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Systems Thinking Analyses for Health Policy and Systems Development
  • A Malaysian Case Study
  • Edited by Jo. M. Martins, Indra Pathmanathan, David T. Tan, Shiang Cheng Lim, Pascale Allotey
  • Published online:
    04 September 2021
    Print publication:
    26 August 2021
  • Health systems are fluid and their components are interdependent in complex ways. Policymakers, academics and students continually endeavour to understand how to manage health systems to improve the health of populations. However, previous scholarship has often failed to engage with the intersections and interactions of health with a multitude of other systems and determinants. This book ambitiously takes on the challenge of presenting health systems as a coherent whole, by applying a systems-thinking lens. It focuses on Malaysia as a case study to demonstrate the evolution of a health system from a low-income developing status to one of the most resilient health systems today. A rich collaboration of multidisciplinary academics working with policymakers who were at the coalface of decision-making and practitioners with decades of experience, provides a candid analysis of what worked and what did not. The result is an engaging, informative and thought-provoking intervention in the debate. This title is Open Access.

  • 1 - An Introduction to Health Systems

  • from Section I
  • Edited by Jo. M. Martins, Indra Pathmanathan, David T. Tan, Shiang Cheng Lim, Pascale Allotey
  • Book:
    Systems Thinking Analyses for Health Policy and Systems Development
    Published online:
    04 September 2021
    Print publication:
    26 August 2021, pp 3-16
    • Chapter
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  • Summary

    Health systems are made up of multiple interacting components including organisations, people and actions. They perform several functions: delivering healthcare services; maintaining and improving health; protecting households from the costs of illness; enabling economic functioning; and shaping societal norms and values. They are also sites of competition and contestation between actors with different interests and visions.

    This chapter outlines the complexity of health systems and explains how they can only be studied and fully understood through a multi-disciplinary lens. It unpacks the different dimensions of health systems complexity, the societal functions performed by health systems, and the contestation between different ideas, values and interest groups. It examines various health systems frameworks and typologies and how they can be used to describe and understand the performance of health systems. It discusses the open and contextual nature of health systems and their relationship with external factors, including shifts in international health policy-making. Finally, the chapter ends with a brief introduction of systems thinking which is discussed further in Chapter 2.

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