the EMR were perceived as reactive and fragmented (66%). Commonly perceived constraints to application of ST were: a perceived notion of its costliness combined with lack of the necessary funding to operationalize it (53%), competing political interests and lack of government accountability (50%), lack of awareness about relevance and value (47%), limited capacity to apply it (45%), and difficulty in coordinating and managing stakeholders (39%).
conclusionWhile several strategies have been proposed to mitigate most of these constraints, they emphasized the importance of political endorsement and adoption of ST at the leadership level, together with building the necessary capacity to apply it and apply the learning in research and practice.
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