Systems and Programs: Moving from Enemies to Friends

Posted on May 29, 2018
By Lauren Gase

Over the past few years, there has been an increasing emphasis on the need for “systems change” to achieve large-scale social impact. 

As someone deeply embedded in research and evaluation at the systems-level, I fundamentally believe that addressing complex problems requires system-level solutions. An increasing emphasis on systems - including a greater focus on multi-stakeholder collaboratives, discussions of leverage points, and the need to shift how organizations operate – gets me excited. I see the potential to do things like reform the justice system, shift to a more prevention-focused model of health and tackle big issues like climate change.

SystemVSProgramsThere is, however, one framing of how to address complex issues that dampens my excitement: systems versus programs. The discussion can become a battle between two opposing forces, including phrases like, “we don’t fund program work,” “we only focus on systems,” or “we need to move from a program focus to a systems focus.” Systems and programs are painted as victor and villain, fundamentally at odds – and I believe this framing is not only incorrect but has the potential to hamper meaningful change. 

I am in full agreement with the adage that we cannot program our way out of complex problems. Programs alone are rarely the solution. In my years as a researcher and evaluator I have learned time and again that focusing entirely on programs can prevent us from addressing structural inequities and root causes. Often, one of my first questions to an organization with a completely programmatic focus is, how does the program fit within your broader agenda to change the system?

That does not mean, however, that programs are fundamentally at odds with the system in which they are situated. It also does not mean that programs are not a critical component of addressing complex problems.

Consider a parable most of us have heard: A fisherman notices people are falling and drowning in a river; so, he goes upstream to prevent it from happening by building a bridge (a systems change). Great idea! But the problem is unlikely to be solved with construction alone. What if people don’t know how to use the bridge or do not see its value, won’t you have to educate them? Moreover, it is highly likely that no matter how beautiful the bridge, not all people will use it (maybe it is too far away), are you going to let those people who fall in drown?

Programs play a critical role in addressing complex health and social challenges. To lower teen pregnancy, we need to provide evidence-based sexuality education, alongside systems to increase access to contraception. Food banks and school meals programs are critical components of a well-functioning food system. In youth development, school-based mental health services are a key strategy to address issues such as trauma. For economic development, opportunities for meaningful employment need to be coupled with job training programs that set people up for success.  The list goes on and on…

SystemANDProgramsTo me, what is needed is a balance between systems and programs: we must consider how programs fit within a systems change strategy. In a recent study of 25 collective impact initiatives, changes to programs and services were identified as a critical component of achieving population-level outcomes. I think it is time that we, as a field, pause and ask ourselves some tough questions: How can we make sure that we are appropriately delivering and scaling programs while also working to change key parts of the system? How can we best use programs to advance a systems-change strategy, for example, training community leaders to advance system reform? In what ways can programs be integrated to better address root causes? It is time to swap the pendulum approach for one that forces us to consider how programs and systems are related. With this shift in thinking, we might then begin to see that programs and system are not enemies, rather, they are friends – maybe even best ones.

Systems Change, Blog, Lauren Gase

Lauren Gase

By Lauren Gase

Dr. Lauren Gase serves as senior researcher for Spark Policy Institute, a social evaluation and research firm that uses systems thinking to help social changemakers working with vulnerable/marginalized populations do good, even better. She has led several studies at the national- and local-level to improve health, educational, and social outcomes. She enjoys using approaches, methods, and data analysis techniques that meaningfully facilitate stakeholder engagement, influence policy and program decision making, and foster organizational improvement. Before joining Spark, Lauren advanced health promoting policy and system changes as the Chief of Health and Policy Assessment at the Los Angeles County Department of Public Health and as a Health Scientist at the Centers for Disease Control and Prevention. She holds a B.S. from University of California–Santa Barbara, a Master’s in Public Health from Emory University, and a Ph.D. in Health Policy from the University of California–Los Angeles.

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