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P23


Health systems performance or performing health systems? maps, models, and meanings in anthropological engagement with health systems research 
Convenors:
Eleanor Hutchinson (London School of Hygiene and Tropical Medicine)
Hayley MacGregor (Institute of Development Studies)
Karina Kielmann (Institute of Tropical Medicine Antwerp)
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Format :
Panel
Sessions:
Wednesday 19 January, -
Time zone: Europe/London

Short Abstract:

This panel explores how medical anthropology both contests and contributes to the analysis of the ‘systemic’ in health systems research. Conversely, we explore the impact of ‘systems thinking’ on anthropological analyses of classification, routines, and relations in health care.

Long Abstract:

The past decade has seen expansion of the field of health systems research, involving researchers across multiple disciplines. Frameworks initially focused on functional inputs - the so-called ‘building blocks’ of systems ‘hardware’ - have since evolved to delineate ‘software’ components, somewhat artificially separated from ‘hardware’ through a focus on social ‘norms and values’. The idea of the ‘system’ remains nonetheless at the heart of the field, with references to complexity science and structured approaches for elucidating systemic phenomena such as hubs, networks, and patterns amidst the acknowledged ‘chaos’ of non-linear complex interactions across systems’ components.

This panel explores the ways in which anthropological perspectives and methods both contest and contribute to health systems research, challenging, in particular, the dominant systemic metaphors that underpin health systems frameworks. We highlight contributions where a broader range of evidence, including the ethnographic, can inform relational understandings of power and agency in health systems ‘performance’ and functionality. Conversely, we ask how ‘systems thinking’ and method might revive anthropological analysis of classification, routines, and relations of health care.

Papers will examine constructs of ‘the system’ and the assumptions these embody, as well as a range of methods used to grasp the 'systemic' in health systems. These include, for example, addressing the following questions: what specific spatial and temporal elements of clinic life are represented through mapping the system in organigrammes and clinical pathways?; how do systems dynamics modelling techniques both unravel and construct the logic of systems interactions?; how can conventional metrics evaluating systems ‘strength’, ‘readiness’, and ‘resilience’ capture elements beyond the availability of material resources and technical capacity?

Accepted papers:

Session 1 Wednesday 19 January, 2022, -