We live in an interconnected world. Everything affects everything; nothing stands alone. At MEASURE Evaluation, we work from this premise – called systems thinking. A system is composed of many inter-related actors and parts. To improve any component of a country’s health system, we often have to address other components first, which requires stepping back for a moment to see how the parts are related and developing a plan that acknowledges those relationships.
An example of systems thinking is working through a country-led partnership. For MEASURE Evaluation, it’s an approach to improve health information systems within a country through collaboration. The factors in play include alignment and respect for how a country defines what information is needed, cooperation to provide resources to set up and sustain the systems to deliver that information, technical assistance when needed to ensure local stakeholders can implement the agreed-on solutions to deliver results, and transparent information flow among all players for mutual accountability. If one or more of those components is broken or is ignored, our collective efforts to improve health will be ineffective, investment will have little to show, and the solution as planned will not be sustainable.
Systems thinking can be challenging because it may lead to a set of actions that seems unfocused to some. But to achieve substantial and sustained improvements, there is no alternative. This approach understands that as health information system components are strengthened and better managed, better quality data will be generated and capacity to use that data by decision makers at every level of the health system will be improved. That will lead to increased understanding about where programs are in greatest need, and yield better decisions on budgeting, properly locating health interventions, and devising more appropriate and effective interventions. Those decisions, in turn, will improve program impact, accountability and sustainability.
MEASURE Evaluation has a long history of using a systems approach, and has developed resources and provided technical assistance to help others engage in systems thinking.