Systems Thinking for Health

An Accredited Drug Dispensing Outlets (ADDOs) dispenser in Tanzania, an example of a successful, scale-able public-private sector collaboration. {Photo credit: MSH.}

Bringing Accredited Drug Shops to Africa and Beyond

Informal retail medicine shops are the first point of care for millions of people in low- and middle-income countries, though the medicines they sell are often of poor quality, costly, or even falsified. More than 20 years ago, MSH teamed up with the Bill & Melinda Gates Foundation to support the owners and operators of these shops, many of which are women-owned, in accrediting, regulating, and expanding their businesses. Starting in Tanzania—and now in Bangladesh, Liberia, Nigeria, Uganda, and Zambia—these shops, are improving the quality and availability of medicines, the community’s use of those medicines, and referrals to health clinics. The ADDOs model is designed based on extensive stakeholder engagement and uses a systems-thinking approach to consider patient and consumer needs and protection, commercial interests of owners, and government regulatory concerns.

Getting to the Heart of Health Systems

We use systems thinking to strengthen health systems for greater impact. Addressing the complex challenges that affect how people seek and receive health care requires a holistic approach to understanding all of the elements that affect health system performance, including the political economy, the availability of resources, local culture and regulations, and the impact of other sectors such as agriculture and education. We put systems thinking into practice by analyzing these connections in a way that generates evidence for sound decisions. We examine not only the enablers of and barriers to use of services but also their root causes and potential opportunities to spark change and improvements. We convene multisectoral partnerships and involve communities to develop iterative, adaptive, data-driven solutions. We listen, build together, and continuously adapt as we go.

Strengthening Health System Foundations for Better Health Outcomes

Our fact sheet breaks down our work in pharmaceutical systems strengthening, our locally led commitment to quality services, and how we prepare, mobilize, and respond to infectious diseases, such as malaria.

Meet Our Technical Experts

Please direct all inquiries and media or speaking engagement requests for our Technical Experts to Jordan Coriza at or 617-250-9107