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Systems Integration

Systems Integration

Transformation About

The Systems Integration Core trains Title V leaders and staff on the use of systems thinking tools to support collective impact as well as other efforts. The Center’s Systems Integration curriculum defines systems integration broadly, considering the many points of potential integration for MCH professionals, including across divisions and bureaus within public health agencies, as well as across sectors and community partnerships.

Learn More

Training activities equip Title V leaders and staff to effectively lead and/or contribute to systems integration activities for MCH programs, and to do so in a consumer-centered way. Training in systems thinking, mapping, and improvement methods, and creating a context for cross-sector collaboration are priorities for the Systems Integration Core.

The MCH profession continues to be challenged in a rapidly changing environment by the need to understand how systems connect with one another to shape and deliver both clinical and public health services to support the health of families. Complicating matters, system interactions reach beyond clinical service delivery and public health into other systems such as schools, social services, employment, criminal justice, and beyond.

Introduction to Systems Thinking

This 22-minute video presents the basics of systems thinking. You can access additional trainings and tools to support this training below.

System Support Maps (SSMs) in Five Minutes

SSMs are a useful tool to visualize and share what is needed to feel supported in carrying out important responsibilitiesSystem support mapping asks participants to individually identify their role, key responsibilities, the needs and resources required to complete these responsibilities, and wishes for what these would look like in an ideal world.

SSMs allow participants to see their role in the broader system and what is takes to succeed in these roles – an especially important exercise in the changing landscape of COVID-19. Sharing SSMs with colleagues is a way to clearly articulate what is needed, to hear what others need, and to identify gaps in the support system. SSMs can help understand and articulate the changing responsibilities and needs associated with the COVID-19 response.

Through this structured process, groups can look across maps and brainstorm how to repurpose and align resources to strengthen support to colleagues during this pandemic. The Systems Integration Core encourages flexibility during this time and can help with creating virtual SSMs to strengthen and align systems.

For the mapping tool mentioned in the video visit:

The Five R's in Five Minutes

The 5 R’s pose questions around the ResultsRolesResourcesRelationships, and Rules that structure a system. In order to move the needle on MCH outcomes and objectives, it is useful to assess the interconnected relationships between the various aspects of the system, including stakeholders, resources, and policies.

This tool provides an opportunity to gather diverse perspectives through a systematic discussion with stakeholders on what defines success, who is needed to move the work forward, what resources are required to achieve success, what relationships are critical to ensure positive results, and which rules confine the system. Identifying what the rules are is the first step; determining if and how the rules need to be adapted to become more flexible during the current pandemic is next.

The Five R's Guiding Questions:

  1. Results: What will success look like? What results are meaningful to you?
  2. Roles: Who are the people or groups of people that affect or are affected by these results?
  3. Resources: What resources are available to help improve results?
  4. Relationships: What are the important relationships between people or groups in the system or between people/groups and specific tasks or activities they need to complete?
  5. Rules: What are the rules governing what happens related to the results or in the scope of your work?

For more information on this and other systems tools from the National MCH Workforce Development Center, visit their Systems tools page.

Systems Tools To Support Complex Collaborations During COVID-19

This video was part of the 2020 Cohort Webinar, held in April 2020.

Systems Integration Toolkit

Technical workforce skills and evidence-based strategies are not necessarily sufficient to move the needle on maternal and child health outcomes; contextual factors such as challenging political environments, lack of leadership support, funding insufficiency, staff turnover, and historically inequitable programs and outcomes also influence Title V’s ability to have an impact. These systems thinking and mapping tools provide opportunities to see your work in the context of the ‘big picture’ and strengthen collaboration within agencies and across sectors. Check out the Toolkit here.

Additional Systems Integration Resources

Learn More. For more training materials compiled from the field, see the MCH Navigator's Systems Integration Training Spotlight and visit the Systems Integration learning module in the Public Health Pronto microlearning program.


This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UE8MC25742; MCH Navigator for $225,000/year. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.