Applied systems thinking: a viable approach to identify leverage points for accelerating progress towards ending...

Area of Science:

• Public Health
• Systems Science
• Global Health

Background:

• Neglected tropical diseases (NTDs) represent a significant global health burden, particularly affecting impoverished populations.
• Understanding the complexity of the global NTD system is crucial for effective intervention and progress.
• Systems thinking offers a framework to analyze and address persistent public health challenges like NTDs.

Purpose of the Study:

• To analyze the complexities of the global neglected tropical disease (NTD) system.
• To identify critical leverage points for catalyzing progress towards NTD elimination.
• To develop a qualitative model of the global NTD system using systems thinking principles.

Main Methods:

• Adapted existing systems change frameworks to create a conceptual model.
• Conducted semi-structured interviews with global and Nigerian NTD stakeholders.
• Analyzed interview data to develop causal loop diagrams and a qualitative system model.

Main Results:

• A comprehensive qualitative model of the global NTD system was developed.
• The model visually represents six key sub-components, highlighting forces and feedback loops.
• The study identified key dynamics within the global NTD system.

Conclusions:

• Five leverage points for NTD system change were identified: clarifying elimination potential, supporting diverse interventions, reducing donor dependency, fostering an open NTD community culture, and addressing health worker incentives.
• The findings challenge a reliance on 'quick win' solutions, urging a deeper systemic approach.
• The developed systems thinking model can be applied to other complex global health challenges.