Blog 8: systems thinking

  1. Interdependence 
    1. Relationships that are symbiotic in that when one person makes a decision it directly affects another or the larger system 
    2. An example from malnutrition is while we were in country we were partnering with the bettah bakery. We worked with them to improve their business model but when they decided to not show up or there was huge miscommunication, it directly impacted our efficiency and work for the muffins
  2. Holism 
    1. The individual parts by themselves cannot operate a complex function– this requires all the parts to work together to form a system to perform that function. 
    2. When it comes to distributing our documentary we are going to be unable to do it without the help of other components of the system. For example, we want to distribute our doc through Marie Stopes and they want to help spread the word about maternal health and mortality throughout their system. We each cannot easily do this by ourselves, we each need the other component to reach our desired outcomes and joint outcome of eliminating maternal mortality.
  3. Multifinality 
    1. The same or similar inputs lead to different outputs. Or a win-win situation for all
    2. Sickle cell diagnostic devices can be used to provide different outputs depending on the context. For example, in Nigeria, sickle cell diagnostics were successful because of their use in family planning, whereas in Sierra Leone programs are more focused on newborn screening efforts. 
  4. Equifinality
    1. The idea that any given output can be reached by a variety of potential means or combination of inputs.
    2. An example for malnutrition is how we originally created a lot of products that essentially all did the same things but through different “means”. We had different products but ultimately the outcome would have been the same – healthier children 
  5. Differentiation 
    1. Each part in the system plays a crucial role and the system would not be whole without each individual part
    2. An example from the Safe Motherhood team would be when we compiled a list of our stakeholders we wanted to interview, we wanted to include as many people as possible. We needed to get the perspectives of the local community members, the PHU, and the hospitals. Each doctor, nurse, midwife-to-be and mother were essential to understanding the problem of maternal mortality in Sierra Leone to help prevent us from jumping to conclusions. 
  6. Regulation 
    1. A process using checks and feedback to make sure goals are being accomplished & taking corrective action. Accountability. 
    2. In the future, the sickle cell team will rely heavily on regulation concepts. For example, during clinical trials, we will need to confirm our test results by comparing our results to the gold standard (either collecting dried blood spot samples or using in-country IEF), and will adjust accordingly. 
  7. Abstraction 
    1. “Zooming out” to look at a problem from multiple angles or “zooming in” to see underlying concepts 
    2. For the Safe Motherhood team, we had a point in our fieldwork when we were coming up with all these theories of how Sierra Leoneans are trying to hide the problem of maternal mortality and how we needed to focus our documentary on exposing the truth. But we had to zoom out to look at the problem from different angles to realize that there could be multiple reasons why people were telling us that maternal mortality wasn’t a problem in their clinic. They could be telling the truth that maternal death didn’t happen in their clinic because any deaths occurred after they had referred them to the hospital and therefore they did not count as patients of the clinic. 
  8. Leverage Points
    1. Places within a complex system where a small shift in one thing can produce big changes in anything
    2. For the Safe Motherhood team, we started our interview process by all just jumping in and asking questions whenever any one of us had one and we didn’t really go in with a set list of questions. But once we started implementing a system where we prepared a set of main questions and designated one interviewer, things were much more efficient and we got better quotes out of our interviews
  9. Emergence: 
    1. When the whole possesses qualities and behaviors that its individual parts do not have on their own. 
    2. Maternal mortality cannot be solved by just by one person. There needs to be multiple social actors who play a role in reducing the rate and promoting safe motherhood. There needs to be different and specific focuses on planned parenthood, clinic staff, community health workers who bridge the gap, surgeons, trainers, and many other people or groups of people who can work together to make sure that women aren’t dying from giving birth. 

Hyacinth Problem: 

  1. I think there should be a negotiation with the community members who live there. It is their home and they should be included in the money-making process. It should be more of a democracy where the community is informed of what is going on and what their involvement would look like. This would create a win-win situation where the community members have an economic opportunity as well as a chance to get rid of the moss and the entrepreneur would be able to continue working and making money. Rather than fighting over resources, everyone should collaborate together to perform one job. 


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