title: "Wood already touched by fire is not hard to set alight": Comment on "Constraints to applying systems thinking concepts in health systems: A regional perspective from surveying stakeholders in Eastern Mediterranean countries".
abstract: A major constraint to the application of any form of knowledge and principles is the awareness, understanding and acceptance of the knowledge and principles. Systems Thinking (ST) is a way of understanding and thinking about the nature of health systems and how to make and implement decisions within health systems to maximize desired and minimize undesired effects. A major constraint to applying ST within health systems in Low- and Middle-Income Countries (LMICs) would appear to be an awareness and understanding of ST and how to apply it. This is a fundamental constraint and in the increasing desire to enable the application of ST concepts in health systems in LMIC and understand and evaluate the effects; an essential first step is going to be enabling of a wide spread as well as deeper understanding of ST and how to apply this understanding.
authors.affiliation: Health Policy, Planning and Management Department, School of Public Health, University of Ghana, Accra, Ghana. ; Julius Global Health, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Irene Akua
authors.initials: IA
authors.lastname: Agyepong
keywords: Decision-making; Health Systems; Low- and Middle-Income Countries (LMIC); Systems Thinking (ST)