2. Systems Thinking
Overview
This module introduces systems thinking as a framework for understanding the complex and interconnected nature of health systems and malaria transmission dynamics. Participants explore how interventions, behaviours, environmental factors, and health system components interact, and how these interactions influence programme outcomes and decision-making.
By the end of this module, participants should be able to:
Understand what systems thinking is, and how it applies to malaria programmes
Identify how interactions within complex systems influence disease outcomes
Explain how systems thinking can improve modelling and decision-making for malaria
Complex adaptive systems
Causal loop diagrams
Interconnections and feedback loops
Non-linear effects and unintended consequences
Systems mapping
Multi-sectoral influences on malaria outcomes
Delivery Plan
This module consists of one session, comprised of an introductory lecture and a group exercise. To allow for sufficient engagement with groups reporting back, 2.5-3 hours for the session is suggested.
| Topic | Description | Duration | Format |
| Introduction to Systems Thinking | Understanding complexity in health systems Key aspects of systems thinking Introduction to causal loop diagrams Why systems thinking matters for malaria control |
30 min | Presentation |
| Systems Mapping Exercise | Participants construct a causal loop diagram, focusing on an element of the malaria system (see exercise details below) Identify relationships, bottlenecks, and feedback loops |
60-75 min | Small group break out exercise |
| Systems Mapping Report Back | Groups present their causal loop diagrams with discussion on how the groups’ elements interact | 45–75 min | Report back & plenary discussion |
| Reflection and Wrap-Up | Key insights and applications to participants’ work How systems thinking informs model design and interpretation |
15 min | Presentation or facilitator reflection |
Practical Exercise
Exercise Title: Mapping the Malaria System
Instructions:
In groups, participants develop a causal loop diagram showing factors influencing malaria burden in a selected setting. Groups are comprised of 3-5 fellows, each allocated to focus on one of the following system elements:
Access to care
Data surveillance systems
Drug resistance and availability of drugs
Acceptance of interventions
Climate change and environmental factors
Funding availability
The exercise can be done using software or analog with poster paper, markers, and sticky notes.
Groups present their causal loop diagrams and identify how the different system elements intersect and interact across the groups. During the faciliated discussion, there is an opportunity to consider where modelling could support decision-making within the system.
Facilitator Guidance
Draw connections between programme operations, funding, behaviour, and outcomes
Support participants in visualising relationships and dependencies
Reinforce that systems thinking helps frame better modelling questions
Materials and Resources
Introductory slide deck
Example causal loop diagrams
Flipcharts or digital collaboration tools