Oosthuizen, Sarie J.Bergh, Anne-MariePattinson, Robert Clive2019-01-162019-01-162018-11Oosthuizen, S.J., Bergh, A.M. & Pattinson, R.C. 2018, 'Systems thinking : a turning point for improving respectful obstetric care in South African health districts', South African Medical Journal, vol. 108, no. 11, pp. 910-914.0256-9574 (print)2078-5135 (online)10.7196/SAMJ.2018.v108i11.13312http://hdl.handle.net/2263/68165This publication is part of the PhD studies of the first author, SJO.Poorly functioning health systems and local health systems barriers affect many women giving birth in low- and middle-income countries. The district clinical specialist teams in South Africa are uniquely positioned to provide facilitation and mentoring during interventions for improving the weak primary healthcare system. To ensure success, four key principles should be considered during scale-up of interventions: systems thinking and awareness of contexts and barriers; a focus on sustainability; harnessing factors known to enhance scalability; and respect for human rights and equity. Asking the right questions about the responsibilities of health systems at the micro-, meso- and macrolevels will benefit scale-up processes and sustain innovative pathways to high-quality obstetric care in communities.en© 2018, South African Medical Association. All rights reserved. This article is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0).District clinical specialist teams (DCSTs)Obstetric careSouth African health districtsSystems thinkingHealth sciences articles SDG-03SDG-03: Good health and well-beingHealth sciences articles SDG-16SDG-16: Peace, justice and strong institutionsHealth sciences articles SDG-17SDG-17: Partnerships for the goalsArticle