Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care

New forms of leadership are required to bring about the fundamental health system changes demanded by primary health care (PHC). Using theory about complex adaptive systems and policy implementation, this paper considers how actors’ sensemaking and the exercise of discretionary power currently combine to challenge PHC re-orientation in the South African health system. The paper concludes that PHC will only become a lived reality when frontline staff are able to make sense of policy intentions and incorporate them into their everyday routines and practices. This requires a leadership of sensemaking that enables front line staff to exercise their collective discretionary power in strengthening PHC.

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Gilson L, Elloker S, Olckers P, Lehmann U. Advancing the application of systems thinking in health: South African examples of a leadership of sensemaking for primary health care. Health Research Policy and Systems. 2014;12(30). doi:10.1186/1478-4505-12-30