The Utility of Systems Thinking in the Context of Infectious Disease Surveillance in India

Abstract

This chapter demonstrates the utility of systems thinking in practice by providing an overview of the infectious disease surveillance system in India using general systems theory. System mapping and systems dynamics modelling, in the form of a causal loop diagram, are used to visualize the key policies, actors, and institutions involved. Focus is placed on all six of the World Health Organization’s (WHO) Health System Strengthening building blocks, with an emphasis on service delivery and information. Systems maps of tuberculosis and measles surveillance, which are covered under two separate surveillance systems, provide a deeper analysis of the different and complex reporting processes involved in disease surveillance. Case detection, reporting, analysis, and response are vital steps involved in any surveillance system. Using information gathered from India’s infectious disease surveillance portal, literature, and key informant interviews, systems thinking is applied to analyze and reflect on gaps and opportunities to pave the way for future reforms.