Foresight Approaches in Global Public Health

MODULE1: INTRODUCTION
Intro
- Potential of innovation for health improvement
- E.g. Telemedicine
o Risks/ problems: ?ethic, data privacy, inequity for access in people w/o
resources
- Foresight tools
- Anticipate changes and act on opportunities and risks

Definition of foresight
- Think about 5 interconnected questions
o What is changing?
o What might be the impact of emerging change?
o What alternative outcomes and different possible futures could the interplay
of emerging changes created?
o What future do we want to build?
o How do we create changes we wish to see?
- Timely public health response require leader to stay ahead of the curve
- Foresight = systematic approach to exploring trends, emerging change, systemic
impacts and mid to long term alterative futures that might evolve from those
changes

Mental bias
- Gut feeling/ intuitions/ cognitive bias are mental shortcuts that can lead to systemic
errors
- Examples
o Optimistic bias = tendency to underestimate negative and overestimate
positive
o Sensitivity to presentation = perception shaped by how something is
expressed in terms of gain or loss, choices made by how outcomes are
categorised or presented
o Heuristic (mental shortcuts)
 Availability = information that is readily available is more easily
recalled and skews judgements
 Representativeness = similar events or things groped on the basis of
perceptions
 Anchoring = starting points influence final results
o Group bias = consensual groups exaggerated initial optimism or cautions and
increase confidence in opinion. Dissonant group can be more accurate.
- Future thinking required rethinking or assumptions and mental models, integrating
diverse perspective reduce risk of having blind spots

Foresight activities in global health

 - Horizon scanning = set of systematic methods for monitoring evolving change by
collecting data on trends and identifying weak signals of change that may impact
futures
- Foresight contribution to public health  allow ability to adapt to and response to
new trends in science and technology etc. and identify risks
- Be alert to small signals, be open minded, getting views and ideas from others
- Foresight does not predict future but gives us a set of tools to be proactive rather
than reactive
- Foresight approach enable us to confront our assumptions and judgements by
identifying and acknowledging possible biases

MODULE2: START USING FORESIGHT

6 steps approach to foresight
- Keep your radar and sonar on
o Keep eyes open and ear alert
o Open to trends and emerging changes
- Break boundaries
o Consider various viewpoint
o Gain new perspective from others especially marginalised group
- Explore outwards as far as you can
o Identify a significant changes and possible impacts
- Map interdependencies
o Work with others to sketch out a systems to map the issues
o Brainstorm emerging changes
o Ask: how do these changes interconnected? Do they amplify or balance each
other’s?
o Discuss the impact of the emerging changes
 Impact (positive/ negative/ neutral)
 Who will be impacted?
- Identify existing allies for changes and make new ones
o Also think abt who will be resisting the changes
- Make the differences vivid

Quick starter guide

- Basic reflective questions
- 6 foresight stages
o Framing the problem
 Ask:
 Will it get naturally better or worse
 What could it possibly disrupt
 What future proof solutions are needed?
o Awareness of change
 Finding that cause that led to change
 Listen to network partner or outliers
 Identify adjacent systems
 Ask:
 Pattern of change that created the current condition
  Assumptions do we made now and for the future
 Emerging changes contributing to or challenging stability
 Now night we have to adapt to the emerging changes
o Analysing impacts of change
 Area if the first impact
 Ripple effects – disruption and transformation
 Ask:
 Where will relevant stakeholder feel the change first
 Who will feel impact most tangibly
 Who will lose and who will benefit
 How can systemic foresight activity enhance accountability
and responsibility for those impacts
o Exploring alternative futures
 Question yours and other assumption
 Assumption reversal = considering the outcome furthest from your
assumption, worse case scenarios?
o Envision preferred futures
 Restate your deepest concerns as their mirror image positive
outcomes and think if they express your best homes and what else
would complete this positive picture?
 Include marginalised people
 Ask:
 How can we create the most inclusive possible conversation
 How can we arrive at specific shared values, goals and actions
given our differences in world view, culture and local contexts
o Creating changes
 Identify allies and challenges
 Who would most likely to block the outcome and why?
 Think how can you make this positive to them?
 15% solutions – what could I do today with only 15% of my time and
resources to lead to change

Some foresight methods and their applications

- Building a decision tree
o Refine your thinking  getting expert ideas  form the POV of other
worldview and cultures  what impact emerging changes might have

- Causal layers analysis

 o Litanies = what are ppl talking about? What events related to the issues?
Trending headlines?
o Systemic = why are these events happening? Explanation we can give? What
do the data suggests?
o Worldview = what world value drive the issue? What value prevent the issue
from changing?
o Myths/ metaphors = who would this issue sum up in a metaphor or image?
- Horizon scanning
o Social/ technological/ environmental/ economic/ political
o Mid/near/ far futures
- Narrative inventories/ mapping
o Face to face methods and digital methods
- Future wheels also called impact wheels
o Explore and map successive cascades of impact form a single change

Choosing the right method for your purpose