Systems thinking in the prevention, control, and elimination of neglected tropical diseases (NTDs)

Objectives: It is estimated that more than one billion people are affected by neglected tropical diseases (NTDs). Whilst there are existing treatments to reduce morbidity, a major challenge is creating robust programs that are both country-led and leverage the existing health systems. Using a systems thinking approach is a critical component for integrating NTD services, as it takes into account all aspects of what might otherwise be considered fragmented systems to create a more efficient system.

Design: This article showcases three case studies where a systems lens was applied: (1) to examine the integration of morbidity management services into the existing health system in Sierra Leone, (2) to integrate lymphatic filariasis mass drug administration (MDA) in the polio campaign in Madagascar, and (3) to embed hydrocele surgeries into the services available in county health facilities in Kenya.

Results: All three cases demonstrate the importance of using a systems lens to assess the current system using a participatory approach, allowing the teams to focus on leverage points to create the highest impact and by extension holistically address population needs.

Conclusion: Systems thinking is valuable in examining key levers that affect NTD interventions. It offers stakeholders opportunities to develop responsive interventions that strengthen health systems.