Brigham Young University, 1668 North 1590 West, Provo, UT 84604, USA.
Health Policy Plan. 2012 Oct;27 Suppl 4(Suppl 4):iv54-61. doi: 10.1093/heapol/czs090.
While reaching consensus on future plans to address current global health challenges is far from easy, there is broad agreement that reductionist approaches that suggest a limited set of targeted interventions to improve health around the world are inadequate. We argue that a comprehensive systems perspective should guide health practice, education, research and policy. We propose key 'systems thinking' tools and strategies that have the potential for transformational change in health systems. Three overarching themes span these tools and strategies: collaboration across disciplines, sectors and organizations; ongoing, iterative learning; and transformational leadership. The proposed tools and strategies in this paper can be applied, in varying degrees, to every organization within health systems, from families and communities to national ministries of health. While our categorization is necessarily incomplete, this initial effort will provide a valuable contribution to the health systems strengthening debate, as the need for a more systemic, rigorous perspective in health has never been greater.
虽然就解决当前全球健康挑战的未来计划达成共识远非易事，但人们普遍认为，那些建议采取有限的有针对性的干预措施来改善全球健康的简化方法是不够的。我们认为，全面的系统观点应该指导卫生实践、教育、研究和政策。我们提出了一些关键的“系统思维”工具和策略，这些工具和策略有可能在卫生系统中实现变革性的改变。这三个总体主题涵盖了这些工具和策略：跨学科、部门和组织的协作；持续的、迭代的学习；以及变革性的领导力。本文提出的工具和策略可以在不同程度上应用于卫生系统中的每个组织，从家庭和社区到国家卫生部。虽然我们的分类必然不完整，但这一初步努力将为卫生系统加强辩论做出有价值的贡献，因为现在比以往任何时候都更需要更系统、更严格的卫生视角。
