Health Systems Complexity: A “Gardening” Metaphor

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International Health Policies
International health policies (IHP) blog is an initiative of the ‘Health Policy unit’ at the Institute of Tropical Medicine in Antwerp, Belgium (ITM), and fits in the wider project of “Strategic Network on International Health Policies.” It is in line with the ITM objective of “Switching the Poles,” aiming to increase the influence of the Global South on the global health debate.

By  on September 12, 2014 | For over two weeks (since 18 August), members of Emerging Voices for Global Health 2014, with the help of expert facilitation from Bruno Marchal and Peter Hill, embarked on the daunting task of making sense of complexity in general, and health systems complexity in particular. This two part – virtual – discussion aimed at unpacking complexity, and the challenges it poses for research and practice.

It was in the middle of this conversation that gardening as a metaphor to navigating complexity emerged, inspired by Kernick’s (2002) paper entitled ‘The demise of linearity in managing health services.’ Kernick proposed gardening over engineering as a perspective to deal with complexity. While the former emphasizes facilitation and flexibility, the latter is predominantly directive and controlling. The metaphor seems to have struck a chord with some EVs. This piece is a report on the convening of these complexity-gardening enthusiasts.

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