course ID: 2

Applied systems thinking for health systems managers and researchers


Health systems are complex adaptive systems. They often operate in rapidly changing social, political and economic environments and are characterized by difficult governance of multiple stakeholders with different agendas and interests, fragmented sub-systems, multiple non-aligned financing arrangements, and incoherent information flows.  This makes intervening in health systems a difficult (and exciting) endeavour. Systems thinking and system thinking tools can help policy makers, health system managers, development agents or the public make sense of this complexity, and propose appropriate interventions to tackle appropriate problems of health systems.

In this course, we provide a primer on what systems thinking is and why it matters for both designing and evaluating health system interventions and reforms.  We share practical examples of how systems thinking is currently being applied, to solve common problems faced by health systems practitioners.

Throughout the week, we will introduce a selection of systems thinking tools and approaches in “hands-on” applied methods sessions, and then apply what has been learned in practical case studies undertaken by individual and group work.  The selected tools and approaches will include: mind mapping for intervention integration; social network analysis; process mapping and modelling; causal loop diagrams; group model building.



At the end of the course participants will:

  1. Have a foundation of systems thinking concepts and theories
  2. Apply use of systems thinking approaches and tools for improving the performance of health systems in low and middle income countries.


The course is intended for health system policy makers and managers, development practitioners, implementation researchers, and graduate students in public health.

Don de Savigny


Health Systems and Policy Research Group, Department of Epidemiology and Public Health, Swiss TPH Institute

Daniel Cobos Muñoz


Research Fellow, Health Systems and Policy Research Group, Department of Epidemiology and Public Health, Swiss TPH Institute

Ligia Paina


Assistant Professor, Health Systems Program, Department of International Health, Johns Hopkins University School of Public Health, Baltimore MD, USA