Public health systems analysis-the transfer of learning between developed and developing countries

This paper explores the role of systems thinking and operational research in furthering our understanding of and our control over complex public health systems. First, it tracks the evolution of our current perception and conceptual modelling of public health systems and the emerging recognition of the need for a whole systems approach. It gives examples of how methods of operational research, particularly those derivative of problem structuring methods, have been used to assist in clarifying the nature of the complexities that surround public health systems, identifying key change agents within public health systems, supporting these agents in making a meaningful contribution, and thereby planning and implementing effective interventions. These examples are drawn from work conducted within the public health systems of both developed and developing countries highlighting the importance of viewing the transfer of 'soft systems' technology as a two-way street with developed nations having (at least) as much to learn from their developing counterparts as they have to teach.