The study Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three intervention districts of BHOMA in Zambia: a qualitative baseline study (Mutale, W., Bond, V., Mwanamwenger, MT, Mlewa, S., Balabanova, D., Spicer, N., et al., 2013) focused its efforts research into reducing the various issues associated with the existing health system in Zambia. Where other countries have managed to meet the deadlines associated with the Millennium Development Goals set by the United Nations, Zambia consistently lags behind. Mutale et al. (2013) set out to determine the various reasons why Zambia is not able to meet these same deadlines by employing a qualitative study that uses internal and external health care information to draw conclusions. To accomplish this task, Mutale et al. (2013) constructed a survey that would be used over a three-month period and given to “30 key informants and 18 [focus group discussions]” (Mutale et al., 2013, p. 293). Furthermore, in order to eliminate any bias, three separate districts were used, “one rural, one semi-rural and one urban” (Mutale et al., 2013, p.293). To establish control of the surveys and ensure their relevance, the surveys were distributed to other similar health facilities before being distributed within the Zambian environment. The survey had six basic categories: service delivery, health human resources, medical supplies, governance, health information and finances. These categories defined some of the most fundamental systematic elements that could cause problems for both the community and the existing health system. This would also provide the perfect framework for qualitative reflection... middle of paper ...... whereby the results could have taken a real position or direction on the issues in question in order to outline a future plan. Instead, research took a passive route in asserting “that it was clear that reported success or failure in one building block explained reported success or failure in other building blocks” (Mutale et al., 2013, p. 298). As an alternative to the chicken or egg argument, I would have liked to see a starting point for working to improve the situation. Works Cited Mutale, W., Bond, V., Mwanamwenger, MT, Mlewa, S., Balabanova, D., Spicer, N. et al. (2013). The current status of WHO's six building blocks for health system strengthening in three BHOMA intervention districts in Zambia: a qualitative baseline study. BMC Health Services Research, 13(1), 291-299. An overview of NVIVO 10 (2013). NVIVO 10. QSR International, 1, 1-2.