Bringing a Complex Systems Approach to WHO Europe Health Workforce Planning (A Two-Day WHO Collaborative)

I would like to thank Tomas Zapata, Cris Scotter, and their team in the Unit of Health Workforce and Health Services in the WHO Regional Office for Europe (Copenhagen) for the opportunity to engage colleagues from different countries for our two-day event: WHO Europe Health Workforce Planning Collaborative

OVERVIEW OF EVENT 

The collaborative sought to advance an international health workforce learning partnership based on shared challenges, adaptive learning and comparative exchange – something that sits at the forefront of all my current work, namely, we need not only international engagement, but also collaboration to learn from each other!

 

Bringing together participants from different systems and contexts creates an important space not simply to compare workforce challenges, but to collectively explore how health systems might build greater adaptive capacity under conditions of growing complexity and uncertainty.

 

The shared challenge we explored was: how do health workforce planning systems remain adaptive, resilient and sustainable under growing multiple pressures?

 

To facilitate the discussions, I was charged with bringing in a complex systems perspective, including participatory systems mapping and a systems approach to theory of change.

What emerged was striking. Despite major differences in health systems and governance structures, many countries are wrestling with similar dynamics: workforce shortages, burnout, fragmented governance, fiscal constraints, uneven regional capacity, data fragmentation and increasing service complexity. At the same time, countries are experimenting with new approaches centred on prevention, collaborative care, learning systems, digital infrastructure, workforce redesign and adaptive planning.

 

One of the most interesting parts of the workshop was moving beyond simply describing problems and instead asking a more difficult question: what actually helps systems adapt under complex conditions? To support this discussion, we developed a working, complexity-informed theory of change and then used participatory systems mapping to collaboratively explore the interacting pressures, feedback loops, leverage points and adaptive capacities shaping workforce planning across contexts.

 

Perhaps the clearest lesson from the discussions is that no country is solving these challenges through single interventions or simple technical fixes. Workforce planning increasingly looks less like a forecasting exercise and more like the governance of a complex adaptive system—one that depends on learning, coordination, institutional memory, trust and the ability to adapt under uncertainty.