Systems Thinking for District Health Systems: Applications, Issues and Challenges

Dear Colleagues,

There is an unprecedented increase in the application of systems thinking to the many ongoing and emerging health system challenges we face at present.  An arsenal of systems thinking approaches and methods is now being applied (Thelen et al. 2023). Applications are typical at global and national policy levels, as well as at institutional levels. However, more recently, subnational district health systems in low- and middle-income countries (LMICs) are applying systems thinking with the potential to improve health outcomes and advance overall health system performance significantly. This Special Issue seeks scientific contributions that examine the practical implementation of systems thinking in district health systems, as well as those that critically reflect on its limitations and potential for improving health outcomes in low- and middle-income countries. Potential topics of interest include, but are not limited to:

• The use of systems thinking in improving the coordination and integration of health services at the district level.
• The application of systems thinking in addressing health inequities and social determinants of health within district health systems.
• The role of community engagement and participation in adopting a systems approach to health system strengthening.
• The use of systems thinking in improving the performance and resilience of district health systems in the face of crises and emergencies.
• The application of systems thinking in the design and implementation of system-level interventions.
• The use of systems thinking to evaluate system effectiveness and effective coverage.
• The practice of systems thinking to reduce fragmentation and other inefficiencies in decentralized health systems.
• The potential for digital health technologies to support the implementation of systems thinking in district health systems.

We welcome empirical studies, case studies, and reviews that draw on diverse disciplinary perspectives and methodologies. Our goal is to foster a deeper understanding of systems thinking methods and approaches in district health systems in low- and middle-income countries and to highlight its potential for improving health outcomes and health equity in these settings.

Thelen, J.; Sant Fruchtman, C.; Bilal, M.; Gabaake, K.; Iqbal, S.; Keakabetse, T.; Kwamie, A.; Mokalake, E.; Mupara, L.M.; Seitio-Kgokgwe, O.; et al. Development of the Systems Thinking for Health Actions framework: A literature review and a case study. BMJ Glob. Health 2023, 8, e010191.

Prof. Dr. Don De Savigny
Dr. Ntuli Angyelile Kapologwe
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Systems is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.