Introduction to Complex Health

Systems

Leanring outcomes and

Threshold Concepts
www.hpsaafrica.org
@hpsa_afric
a

ICHS 0

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ica

By the end of this course students are expected to be able

to:

Show understanding of the dynamic and complex nature of

health systems by reflecting on and describing their value
bases and functioning, their components and the central roles
and behaviours of a range of agents.
Discuss health systems as social constructions, influenced by
and influencing the agents within them, as well as influenced
by broader political and economic forces, generating public
value and contributing to societal development.
Apply these understandings to assessment of own health
system and comparison between health systems.
Apply relevant analytical skills and an understanding of
complex systems in order to develop ideas about action to
strengthen health systems.
Develop the personal communication, teamwork and
leadership skills which are important for supporting health
system change.
Demonstrate understanding of and openness to different
perspectives on the nature of health systems.

Health systems are socially constructed; they exist within

contexts and histories and are driven by and impact on a
range of agents.
Health systems are integrative by nature, and consist of
complex inter-relationships; we all have a role in the system.
Health systems comprise interacting dimensions of hardware
and software.
Health system effectiveness is a whole system judgement
rather than one based on the effectiveness of specific
interventions.
People are at the centre of the health system, driven by values
and contexts
People make sense of the system around them and act based
on their understandings and mind sets
Power is everywhere: in agency, service delivery and decisionmaking.
Everyone has a part to play in the system, working towards
shared goals
The health system is knowable and changeable.
The health system is a complex adaptive system.

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following usual academic conventions.
Citation of this work must follow normal academic
conventions. Suggested citation:
Introduction to Complex Health Systems,
Presentation 1. Copyright CHEPSAA (Consortium
for Health Policy & Systems Analysis in Africa)
2014, www.hpsa-africa.org
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Funding
This document is an output from a project funded by the European Commission (EC) FP7Africa (Grant no. 265482). The views expressed are not necessarily those of the EC.

The CHEPSAA partners

University of Dar Es
Salaam

University of the
Witwatersrand

Institute of Development Studies

Centre for Health Policy

University of Ghana

University of Leeds

School of Public Health,

Department of Health Policy,
Planning and Management

Nuffield Centre for International

Health and Development

University of Nigeria
Enugu

London School of
Hygiene and Tropical
Medicine

Health Policy Research Group &

the Department of Health
Administration and Management

Great Lakes University

of Kisumu
Tropical Institute of Community
Health and Development

University of Cape Town

Health Policy and Systems

Health Economics and Systems

Analysis Group, Depart of Global
Health & Dev.

Karolinska Institutet
Health Systems and Policy Group,
Department of Public Health
Sciences

Swiss Tropical and Public

Health Institute
Health Systems Research Group