Current HIV/AIDS Reports

, Volume 16, Issue 4, pp 279–291 | Cite as

Making Smarter Decisions Faster: Systems Engineering to Improve the Global Public Health Response to HIV

  • Anjuli D. WagnerEmail author
  • Jonny Crocker
  • Shan Liu
  • Peter Cherutich
  • Sarah Gimbel
  • Quinhas Fernandes
  • Melissa Mugambi
  • Kristjana Ásbjörnsdóttir
  • Sarah Masyuko
  • Bradley H. Wagenaar
  • Ruth Nduati
  • Kenneth Sherr
Implementation Science (E Geng, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Implementation Science


Purpose of Review

This review offers an operational definition of systems engineering (SE) as applied to public health, reviews applications of SE in the field of HIV, and identifies opportunities and challenges of broader application of SE in global health.

Recent Findings

SE involves the deliberate sequencing of three steps: diagnosing a problem, evaluating options using modeling or optimization, and providing actionable recommendations. SE includes diverse tools (from process improvement to mathematical modeling) applied to decisions at various levels (from local staffing decisions to planning national-level roll-out of new interventions). Contextual factors are crucial to effective decision-making, but there are gaps in understanding global decision-making processes. Integrating SE into pre-service training and translating SE tools to be more accessible could increase utilization of SE approaches in global health.


SE is a promising, but under-recognized approach to improve public health response to HIV globally.


Implementation science Systems engineering HIV Public health approach 



ADW was supported by F32HD088204, JC was supported by R01MH113435, BHW was supported by K01MH110599, and support was provided by the Implementation Science Core of the University of Washington/Fred Hutch Center for AIDS Research, an NIH-funded program under award number AI027757 which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, and NIDDK. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Anjuli D. Wagner
    • 1
    Email author
  • Jonny Crocker
    • 1
  • Shan Liu
    • 2
  • Peter Cherutich
    • 3
  • Sarah Gimbel
    • 1
    • 4
  • Quinhas Fernandes
    • 1
    • 5
  • Melissa Mugambi
    • 1
  • Kristjana Ásbjörnsdóttir
    • 6
  • Sarah Masyuko
    • 1
    • 3
  • Bradley H. Wagenaar
    • 1
  • Ruth Nduati
    • 7
  • Kenneth Sherr
    • 1
    • 2
    • 6
  1. 1.Department of Global HealthUniversity of WashingtonSeattleUSA
  2. 2.Department of Industrial & Systems EngineeringUniversity of WashingtonSeattleUSA
  3. 3.Ministry of HealthNairobiKenya
  4. 4.Department of Family and Child NursingUniversity of WashingtonSeattleUSA
  5. 5.Ministry of HealthMaputoMozambique
  6. 6.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  7. 7.Department of Pediatrics and Child HealthUniversity of NairobiNairobiKenya

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