Irrigating Our Health Ecosystems with System Change Practitioners

Irrigating Our Health Ecosystems with System Change Practitioners

We are living through a pivotal moment in human history. We are in the throes of disruption as the systems we have come to rely upon seem to collapse, forcing us into constant firefighting mode. The dehumanisation of health systems has been intensified by the COVID-19 pandemic, leaving us feeling that we have spent many years sticking plasters over complex issues. People inside health systems are overwhelmed and burnt out; people outside them are underwhelmed by the care with which they are being provided. There is an innate tension between our desire to support, care and transform, and the crushing complexity that renders us paralysed and hopeless in the face of the current challenges.

After experiencing the health system up close due to some personal health challenges, I committed myself to supporting access to better healthcare for all. I have since been privileged to work with leading organisations alongside some inspiring innovators, systems thinkers and entrepreneurs. But in recent years I have come to a new and challenging realisation: improving health outcomes on a case-by-case basis is not enough. In many cases, it is too late to intervene once people are already sick. This understanding started me on a new path: exploring how best to invest in resilience at an individual, community and systems level to shift from curing diseases to sustaining good health whenever possible. That meant questioning the whole purpose of the health system.

Human cell vs space

Just as COVID-19 swept the globe in early 2020, I had the opportunity to join Basecamp: the School of System Change’s core six-month learning journey to help leaders navigate complex challenges. Basecamp deeply transformed the way I approach my work, my role and the agency I have within the wider health system. I joined the programme feeling overwhelmed by the challenges at hand but I suddenly experienced an ‘unlocking’ — allowing me to pursue deeper transformation as part of my role.

And while I felt I benefited greatly from the Basecamp program, I knew deep down that the depth of the teachings could accelerate change across many organisations and countries; spreading like a positive wave transforming ourselves and the systems we live in. This is why I choose to partner with the School to see how we might irrigate our health ecosystems with system change practitioners. What we mean by irrigation is the spreading of system change capabilities/system leadership across geographies, ecosystems and thematic areas to increase our collective transformation capacity.

As far as I can remember, we have been operating on the belief that big plans will be sufficient, money will be sufficient, collaboration will be sufficient. Two key ingredients essential to transformation keep being overlooked when we approach it: people and learning.

Our hypothesis is that we can significantly accelerate a paradigm shift by nurturing an ecosystem of system change practitioners that would irrigate health systems with new ways of acting, behaving, and collaborating.

The principles of irrigation with the School of System Change was based on several interventions namely — the roll out of the Basecamp for Health System Transformation across EMEA for several years, the creation of a community of system change practitioners in the field of community health, the training and nurturing of future system change facilitators, and the curation of resources and evidence that demonstrate the value and impact of system leadership on our capacity to transform towards just and regenerative systems. The intention of this partnership is to connect with representatives of organisations both big and small that are committed to health system transformation and strengthening their system leadership skills required for this paradigm shift to happen, namely:

  1. Embracing complexity: The School creates the space for participants to question their worldview, deep seated beliefs and mental models. There are a number of deep-rooted challenges that typically prevent us from strategizing, operating and even holding conversations while embracing the complexity we are facing. Yet there are also a number of mindsets and methodologies that can support us in approaching complex challenges with more intention and awareness. Doing this is one of the skills of being a systemic practitioner — and, while it may not be what we are used to, it is an approach that allows us to get the beat of the system. As Donella Meadows points out, “we can’t control systems or figure them out. But we can dance with them!”
  2. Newfound agency: There are many of us working in health right now who are disheartened, demotivated or overwhelmed by the limitations of our health systems. System change is as much about new systemic practices, tools, frameworks and methodologies as it is about a personal journey — a deep empowerment reconnecting practitioners with their individual purpose and the agency they have in their respective environment. Systemic practitioners gain awareness of the possible tension between the current system as it is, where there may be opportunities to harness change and what may be their role in reorganising, reimagining and rethinking system transformation. This also brings to the surface the possible tension between what our organisations want us to focus on versus where deeper change can happen. In health, for example, the focus on keeping people healthy isn’t yet valued in most geographies. The financial investment, the governance models and the decision-making processes are currently pointing towards ill health and treating diseases, rather than being organised towards keeping people healthy. How might we create space to question the overarching purpose of our health systems when the lights need to be kept on, and patients cared for? Systemic practitioners are individuals that can translate their organisational mandate while addressing root causes and contributing to the bigger vision for transformation.
  3. Hopeful imagination: We need the power of hopeful imagination combined with new tools and knowledge to navigate our way towards a better future. Reimagining new systems takes grounded leaders leaning into today’s challenges and operating from a deep sense of connection and intention to sense what are the emerging futures. System change practitioners operate on the premise that each of us is the system.
  4. New forms of organising and collaborating: In order to confront the challenges ahead — from the climate crisis, to collapsing health systems, to mass inequality, we need an unprecedented level of collaboration and collective action between citizens, organisations, sectors and countries. Organisational mandates may prevent us from embracing complexity and changing the systems we operate in at a deeper level, perpetuating systemic issues as a result. The quality of our future partnerships will rely on a more agile and unified response to health crises — new forms of shared governance with a stronger emphasis on coordination and cooperation. This calls for institutions, organisations and grounded leaders that take a systemic view in leading their organisations and countries in an emerging future.

There is an urgent need to democratise system leadership to shift the paradigm in health and beyond. The new strategy of the School of System change aims at ‘irrigating’ the field by nurturing systemic practitioners across sectors and geographies to access new knowledge and practices, catalysing change across ecosystems and learning communities. Join us on this journey of inquiry and learning, as we work together to reimagine our systems by irrigating different sectors and geographies with newly equipped system change practitioners.

originally published at School of Systems Change

Subscribe to the School of System Change newsletter to receive a monthly dispatch of systems change in practice and alumni stories, community resources, and upcoming courses and events. Explore School courses.

Marion Birnstill is a seasoned global health and partnering professional with close to 15 years’ experience spanning a career working for leading organisations across the private, public and non-profit sectors. Throughout the years Marion built a career co-creating, facilitating and managing partnerships across big and small organisations and discovered that social change and improvement of health is not enough. Privileged to work with some of the leading health innovators, systems thinkers and entrepreneurs, she has been challenging the status quo by advocating for new ways of partnering with the belief that collective action and impact approaches are needed to drive transformation and systemic change. She has also been exploring how to best invest in resilience at individuals, communities and health systems level to shift from curing bad health to sustaining good health.

Network Weaver is dedicated to offering free content to all – in support of equity, justice and transformation for all.

We appreciate your support!