ReviewBMJ global health2023
Development of the Systems Thinking for Health Actions framework: a literature review and a case study.
Review in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systems thinking in public health interventions: a systematic review of barriers and facilitators.BMC health services research · 2026Pooled it
- Data-driven decision-making for district health management: a cluster-randomised study in 24 districts of Ethiopia.BMJ global health · 2024Trial
- Palliative care development as a solution to mitigate the human crisis of cancer in low- and middle-income countries: a theory of change approach.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Skills-Based Human Capital Management in Latvian University Hospitals: A Qualitative Multi-Institutional Study.Healthcare (Basel, Switzerland) · 2026Article
- Gender-sensitive and diversity-sensitive end-of-life care in Switzerland (GiveCare): a mixed-methods study protocol.BMJ open · 2026Article
- Article
- Integrating systems thinking and implementation science in biomedical informatics research.JAMIA open · 2026Review
- Learning from 30 years of systems thinking in healthcare.Frontiers in health services · 2026Article
- Goals in Nutrition Science 2025-2030.Frontiers in nutrition · 2026Review
- The theory behind the strategies: interpreting the expert recommendations for implementing change taxonomy through four behavioural lenses.Frontiers in health services · 2026Article
- Neglected tropical diseases elimination in Africa: lessons from regional control programmes.Tropical medicine and health · 2025Review
- Effect of early clinical exposure based health systems science course in the Korean medical education: a prospective observational study.BMC medical education · 2025Observational
- Advancing implementation of shared care for cancer survivors using a systems thinking approach (the SEAMLESS study).Journal of cancer survivorship : research and practice · 2025Article
- Enablers and barriers for policymaker engagement in health research from the perspective of policymakers: a scoping review.BMJ open · 2025Article
- Health systems science and systems thinking: qualitative evaluation of preclinical medical student reflections in a role-play simulation game.BMC medical education · 2025Article
- Advancing environmentally sustainable learning health systems: Perspectives from a Canadian health center.Learning health systems · 2025Article
- Systems thinking to understand the complexity of antimicrobial resistance across One Health: A systematic review of current approaches.One health (Amsterdam, Netherlands) · 2025Review
- Nurses' attitudes, practices, and barriers toward sustainability behaviors: a qualitative study.BMC nursing · 2025Article
- A co-designed conceptual model for implementing falls prevention programmes for community-dwelling older adults in Singapore: a systems thinking approach.Age and ageing · 2025Article
- Operationalizing systems thinking approach to sustain public health rehabilitation programs: a rapid review and strategic synthesis.Frontiers in rehabilitation sciences · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
backgroundSystems thinking is an approach that views systems with a holistic lens, focusing on how components of systems are interconnected. Specifically, the application of systems thinking has proven to be beneficial when applied to health systems. Although there is plenty of theory surrounding systems thinking, there is a gap between the theoretical use of systems thinking and its actual application to tackle health challenges. This study aimed to create a framework to expose systems thinking characteristics in the design and implementation of actions to improve health.
methodsA systematised literature review was conducted and a Taxonomy of Systems Thinking Objectives was adapted to develop the new 'Systems Thinking for Health Actions' (STHA) framework. The applicability of the framework was tested using the COVID-19 response in Pakistan as a case study.
resultsThe framework identifies six key characteristics of systems thinking: (1) recognising and understanding interconnections and system structure, (2) identifying and understanding feedback, (3) identifying leverage points, (4) understanding dynamic behaviour, (5) using mental models to suggest possible solutions to a problem and (6) creating simulation models to test policies. The STHA framework proved beneficial in identifying systems thinking characteristics in the COVID-19 national health response in Pakistan.
conclusionThe proposed framework can provide support for those aiming to applying systems thinking while developing and implementing health actions. We also envision this framework as a retrospective tool that can help assess if systems thinking was applied in health actions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.