Center for Research in Nursing and Health Care, University of Costa Rica, San José, Costa Rica.
Independent Researcher and Professional Consultant, Boston, MA, United States.
Front Public Health. 2023 Mar 16;11:968357. doi: 10.3389/fpubh.2023.968357. eCollection 2023.
The Systems Thinking Accelerator (SYSTAC) is a community to engage, connect and collaborate to elevate the field of systems thinking with a focus on low- and middle-income countries, highlighting the need to identify existing capacities within research and at the practice level. The study aimed to explore if there is a perceived need for and benefit from the application of Systems Thinking tools for analysis and diagnosis of problem-solving within Healthcare in the Region of the Americas in 2021 and the existing capabilities.
The identification and deconstruction of the needs, demands, and opportunities regarding systems thinking in the Americas were approached by: (i) adapting the tools and Systems Thinking definition to reflect regional nuances, (ii) identifying stakeholder exercise, (iii) needs assessment survey distribution, (iv) stakeholder mapping analysis, (v) workshop. More information on the adaptation and execution of each tool can be found below.
123 stakeholders were identified, of which 40 participated in the needs assessment survey. 72% of respondents indicated little knowledge of the tools and approaches of systems thinking but a high interest in developing them, as stated by 87% of respondents. Qualitative tools were most frequently used, such as brainstorming, problem trees, and stakeholder mapping. Systems thinking is mainly used when conducting research, implementing, and evaluating projects. A clear need and want for training and developing capacities in health systems thinking were identified. However, in practice, systems thinking faces challenges like resistance to change and to the transformation of health processes, barriers at the institutional level, and other administrative disincentives that hinder its application, being institutional transparency, political will, and the articulation of the actors the main challenges.
Strengthening and building personal and institutional capacities in systems thinking theory and practice requires overcoming challenges such as lack of transparency and inter-institutional cooperation, the low political will to implement it, and difficult stakeholders' integration. As a first step, it is crucial to understand further the stakeholder network and the capacity needs of the region, gain buy-in from strategic players to establish the use of system thinking as a priority, and develop a roadmap.
系统思维加速器（SYSTAC）是一个社区，旨在通过关注中低收入国家，参与、连接和合作来提升系统思维领域，强调需要确定研究和实践层面现有的能力。本研究旨在探讨 2021 年在美洲地区，医疗保健领域中应用系统思维工具进行分析和诊断问题解决是否存在感知到的需求和益处，以及现有的能力。
通过以下方式来确定和解构美洲地区系统思维的需求、要求和机会：（一）调整工具和系统思维定义以反映区域细微差别；（二）确定利益相关者活动；（三）需求评估调查分配；（四）利益相关者图谱分析；（五）研讨会。更多关于每个工具的调整和执行的信息可以在下面找到。
确定了 123 名利益相关者，其中 40 名参与了需求评估调查。72%的受访者表示对系统思维的工具和方法了解甚少，但有 87%的受访者表示有很高的兴趣开发这些方法。最常使用的定性工具，如头脑风暴、问题树和利益相关者图谱。系统思维主要用于开展研究、实施和评估项目。明确需要并希望在卫生系统思维方面进行培训和发展能力。然而，在实践中，系统思维面临着一些挑战，例如对变革和卫生流程转型的抵制、机构层面的障碍以及其他行政抑制因素，这些都阻碍了其应用，而机构透明度、政治意愿和行动者的协调是主要挑战。
加强和建立系统思维理论和实践方面的个人和机构能力，需要克服缺乏透明度和机构间合作、实施系统思维的政治意愿低以及难以整合利益相关者等挑战。作为第一步，了解利益相关者网络和该地区的能力需求，获得战略参与者的认可，将系统思维的使用确立为优先事项，并制定路线图至关重要。
