Abstract
dc:description.abstractGlobal health has developed as a concept over the past 25 years and signifies the efforts by a host of transnational actors directed toward health equity across the world. A holistic enterprise, global health involves not only the improvement of healthcare, but also embraces academic, political and educational perspectives. The complexity and scale of this endeavour challenges reductive approaches to intervention: many efforts to make matters better either do not work, or do not work as intended. As a result, there is a growing recognition of the importance of taking a systems approach to global health, yet without a clear articulation of what this means. This thesis seeks to answer the question of what is meant by a systems approach to global health. It explores the use of the word ‘systems’ in the global health literature, and widens this contextual understanding to some of the extensive literature on both systems thinking and systems practice. While a systems approach to global health is not currently clearly defined, systems engineering is identified as a highly developed, codified, body of knowledge which marries systems thinking with systems practice and which has been advocated as being relevant to healthcare. A recent consensus systems approach to healthcare improvement from the UK, at the interface of engineering and medicine, is identified as a candidate model for global health. A programme of primary research is described to assess the extent to which this systems approach to healthcare improvement is applicable to the broader enterprise of global health. The research takes the form of two embedded projects, across two countries, using narrative analysis to understand the lived experience of a range of global health actors. This experience is then synthesised using a framework approach to adapt both the content and structure of the candidate model. The result, a systems approach to global health, is presented as both a working definition and a visual model. The strengths of this model are also its limitations: while directly informed by the lived experience of those communities accessible to the research team, it remains silent on the experience of those beyond their purview. A future programme of action research is planned to refine the model, working within the global health community.
Degree
thesis:*- Name dc:type.qualificationname
- Doctor of Philosophy (PhD)
- Level dc:type.qualificationlevel
- Doctoral
- Grantor dc:publisher.institution
- University of Cambridge
- Year dc:date.issued
- 2021
Author and committee
dc:creator, dc:contributor.*- Author dc:creator
-
- Bashford, Thomas
- Advisor dc:contributor.advisor
-
- Clarkson, P John
Subjects
dc:subject × 5Rights
dc:rights- Licence
- Language dc:language
- eng
Identifiers
dc:identifier.*- DOI dc:identifier.doi
- https://doi.org/10.17863/CAM.65441
- OAI identifier oai:identifier
- oai:www.repository.cam.ac.uk:1810/318325