Systems Thinking in Short-term Health Missions: A Conceptual Introduction and Consideration of Implications for Practice

A strong tradition of short-term health missions (STHMs) exists around the world. STHMs have positive and negative effects on local health systems, and these consequences are often unanticipated and unintended. Conceptualizing local health systems as complex adaptive systems (CASs) may help global health actors approach global health activities, including health missions with a greater appreciation for local cultural and environmental context, leading to increased local capacity and impact while minimizing unintended negative consequences. For some, this might entail a shift in practice as it relates to short-term humanitarian work. In this paper, we introduce readers to health as a complex adaptive system (CAS). We then consider implications for practice, including adopting a “learning health system approach,” that engages local stakeholders in an ongoing, iterative process of mutual learning and self-organization.