The original version of this article, by Ben Ramalingam, appeared on Aid on the Edge of Chaos
Despite increased prominence and funding of global health initiatives, attempts to scale up health services in developing countries are failing, with serious implications for achieving the Millennium Development Goals
. A new paper
argues that a key first step is to get a more realistic understanding of health systems, using the lens of complex adaptive systems.
Much ongoing work in development and humanitarian aid is based on the idea of “scaling up” effective solutions. Healthcare is one of the areas where this idea has played a central role – from the World Health Organization’s Health for All in the 1960s to UNICEF’s child healthcare programs, from rolling out HIV-AIDS, malaria and TB treatments to the package of interventions delivered to achieve the Millennium Development Goal on health.
However, despite the fact there are many cost-effective solutions to health problems faced in developing countries, many agencies are still frustrated in their attempts to deliver them at scale. This may be because of a widespread failure to understand the nature of health systems.
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Image Credit: Adapted from Table 1, “Understanding pathways for scaling up health services through the lens of complex adaptive systems,” Health Policy and Planning, Oxford University Press.