This issue

– systemic design practice for policymaking
– Close the gap campaign report
– 2021 government trends
– how can we tell if we are effective system stewards?
– COVID-19 health information and CALD communities
Plus what I'm reading.

Research brief: Systemic design practice in policymaking

Governments around the world are adopting the processes and tools of systems thinking, human-centred design and co-design. A paper in Policy Design and Practice proposes a new practice framework for systemic design in public policy and social innovation. Read our brief on the paper.

Close the gap campaign report 

Since 2010, the Close the Gap Campaign Steering Committee has developed an annual report on action needed to achieve health equality for Aboriginal and Torres Strait Islander peoples. 

This year’s report showcases the leadership of Aboriginal and Torres Strait Islander peoples, communities and organisations throughout critical health crises in 2020. Aboriginal and Torres Strait Islander communities successfully led the way in the COVID-19 response, keeping communities safe and rates of COVID-19 cases six times lower than the rest of the Australian population 

The need for strengths-based approaches 

The report features strengths-based examples in addressing the most complex of challenges. These include climate change, the COVID-19 pandemic and the increasing need for social and emotional wellbeing services in Aboriginal and Torres Strait Islander communities. 

This approach rejects deficit-based policies and culturally unsafe systems that reduce Aboriginal and Torres Strait Islander people and communities to a ‘health problem’ to be solved. This approach reflects an understanding that investing in Aboriginal and Torres Strait Islander-led solutions is the most effective way to improve health outcomes for Australia’s First Peoples. 

Recommendations 

The report makes a series of recommendations in the areas of: 

• structural reform 
• strengths-based, community driven approaches to crisis adaptation and response. 

The Lowitja Institute prepared the report for the Close the Gap Campaign Steering Committee as well as an accompanying policy brief.

2021 government trends 

A report from the Deloitte Center for Government Insights outlines nine trends transforming government post COVID. These include: 

1. Accelerated digital government 

The pandemic accelerated the digital delivery of public services. From telehealth to telework, virtual courts to virtual education, large-scale digital innovations were rolled out at speed. The digital infrastructure, digital workforce, and citizen-facing connectivity that enabled these successes will lay the foundation for future innovation. 

2. Location liberation 

The forced shift to a distributed and highly virtual model showed that remote work can be efficient and effective. Both private and public sector organisations are undergoing a transition that cannot be easily reversed. Workflows will likely have to adapt and workforces may settle into a different kind of life balance. 

3. Inclusive, equity-centred government 

Governments are recognising the need to address the underlying causes of systemic imbalances. Approaches include inclusive policy and service design; equitable access to public goods; co-creation and citizen engagement. 

4. Government as a cognitive system 

Governments are increasingly using a cognitive approach to decision-making. This relies on past evidence, real-time data and forecasts to inform policy. It represents a fundamental shift from the traditional “predict-prevent-evaluate” cycle. Instead governments can design programs with an intelligence architecture: using real-time information to adapt predictive models founded on the hindsight of past performance. 

A NSW Treasury blog post discusses how to take the concept of system stewardship and turn it into practical frameworks. Commissioning NSW is adapting a framework called 'The Quadruple Aim' which was developed to drive healthcare system reform. 

What is system stewardship? 

System stewardship is about creating the right conditions for actors within a system to deliver positive social impact. This is instead of trying to impose order top-down or leaving service provision to the free market. It involves moving from mandates to relationships and incentives, from siloes to collaborative models, and shifting from thinking linearly to thinking systemically. 

What is the quadruple aim? 

This framework has four elements: 

1. Outcomes: These enable setting a clear vision and goals for what the system should be achieving. Given the complexity of the systems that governments steward, it can be a challenge to identify the most appropriate outcomes that reflect the wants and needs of communities. 

2. Customer experience: This means taking time to uncover lived experience early in system design, considering indicators that capture experience when evaluating policy, and investigating in co-design models. 

3. Provider experience: This includes the individual experiences of all actors in the delivery chain who contribute to realising the impact of a policy. The commissioners in the delivery chain can make it easy to partner with and across government, or they can create counterproductive administrative burden that impedes service delivery. 

4. Sustainability: This is about considering efficiency, effectiveness and value for money but it is also about resiliency. When working in complex systems, actions that seem to increase efficiency can undermine resiliency. This is often driven by decision-makers considering components of a service, rather than using a systems lens to consider the interplay of complex dynamics between all the components. 

Communicating COVID-19 health information to CALD communities ​

An article in Public Health Research and Practice presents the outcomes of a research collaboration between Culturally And Linguistically Diverse (CALD) community leaders and health behaviour change scientists during the COVID-19 crisis.  

It is often assumed that providing people with information will result in compliance. However achieving desired behaviours in a target population involves understanding the needs of the population and the barriers and enablers to behaviour change. 

Challenges faced by CALD communities 

The following challenges can occur: 

• Translation of information into all of the various languages spoken by community members. 
• Testing of translated materials to ensure that messages are understood by people who might also have limited health literacy. 
• Using trusted messengers to deliver information (e.g. community leaders, advocates) 
• Communication methods that are appropriate to and accessible by CALD communities (e.g. ethnic radio, newspapers). 
• CALD voices being represented and embedded in government and healthcare decision making. 

Effective messaging for CALD communities 

1. Beyond translation: Translating health information alone does not lead to behaviour change. The process of language translation must also consider the audience’s frame of reference, and the context in which the translated material will be used. 
2. Trusted messengers: Translated information should be delivered using trusted messenger as its effectiveness depends on how an audience perceives the credibility of its source. 
3. Accessible channels: Information should be delivered in ways that are accessible and appropriate to the target community. 
4. Avoid blame and stigmatisation: Infectious disease outbreaks create feelings of fear that can exacerbate racist behaviour. Supporting communities that are disproportionately affected should not be interpreted as singling out groups more likely to spread disease. 

1. Changing your mind can make you less anxious 

This article in The Atlantic looks at how rethinking your opinions and changing your views can make you less anxious. When it comes to changing our views, we are adept at resisting. Cognitive biases tell us: “You are right - disregard all evidence to the contrary.” These include confirmation bias (focussing on and preferentially remembering information that reinforces our beliefs) and anchoring bias (over-relying on one key piece of information).  

2. How vulnerable is the world? 

An Aeon article suggests one way of looking at human creativity is as a process of pulling balls out of a giant urn. The balls represent ideas, discoveries and inventions. Over the course of history, we have extracted many balls. Most have been beneficial to humanity. The rest have been various shades of grey. What we haven’t pulled out yet is a black ball: a technology that invariably destroys the civilisation that invents it. What happens then? 

‘Til the next issue

Maria Katsonis