Worldwide, policymakers, health system managers, practitioners and researchers struggle to use evidence to improve policy and practice. There is growing recognition that this challenge relates to the complex systems in which we work. The corresponding increase in complexity-related discourse remains primarily at a theoretical level. This paper…

Incremental approaches to introducing change in Canada's health systems have not sufficiently improved the quality of services and outcomes. Further progress requires 'large system transformation', considered to be the systematic effort to generate coordinated change across organisations sharing a common vision and goal. This essay draws on…

There are tradeoffs in knowledge synthesis--for example, between comprehensiveness and timeliness, between generalisability and policy relevance. The tradeoffs are particularly challenging for public health. A growing international community is grappling with building more relevant and useful knowledge bases, to facilitate use of this knowledge in…