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Knowing that we know nothing: the socratic paradox and health sector reform in png

Knowing that we know nothing: the socratic paradox and health sector reform in png. “As for me, all I know is that I know nothing…” (aphorism attributed to Socrates) . Luke Elich & Benjamin DAY . PRESENTATION OUTLINE. The PNG health sector, 2001-2010

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Knowing that we know nothing: the socratic paradox and health sector reform in png

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  1. Knowing that we know nothing:the socratic paradox and health sector reform in png “As for me, all I know is that I know nothing…” (aphorism attributed to Socrates) Luke Elich & Benjamin DAY

  2. PRESENTATION OUTLINE • The PNG health sector, 2001-2010 • Conventional health system planning framework • Planning & review in the PNG health sector • Understanding the health system • Simple, complicated & complex problems • Complexity in PNG • The Socratic paradox & its implications

  3. PNG & ITS HEALTH SECTOR, 2001-2010 • PNG experienced unprecedented economic growth and relative political stability • 2001-2010 PNG National Health Plan supported by numerous development partners via a ‘Sector Wide Approach’ (AusAID was dominant) • Independent health monitoring and review group (IMRG) formed in 2006 to provide an objective assessment of overall sector performance & analyse causes of good/poor performance • *** • PNG health system, according to the PNG government, deteriorated by many measures during the decade

  4. CONVENTIONAL HEALTH SYSTEM PLANNING FRAMEWORK Source: USAID Health Systems 20/20 (2012) The Health System Assessment Approach: A How-to Manual

  5. PLANNING & REVIEW IN PNG HEALTH SECTOR Independent Monitoring & Review Group Report 1 (2007) # Recommendations:

  6. Understanding the health system • WHO Framework for Action: “A health system consists of all organisations, people and actions whose primary intent is to promote, restore or maintain health. It goals are improving health and health equity in ways that are responsive, financially fair, and make the best or most efficient, use of available resources.” • *** • A system is an interconnected set of elements that is coherently organized in a way that achieves something. The purpose of a system needs to be deduced from its behavior, not from rhetoric or stated goals. • Source: Donella Meadows (2008) Thinking in Systems: A Primer

  7. SIMPLE, COMPLICATED AND COMPLEX PROBLEMS Adapted from Gloubermanand Zimmerman (2002)

  8. COMPLEXITY IN PNG

  9. The SOCRATIC PARADOX & ITS IMPLICATIONS • Our collective understanding of how best to intervene to improve the PNG health system is exceedingly limited. • Suggestions for Aid Programming • Application of complexity science and systems thinking • Stimulate innovation, context sensitive evaluation and research • Long term focus – maintain relationships. • Avoid changes to programming and support • Identify and take advantage of ‘black swan’ opportunities

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