Advancing the application of systems thinking in health: a realist evaluation of a capacity building programme for district managers in Tumkur, India

Health systems interventions, such as capacity-building of health workers, are implemented across districts in order to improve performance of healthcare organizations. However, such interventions often work in some settings and not in others. The paper aims at demonstrating how the realist evaluation approach advances complex systems thinking in healthcare evaluation by applying the approach to understand organizational change within local health systems in the Tumkur district of southern India. The paper finds that local health systems may differ in their internal configuration and hence capacity building programmes need to accommodate possibilities for change through different pathways.

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Prashanth NS, Marchal B, Devadasan N, Kegels G, Criel B. Advancing the application of systems thinking in health: a realist evaluation of a capacity building programme for district managers in Tumkur, India. Health Research Policy and Systems. 2014;12(42). doi:10.1186/1478-4505-12-42