Abstract for: system sciences in public health for health systems and services research: Some reflections from other disciplines
Health systems travels from political sphere to policy spaces to determine health services at first programmatically and thereafter operationally. In this deterministic pathway, implementation is a bureaucratic structure of an operational form of governance. Thus we design health systems (such as the Building Blocks or Control Knobs) with elements like governance, finance, service delivery, information architecture etcetera, which have functional properties and direct contributions in the production and management of health care (including public health prevention and promotion). This defines health systems as a physical system. This physicality is conceptualised as an exclusive space and indifferent to the other forms of systemic interactions occurring in the environment. This explains why the epidemiological models failed in projection exercises during the pandemic. The systems inclusive of public health complexity would go beyond the practice of ‘implementation science’ (systems of the principles of functions), instead engage with the normative space of ‘design science’ (systems of the principles of reasons). We take this argument to understand how systems science is defined and designed in other disciplines, such as management science, sustainability science, science and technology studies, economics, physics, evolutionary biology, and ecology. This could help in tracking the normative and operative guidelines in redefining and redesigning health systems and also in understanding their interactions with the existing environment.