Abstract for: Reverse Engineering: Local Implementation of Cervical Cancer Prevention for Global Health

We share a case of applying System dynamics for engaging local actors in a participatory modeling intervention for tackling cervical cancer in Peru as part of a global initiative of public health. We show the main results of workshops through the development of what we call a case of “SD-based reverse engineering” and the opportunities that it brings to the academic community of Implementation Science. We used models as boundary objects that allowed stakeholders to develop shared understandings of a system and identify leverage points for implementing cervical cancer prevention guidelines. Facilitators and experts helped build consensus and shared understanding expressed as aggregated flowcharts, which were then “reversed engineered” to create locally-informed SD models that included barriers, good practices, and opportunities for scaling cervical cancer prevention. Workshops allowed for lessons and reflections from a systemic perspective and were also the basis for decision-making and public policy. The participative design of the workshops enabled to capture actors´ mental models and build systemic models of the cervical cancer control and prevention process. Models made the system visible as a whole, and allowed mapping barriers, good practices and opportunities (identified by the participants) and also made accumulations explicit that might be problematic for prevention programs success. This contribution underscores the transformative potential of System dynamics modeling as a strategic tool for addressing complex healthcare challenges, particularly in cervical cancer prevention. We demonstrate how participatory modeling can bridge the gap between global health objectives and local implementation realities. Our approach allowed for a structured yet flexible engagement of diverse stakeholders, fostering a shared understanding of systemic barriers and opportunities in HPV screening, triage, and treatment.