In 1895, poet Joseph Malins described an ill-starred town shadowed by a cliff. Citizens would regularly tumble off the cliff, so the town mercifully pays for a public ambulance. The poet berates the town for not building a fence at the rim of the cliff. As the G20 come together this July in Hamburg, they should take heed and learn the lessons from this fenceless town. Addressing global health security challenges like pandemics and resistance to antibiotics requires not just an ambulance, but a fence too.Read More
Filtering by Category: complex adaptive systems
During the past few years complex adaptive systems theory has suddenly become very popular in the health systems research field. However, I have to admit that, until recently, I was something of a complex systems modeling sceptic. A couple of recent events, notably the FHS workshop and an NIH conference, have changed my perspective. Here's what has driven my change in thinking.Read More
Alexander Galloway (2011) in his article ‘Are some things unrepresentable?’ cites a causal loop diagram as an example of a critical tension in communication where the more information that is represented the less information is actually conveyed. He dubs it ‘McChrystal’s Law’, and then proceeds to suggest that such visualisations contribute to a political violence committed against the viewer, in part because the aesthetics of the diagram overstate its ability to represent. Yikes!
Unfortunately, McChrystal’s Law is just the tip of the iceberg when it comes to communicating complexity. At a three-day workshop jointly convened by Future Health Systems and the STEPS Centre examining complex adaptive systems (CAS), we had an interesting discussion about some of those challenges.Read More
Many will already be familiar with the term ‘complex adaptive systems’ (CAS). It’s certainly something we’ve talked about a lot within the Future Health Systems consortium. But it’s a term, and concept and a practice that has taken me some time to fully comprehend and to utilize in my own work. We are implementing a number of implementation research projects in Eastern Uganda, and most of my attention has been focused on the day-to-day operations of these large projects. However, I’ve found CAS tools to help me step back and get a broader picture of our research intervention. Here’s why.
At a recent workshop on methods for understanding complex adaptive systems (CAS) in the context of health systems strengthening, we looked at a number of modelling techniques, like agent-based modeling and causal loop diagrams, some purporting to be participatory in nature. But is the idea of participatory approaches to complex systems thinking inherently contradictory? Inherently confusing? Or are they revolutionary, altering how we see the world and empowering us to transform health systems radically?Read More
At the recent workshop on methods for complex adaptive systems (CAS) research in Baltimore, jointly organised by the STEPS Centre and Future Health Systems, thoughts turned to the legacy of such long-term programmes. Though they had different funders, both STEPS and FHS started in 2006. So now, as both programmes start thinking about their 10th anniversaries, how can we begin to summarise all that research and the influence that it has had?Read More
As discussed at a methods workshop held in Baltimore in June 2014, systems mapping and conceptualization – a key part of the puzzle of intervening in complex systems – is a process of developing diagrams to illustrate system boundaries and the connections between variables.
CLDs are one type of system map, but they are by no means the only one. What makes CLDs particularly useful is that, in addition to mapping a system structure, they help build understanding of connections between a range of variables.
The increased momentum around complexity and tools such as the CLDs begin to raise issues that question the very core of the paradigms in which we generally operate in public health. That creates demand for understanding what CLDs are and when to develop and use them. It also creates an opportunity to drop some of the communication barriers that exist between disciplines and to push the boundaries of our understanding of complex systems.Read More