Lecture 2A: Systems Thinking In Practice - Understanding and Engaging with Stakeholders

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来自 Johns Hopkins University 的课程

Systems Thinking In Public Health

299 个评分

Johns Hopkins University

Systems Thinking In Public Health

299 个评分

This course provides an introduction to systems thinking and systems models in public health. Problems in public health and health policy tend to be complex with many actors, institutions and risk factors involved. If an outcome depends on many interacting and adaptive parts and actors the outcome cannot be analyzed or predicted with traditional statistical methods. Systems thinking is a core skill in public health and helps health policymakers build programs and policies that are aware of and prepared for unintended consequences. An important part of systems thinking is the practice to integrate multiple perspectives and synthesize them into a framework or model that can describe and predict the various ways in which a system might react to policy change. Systems thinking and systems models devise strategies to account for real world complexities. This work was coordinated by the Alliance for Health Policy and Systems Research, the World Health Organization, with the aid of a grant from the International Development Research Centre, Ottawa, Canada. Additional support was provided by the Department for International Development (DFID) through a grant (PO5467) to Future Health Systems research consortium. © World Health Organization 2014 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Johns Hopkins University Bloomberg School of Public Health has a non-exclusive license to use and reproduce the material.

从本节课中

Introduction to Systems Thinking and Complex Adaptive Systems

This module introduces the basics of systems thinking and the rationale for using a systems approach to solve public health problems in complex adaptive systems.

Video: Introduction to Systems Thinking1:11

Lecture 1A: Why Use Systems Thinking13:12

Lecture 1B: Health Systems Applications of CAS: Health Systems Frameworks and the Problem of Implementation20:14

Lecture 1C: CAS Pathways: The Problem of Scaling Up19:58

Lecture 1D: Where Systems Thinking Helps: Understanding the Types of Problems, Theories, Methods, and Tools21:16

Lecture 2A: Systems Thinking In Practice - Understanding and Engaging with Stakeholders7:25

Lecture 2B: Network Analysis, Participatory Impact Pathways Analysis, and Summary10:55

与讲师见面

David Bishai, MD, PhD
Professor
Population, Family and Reproductive Health
Ligia Paina, PhD
Assistant Scientist
International Health

[MUSIC]

Hi everyone.

My name is Ligia Paina, and

I'm an assistant scientist in the department of international health.

In today's lecture, we'll be going over understanding stakeholders and

how to engage with them.

First we'll discuss who is the stakeholder.

Then we will go over three common approaches to understand and

engage with stakeholders.

And we'll conclude with a summary of the key takeaways.

So who is a stakeholder?

Being from Romania, when I hear about a Stakeholder, I think of.

He has a stake, but what he does with his stake is quite cruel,

so hopefully we wouldn't have to invite him to a meeting.

More common Stakeholders in public health are the community health workers,

mothers, politicians,

ministers of health, non-governmental organizations and everyone in between.

A stakeholder can be any person or organization or social group, for

that matter, who has a vital interest in the issue at hand.

But again, who has a stake in an issue really depends on the problem in

the context that you're working in.

So, it's very helpful to have that well defined beforehand.

And stakeholders, they each bring to the table different perspectives.

A community health worker like in the left picture will have a different perspective

than one of the politicians or

ministers of health that you see illustrated on the right-hand side.

So, it's important to bring them together.

Because as you remember from the biggest lecture, in complex systems, the actors in

the relationships, and how they change overtime are really, really important.

So, looking at these characteristics, and the types of tools that one might use,

in today's lecture we'll focus on three of these mainly the ones that would

help us understand who the stakeholders are in case we don't know who they are.

And then to capture their different perspectives in order to both understand

them and depending on the situation try to obtain buy-in or build consensus.

It's worth noting another approach and

this will be covered in subsequent lectures in more detail.

But group, or participatory model building is an approach that really allows

us to cut across and understand all of these different characteristics.

And it's usually used in building causal loop diagrams or system dynamics models.

But, in order to get to that stage and invite stakeholders to your table

to collaborate on a model together, it's often helpful to understand who they are,

where they are, and what their interest might be.

And the three tools we'll be going over briefly today

help us get a little bit closer to that.

And I should mention that this is not an exhaustive list.

But hopefully going through these three will give you a flavor of

various approaches that might be available.

So the first of the approaches is the Stakeholder Analysis, and the main use of

the Stakeholder Analysis is to identify stakeholders, and to anticipate

what their position will be in relation to a policy change or to an issue.

And one of the nicely arranged stakeholder analysis of purchase was

put together by Professor Hyder and colleagues, and it outlines three phases.

And I suggest that you read the article for greater detail.

But I'll highlight that the first phase is focused on defining

the outcomes of interest, or policy changes of interest,

as well as what you expect the consequences of these to be.

And as part of that, it's important to define the aim of the analysis,

the time dimension, whether you're looking back or forward looking,

the context in which you're working in, and at what level the analysis will take

place, acknowledging that you might have multiple levels of interest.

Based on this definition, the second phase involves the data gathering and

that is done through communications with stakeholders in-depth interviews and

other ways to collect information that helps you identify, map and

profile the stakeholders.

And finally the third phase helps you analyze the data that you gathered and it

helps you understand stakeholders in terms of their power position and perspective.

So this third phase really gives you the results of your analysis.

But it's important to note that while perhaps you might get a lot of

gratification from the matrices and tables that you'll construct, what is really

important and the most difficult part are the steps taken in Phase I and Phase II.

Which are creating the boundaries of your analysis and

helping to define what types of stakeholders you'll explore.

And this three-phase approach is further broken down into 12 steps,

and you'll see that the first four steps map to the first phase, and so forth.

Again these steps highlight the need to articulate a very clear problem statement

and to really spend time to understand, systematically

who the key stakeholders might be and in what categories they might fit in.

And, you'll see that the type of data that you collect then helps you

categorize them by power,

influence, as well as by the level of agreement with the policy proposal.

And it's worth noting as well that the 12th step

highlights the fact that stakeholders are not a static group or category.

They might change over time, they might change in composition.

So you might have new actors that come in that are important.

Stakeholders might change their position as to the issue that you're interested in.

So it's often times advised to consider planning for

repeating the analysis in time.

That was a very brief overview of the methods and what you will eventually

get are these matrices and tables that can be used to analyze the data.

And this table is an example that would help you categorize the different

stakeholders by level in the system and

also by different characteristics that might be of interest.

And the idea is that, eventually,

you should be able to place the different stakeholders along a similar graph.

This one is the two axes are agreement and power and

influence, but you might find that there are other dimensions of interest.

And what these will help you do is identify where the stakeholders might be

placed so that you can think through ways to engage with them, how to involve them,

how to collaborate with them, how to monitor people's behavior,

where to target the information that you might have available.

For further references I think that there are many resources out there for

Stakeholder Analysis.

I'm selecting three of them, the first two for methodological purposes and

the third one because it gives many examples of different matrices and

tables that you might be interested in using.

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