Advancing the application of systems thinking in health: sustainability evaluation as learning and sense-making in a complex urban health system in Northern Bangladesh

Publish Date: August 2014
Author: Eric G Sarriot, Michelle Kouletio, Dr Shamim Jahan, Izaz Rasul and AKM Musha

Starting in 1999, Concern Worldwide Inc. (Concern) worked with two Bangladeshi municipal health departments to support delivery of maternal and child health preventive services. A mid-term evaluation identified sustainability challenges. Concern relied on systems thinking implicitly to re-prioritize sustainability, but stakeholders also required a method, an explicit set of processes, to guide their decisions and choices during and after the project.

This MCSP co-authored article in the journal Health Research Policy and Systems examines Concern’s use of the Sustainability Framework method to generate creative thinking from stakeholders, create a common vision, and monitor progress. The authors conclude that sustainability is dynamic and results from local systems processes, which can be strengthened through both implicit and explicit systems thinking steps applied with constancy of purpose.


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