Health Systems:How to make innovations contagious?

Improving health worldwidewww.iceh.org.uk www.lshtm.ac.uk

Karl BlanchetSeptember 2012

IAPB 9th GA, India

Research needs

(Blanchet et al. 2012)

How do we look at systems?

How do we look at systems?

• Paradigm shifts–Connected–Unique–Embedded–Fluid

Connected• The whole system (de Savigny, 2010)

• Social Network Analysis (Borgatti, 2010)

Study in Ghana 2011 (Blanchet and James, 2011 and 2012)

Connected

Improving health worldwidewww.iceh.org.uk www.lshtm.ac.uk2006

Connected

Improving health worldwidewww.iceh.org.uk www.lshtm.ac.uk2010

Unique• No standard model • Diversity• Measuring – Performance (equity, efficiency...?)– Sustainability (Sustainability Analysis

Process)– Resilience

EmbeddedPolitics

Social

HS

Eye HS

Eye Health Systems Assessment (EHSA)

• Guideline• Country reports– Ghana – Sierra Leone

Fluid• Flows and Dynamics• Complex adaptive system• Diffusion of innovations Theory

(Rogers, 1985)

Attributes of innovationsRelative advanta

ge(5=very

high relative

advantage)

Compatibility

(5=very highly

compatible- 1=very

incompatible)

Complexity

(5=not complex –

1=very highly

complex)

Triability

(5=very highly

triable – 1=very highly

untriable)

Observability

(5=very highly

observable – 1=very highly

unobservable)

Total(max =

25)

Continue?

Facility-based Consultations

5 5 5 1 3 19 Yes

Cataract surgery

5 5 2 1 5 18 Yes

Outreach activities

5 2 2 1 3 13 No

School health

5 2 1 1 1 10 No

Blanchet and James, Submitted

HSR: What for?

Health Systems Dashboard

Thank you

Thank you to our Donors:Swiss Red Cross

CBMHandicap International

Sightsavers

Improving health worldwidewww.iceh.org.uk www.lshtm.ac.uk