PT - JOURNAL ARTICLE AU - Thelen, Jenna AU - Sant Fruchtman, Carmen AU - Bilal, Muhammad AU - Gabaake, Kebabonye AU - Iqbal, Shahid AU - Keakabetse, Tshiamo AU - Kwamie, Aku AU - Mokalake, Ellen AU - Mupara, Lucia Mungapeyi AU - Seitio-Kgokgwe, Onalenna AU - Zafar, Shamsa AU - Cobos Muñoz, Daniel TI - Development of the Systems Thinking for Health Actions framework: a literature review and a case study AID - 10.1136/bmjgh-2022-010191 DP - 2023 Mar 01 TA - BMJ Global Health PG - e010191 VI - 8 IP - 3 4099 - http://gh.bmj.com/content/8/3/e010191.short 4100 - http://gh.bmj.com/content/8/3/e010191.full SO - BMJ Global Health2023 Mar 01; 8 AB - Background Systems thinking is an approach that views systems with a holistic lens, focusing on how components of systems are interconnected. Specifically, the application of systems thinking has proven to be beneficial when applied to health systems. Although there is plenty of theory surrounding systems thinking, there is a gap between the theoretical use of systems thinking and its actual application to tackle health challenges. This study aimed to create a framework to expose systems thinking characteristics in the design and implementation of actions to improve health.Methods A systematised literature review was conducted and a Taxonomy of Systems Thinking Objectives was adapted to develop the new ‘Systems Thinking for Health Actions’ (STHA) framework. The applicability of the framework was tested using the COVID-19 response in Pakistan as a case study.Results The framework identifies six key characteristics of systems thinking: (1) recognising and understanding interconnections and system structure, (2) identifying and understanding feedback, (3) identifying leverage points, (4) understanding dynamic behaviour, (5) using mental models to suggest possible solutions to a problem and (6) creating simulation models to test policies. The STHA framework proved beneficial in identifying systems thinking characteristics in the COVID-19 national health response in Pakistan.Conclusion The proposed framework can provide support for those aiming to applying systems thinking while developing and implementing health actions. We also envision this framework as a retrospective tool that can help assess if systems thinking was applied in health actions.No data are available.