Abstract
Health systems embrace the input and output, or outcome, of the health of a society or country. Performance of governments in population health is linked to the capacity and capability of respective health system in the policy, strategy, development, implementation, monitoring and financing healthcare in the community at the three levels of health services in preventive, curative and rehabilitative care. Most systems, often embedded with unpredictable behaviours, are not built with the capacity to understand or assess strengths, weaknesses or constraints in parts of or the whole health system. A systems approach will strengthen health systems and provide a framework for improvement and enhancement of the performance and efficiency. It helps to review the complexity, characteristics and relationships of the entire health system, which is constantly changing for obvious reasons. Systems thinking facilitates the design, implementation and evaluation of strategic and innovative plans, from simple to complicated interventions, for the successful and effective operations in services delivery in the equitable manner to the population. The adoption of the systems thinking approach will enable policymakers, academics and practitioners with scientifically sound plans to attain health improvement in the community. The WHO’s framework of health system building blocks effectively describes six subsystems of an overall health system architecture. The chapter will review the systems approach and explore its feasibility and practicality in healthcare, particularly in achieving Health for All in the community.
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References
Berwick, D., & Fox, D. M. (2016). Evaluating the quality of medical care: Donabedian’s classic article 50 years later. Milbank Quarterly, 94(2), 237–241. https://doi.org/10.1111/1468-0009.12189
Chiu, W. K., & Fong, B. Y. F. (2022a). Systems thinking for sustainable healthcare systems. In B. Y. F. Fong, Systems thinking and sustainable healthcare delivery, pp. 1–17. Routledge.
Chiu, W. K., & Fong, B. Y. F. (2022b). Chemical Pollution and Healthy Ageing: The prominent need for a cleaner environment. In V. T. S. Law & B. Y. F. Fong (Eds.), Ageing with dignity in Hong Kong and Asia: Holistic and humanistic care (pp. 277–287). Springer Nature Singapore. https://doi.org/10.1007/978-981-19-3061-4_19
Chiu, W. K., Fong, B. Y. F., & Ho, W. Y. (2022). The importance of environmental sustainability for healthy ageing and the incorporation of systems thinking in education for a sustainable environment. Asia Pacific Journal of Health Management, 17(1), 84–89. https://doi.org/10.24083/apjhm.v17i1.1589
Cristiano, S., & Zilio, S. (2021). Whose health in whose city? A systems thinking approach to support and evaluate plans, policies, and strategies for lasting urban health. Sustainability, 13(21), 12225. https://doi.org/10.3390/su132112225
de Savigny, D., & Adam, T. (2009). Systems thinking for health systems strengthening. World Health Organization. https://apps.who.int/iris/handle/10665/44204
Filip, R., Gheorghita Puscaselu, R., Anchidin-Norocel, L., Dimian, M., & Savage, W. K. (2022). Global challenges to public health care systems during the COVID-19 Pandemic: A review of pandemic measures and problems. Journal of Personalized Medicine, 12(8), 1295. https://doi.org/10.3390/jpm12081295
Fong, B. Y. F., Chiu, W. K., Chan, W. F. M., & Lam, T. Y. (2021). A review study of a green diet and healthy ageing. International Journal of Environmental Research and Public Health, 18(15), 8024. https://doi.org/10.3390/ijerph18158024
Goodman, M. (2018). Systems thinking: What, why, when, where, and how? The Systems Thinker. https://thesystemsthinker.com/systems-thinking-what-why-when-where-and-how/
Kaplan, G., Bo-Linn, G., Carayon, P., Pronovost, P., Rouse, W., Reid, P., & Saunders, R. (2013). Bringing a systems approach to health. NAM Perspectives. https://doi.org/10.31478/201307a
Manyazewal, T. (2017). Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities. Archives of Public Health, 75, Article 50. https://doi.org/10.1186/s13690-017-0221-9
McNab, D., McKay, J., Shorrock, S., Luty, S., & Bowie, P. (2020). Development and application of ‘systems thinking’ principles for quality improvement. BMJ Open Quality, 9(1), Article e000714. https://doi.org/10.1136/bmjoq-2019-000714
Mutale, W., Balabanova, D., Chintu, N., Mwanamwenge, M. T., & Ayles, H. (2016). Application of system thinking concepts in health system strengthening in low-income settings: A proposed conceptual framework for the evaluation of a complex health system intervention: The case of the BHOMA intervention in Zambia. Journal of Evaluation in Clinical Practice, 22(1), 112–121. https://doi.org/10.1111/jep.12160
Mutale, W., Bond, V., Mwanamwenge, M. T., Mlewa, S., Balabanova, D., Spicer, N., & Ayles, H. (2013). Systems thinking in practice: The current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: A baseline qualitative study. BMC Health Services Research, 13, Article 291. https://doi.org/10.1186/1472-6963-13-291
Peters, D. H. (2014). The application of systems thinking in health: Why use systems thinking? Health Research Policy and Systems, 12, Article 51. https://doi.org/10.1186/1478-4505-12-51
Pineo, H., Zimmermann, N., & Davies, M. (2020). Integrating health into the complex urban planning policy and decision-making context: A systems thinking analysis. Palgrave Communications, 6, Article 21. https://doi.org/10.1057/s41599-020-0398-3
Rwashana, A. S., Nakubulwa, S., Nakakeeto-Kijjambu, M., & Adam, T. (2014). Advancing the application of systems thinking in health: Understanding the dynamics of neonatal mortality in Uganda. Health Research Policy and Systems, 12, Article 36. https://doi.org/10.1186/1478-4505-12-36
Sarriot, E. G., Kouletio, M., Jahan, S., Rasul, I., & Musha, A. K. M. (2014). Advancing the application of systems thinking in health: Sustainability evaluation as learning and sense-making in a complex urban health system in Northern Bangladesh. Health Research Policy and Systems, 12, Article 45. https://doi.org/10.1186/1478-4505-12-45
Stansfield, J., South, J., & Mapplethorpe, T. (2020). What are the elements of a whole system approach to community-centred public health? A qualitative study with public health leaders in England’s local authority areas. BMJ Open, 10(8), Article e036044. https://doi.org/10.1136/bmjopen-2019-036044
World Health Organization. (n.d.). Health system govenance. https://www.who.int/health-topics/health-systems-governance#tab=tab_1
World Health Organization. (1978). Declaration of Alma-Ata. https://www.who.int/teams/social-determinants-of-health/declaration-of-alma-ata
World Health Organization. (2008). The world health report 2008: Primary health care now more than ever. https://apps.who.int/iris/handle/10665/43949
World Health Organization. (2018). Declaration of Astana. https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf
Zhang, X., Bloom, G., Xu, X., Chen, L., Liang, X., & Wolcott, S. J. (2014). Advancing the application of systems thinking in health: Managing rural China health system development in complex and dynamic contexts. Health Research Policy and Systems, 12, Article 44. https://doi.org/10.1186/1478-4505-12-44
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Fong, B.Y.F., Chiu, WK. (2023). A Systems Approach to Achieving Health for All in the Community. In: Fong, B.Y.F., Wong, W.C.W. (eds) Gaps and Actions in Health Improvement from Hong Kong and Beyond. Springer, Singapore. https://doi.org/10.1007/978-981-99-4491-0_4
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