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Table 1 Box 1: Approaches intended to rewire intangible software in health systems

From: How to work with intangible software in public health systems: some experiences from India

Approaches intended to enable visioning and leading These approaches focus on enabling health workers to see value in their routine work and recognize themselves as leaders, and in doing so work towards recognizing and rewriting some of the systemically embedded routine scripts and practices that hinder change.

Approaches targeted at engaging with evidence better These approaches work on the premise that health workers at all levels need to engage with data with more intensity than as “fillers” of forms, and that if they are given an opportunity to do so, they have the capacity to critically engage with evidence and think of locally relevant solutions.

Approaches intended to help health workers navigate contextual complexities This cluster of ideas recognize that the day-to-day contexts that health workers have to reckon with are complex and challenging, and that there is a need to support health workers to handle such challenges, rather than blaming them for nonachievement or for being risk-averse.

Approaches intended to build the cultural competence of health workers and to enhance community relationships These approaches focus on sensitizing health workers to the needs of the community, providing a better sociocultural—and a more humane—orientation to health providers.

Approaches that recognize and reward performance These approaches are intended to recognize existing “exemplars” in the system, and to honour and reward them for their personal values, humane orientation, community relationships, innovations and commitment to their work. These awards are not meant to be for the achievement of numerical targets in the conventional sense.

Approaches targeted at enabling collaborative work and breaking power/gender hierarchies This set of approaches is targeted at breaking gender and power hierarchies in the system and enabling collaborative work across cadres or different teams of people.