Section B
Mental Models and the Health System
To Do What Is Right …
2
Systems Thinking: STAR Question
! How can we see the dynamics, interconnections, deeper
patterns, and purposes of systems?
3
Do You Really Know What Are the
Production Systems of Your Country?
! You are the Minister of Agriculture. You are asked by a
reporter from CNN to describe the agricultural system in
your country.
! What is your answer?
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The Agricultural System
! Who “produces crops” in
your mental model of the
agricultural system?
! How does your answer
determine the roles and
functions of the Ministry
of Agriculture?
5
Do You Really Know What Are the Health
Systems of Your Country?
! You are the Minister of Health. You are asked by a reporter
from CNN to describe the health system in your country.
! What is your answer?
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The Health System
! Who “produces health”
in your mental model of
the health system?
! How does your answer
determine the roles and
functions of the Ministry
of Health?
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The Household Production of Health
! Premises
1. Households are the primary units for the production of
health
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Mothers as Primary Managers
! Mothers are the primary managers and implementers of the
household health production tasks
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The Household Production of Health
! Premises (continued)
2. Households, like every social institution, have three
basic capabilities
! Resources
! Practices
! Values
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Productive Capabilities
Resources
! Material
! Non-material
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Productive Capabilities
Practices
! Formal
! Informal
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Productive Capabilities
Values
! Progress resistant
! Progress promoting
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Health Production Capabilities
Values
Households
Practices
Resources
1. Which health production capabilities are more important –
material or non-material?
2. What do we mean when we say that a person or household
is “resourceful”?
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The Household Production of Health
! Premises (continued)
3. Households produce health in the context of the local
community and the wider society—which is a nation’s
health production system
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The Health Production System
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Community Institutional Resources
! ! ! ! ! ! ! Clan/ethnic affiliations
Religious organizations
Business enterprises
Political parties
Cooperatives/Unions
NGOs
Government institutions
- Schools
- Health centers
- Extension services, etc.
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The Health Production System
Households
Values
H
E
A
L
T
H
Resources
Practices
Government
Values
Resources
Practices
Community
Values
Resources
Practices
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What Are Some Essential Features of the
Household Health Production System?
! Decentralized (multi-minded)
! Self-sustaining
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Leadership Challenges in Health
1. How do you get all the diverse actors in a “multi-minded”
health production system to move together in towards
common goals?
2. How do you overcome the barriers to change generated by
long-standing, self-sustaining institutional cultures at every
level?
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