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Participatory system dynamics modeling: advancing equity through contextualized implementation science in global
Asma Mohamedsharif1, Ayat Abu-Agla2, Juliane Mielke3
1Faculty of Medicine, AlNeelain University, Khartoum, Sudan. asma3omshy@gmail.com.
BMC Global and Public Health
|February 3, 2026
Summary
Participatory System Dynamics Modeling (PSD) addresses implementation science failures in low- and middle-income countries (LMICs) by accounting for complex contexts. This approach builds capacity for context-responsive health interventions.
Area of Science:
- Implementation science
- Health equity
- Systems thinking
Background:
- Implementation science in low- and middle-income countries (LMICs) often fails due to inadequate consideration of contextual complexity.
- Conventional approaches treat context as static, overlooking dynamic interactions and power relations that influence intervention outcomes.
- A significant epistemic gap exists in understanding how context truly shapes sustained health intervention impact.
Purpose of the Study:
- To introduce Participatory System Dynamics Modeling (PSD) as a transformative approach for implementation science in LMICs.
- To demonstrate how PSD can overcome the limitations of traditional methods in addressing contextual complexity.
- To advocate for the integration of PSD into health planning and research infrastructures.
Main Methods:
- PSD integrates diverse evidence (administrative data, research, expert insight, lived experiences) into interactive simulation models.
- Stakeholders co-create PSD models, revealing feedback loops, time delays, trade-offs, and unintended consequences.
- The approach moves beyond linear planning and superficial stakeholder consultation.
Main Results:
- PSD enables the co-creation of dynamic models that reflect local realities, power dynamics, and feedback loops.
- Examples from LMICs illustrate how PSD strengthens implementation by aligning interventions with local contexts.
- The method facilitates systemic reflection, leading to more robust and sustainable health interventions.
Conclusions:
- PSD offers a powerful methodological shift for implementation science, enhancing its ability to address contextual complexity.
- Embedding PSD into health systems strengthens capacity for context-responsive and system-informed intervention delivery.
- This approach is crucial for advancing health equity and ensuring sustained impact of health interventions in LMICs.
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