A causal loop analysis of the sustainability of integrated community case management in Rwanda
Bibliographic Data
| ID | 4738934 |
|---|---|
| Authors | Eric Sarriot (0000-0002-8889-3063), Marina Morrow (0000-0002-4648-1909), Melanie Morrow (0009-0006-3710-0613), Anne Langston, Jennifer Wei, Jennifer Weiss, Justine Landegger (0000-0002-9900-417X), Laban Tsuma |
| Year | 2015 |
| Volume | 131 |
| Pages | 147-155 |
| Publication date | 2015-04-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2015.03.014 |
| PMID | 25779620 |
| OpenAlex | W2092143914 |
| Language | EN |
| Citations received | 13 |
| References cited | 12 |
Expansion of community health services in Rwanda has come with the national scale up of integrated Community Case Management (iCCM) of malaria, pneumonia and diarrhea. We used a sustainability assessment framework as part of a large-scale project evaluation to identify factors affecting iCCM sustainability (2011). We then (2012) used causal-loop analysis to identify systems determinants of iCCM sustainability from a national systems perspective. This allows us to develop three high-probability future scenarios putting the achievements of community health at risk, and to recommend mitigating strategies. Our causal loop diagram highlights both balancing and reinforcing loops of cause and effect in the national iCCM system. Financial, political and technical scenarios carry high probability for threatening the sustainability through: (1) reduction in performance-based financing resources, (2) political shocks and erosion of political commitment for community health, and (3) insufficient progress in resolving district health systems--"building blocks"--performance gaps. In a complex health system, the consequences of choices may be delayed and hard to predict precisely. Causal loop analysis and scenario mapping make explicit complex cause-and-effects relationships and high probability risks, which need to be anticipated and mitigated
Business · Causal loop diagram · Economics · Environmental economics · Public economics · Risk analysis (engineering · Sustainability · System dynamics · Child Nutrition and Water Access · Computer Science · Global Maternal and Child Health · Healthcare Systems and Reforms
The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care
The role of governance in implementing sustainable global health interventions
Integrated delivery of family planning and childhood immunisation services
Integrated community case management
Advancing sustainable development goals through immunization
A systems approach to assessing complexity in health interventions
How to do (or not to do)…using causal loop diagrams for health system research in low and middle-income settings
The role of integrated community case management projects in strengthening health systems
Using Systems Thinking to train future leaders in global health
Challenges for gatekeeping
Leadership and governance of community health worker programmes at scale
Evaluating the issue of sustainable tourism with a system dynamic approach
Learning from Success
Sustainability science
Planning for the sustainability of community-based health programs
Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance
Implications of adopting a complexity framework for development
Advancing Systems Thinking in Evaluation
An equity analysis of performance-based financing in Rwanda
| Citations per year | 1.3 |
|---|---|
| Citation span | 2016 - 2023 (8) |
| Highly cited | No |