TY - JOUR T1 - The centrality of behavior change in health systems development JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 132 LP - 133 DO - 10.9745/GHSP-D-13-00170 VL - 2 IS - 1 AU - Joseph F. Naimoli AU - Kathleen A. Parker AU - James Heiby Y1 - 2014/02/01 UR - http://www.ghspjournal.org/content/2/1/132.abstract N2 - The Global Health: Science and Practice editorial, “The 6 domains of behavior change: the missing health system building block,”1 serves as a welcome reminder of the pivotal role of behavior change in health systems development. Moreover, we agree that serious attention to health systems strengthening (HSS) and behavior change is necessary to achieve the ambitious Millennium Development Goals (MDGs) for health by 2015 and beyond. The editorial makes certain assumptions, however, about HSS and behavior change that we believe merit a response and clarification.First, the editorial assumes that the absence of a “building block” on behavior change in the World Health Organization HSS framework2 represents a failure of the framework to adequately address the importance of behavior change in health systems development. Yet even a cursory review of the building blocks (governance, financing, service delivery, human resources, information, and medicines/vaccines/health technologies) reveals the crucial role of behavior change and the presence of behavior change interventions in each of the 6 subsystems represented by the framework. The targets of behavior change are not limited to individuals but include the full spectrum of health system actors, including client groups, communities, governments, nongovernmental … ER -