Applying Systems Thinking for Nutrition

“

People don't live their lives in health sectors or education sectors or infrastructure sectors, arranged in tidy compartments.

People live in families and villages and communities and countries, where all the issues of everyday life merge. We need to connect the dots.

— Robert Zoellick, former head of the World Bank

SPRING takes a systems approach to tackling nutrition. This means looking at the forest and the trees — seeing interrelationships, processes of change, and feedback mechanisms.

Practitioners working in nutrition must start thinking about the effect food, health, and education systems have on nutrition practices and outcomes.

SPRING identified factors that influence and interact with one another as they impact nutrition outcomes.

Policies and Governance

Policies and governance affect food, health, and the environment. SPRING has developed these tools to support governments in their efforts for improved nutrition.

Infrastructures and Markets

Roads and “brick and mortar” structures are necessary for nutrition - to provide health and nutrition services and to store, distribute, and sell agriculture, food, sanitation, and hygiene products.

Inputs and Services

A systems approach calls for increased prioritization of nutrition-related inputs and integration of nutrition in existing services and the systems to support those services.

Information and Communication

Alignment or harmonization of communication by the public and private sector as well as the health, agriculture, and education sectors is essential for the social change that is required for behavior change at all levels.

Financing

Political will for nutrition must be reflected through financial support. Only by taking a broad systems approach can financing be effectively allocated and used to improve nutrition.

Household Resources

Systems thinking links efforts to improve household resources and maximize the use of resources for education, food, health, WASH, and other nutrition needs.

Sociocultural Environment

Social roles, relationships, and policies in public settings influence perceptions of and access to resources and services, as well as nutrition-related behaviors and decisions.

We believe that together these factors form multiple interdependent systems that shape nutrition.

systems diagram

Systems thinking informs SPRING’s work in three areas

1.Generating evidence around how complex dynamics impact nutrition

2.Creating and testing tools for improving nutrition through systems thinking

3.Assessing the nutrition landscape through a systems lens

Generating evidence around how complex dynamics impact nutrition

SPRING has pioneered efforts to gather and build evidence on the role of systems in achieving scale for nutrition programs. SPRING’s Pathways to Better Nutrition Case Studies took an innovative approach to documenting the influence of multi-sectoral national nutrition action plans at the national level and in a few districts. Because our country-driven research took place over multiple years, we were able to provide a rare time-series view of changes in planning processes and funding mechanisms for nutrition.

SPRING’s Pathways to Better Nutrition Recommendations

Policy

Clear, long-term, multi-stakeholder policies are critical for increasing the commitment to improved nutrition.

Icon of a rising arrow and map point.

Take a long view of scale-up
Reach the local level

Drivers of Change

A strong, supportive, and dynamic enabling environment needs to be created to carry out the policy.

Icons of a government building, people and a microscope.

Work within sustainable structures
Address human resource constraints
Launch monitoring and evaluation (M&E) framework

Prioritization

Prioritization of nutrition during yearly sector workplanning determines the amount of funding, time, and effort it will receive.

Icons of papers and lists.

Align with priorities named in nutrition plan
Embed nutrition in sector and organizational plans

Funding

Increased funding for nutrition (and, importantly, spending of that funding) means greater implementation of high-impact nutrition activities. These activities should lead to gains in healthy and productive life years.

Icons of a clipboard, arrows and prescription cap.

Use budget as planning tools
Invest in key drivers of change
Consider formal funding mechanisms for nutrition

Click here for more information about SPRING's Pathways to Better Nutrition work.

Creating and testing tools for improving nutrition through systems thinking

These tools are created to help policymakers and other stakeholders identify gaps, and integrate nutrition into food, health, and other systems.

Budget Analysis Tool

An easy-to-use tool and process guide for stakeholders to better understand nutrition funding by donors and government ministries

Nutrition Workforce Mapping Toolkit

Tools and process for mapping nutrition services provided by the health workforce, based on policies, job descriptions, training curricula, managerial reports, and observations

Community Health Worker Nutrition Advocacy Tool

Graphically appealing and user friendly slide decks on the role that community health workers play in delivering evidence-based, cost-effective nutrition interventions that can help stakeholders advocate for increased commitment to nutrition by health services and community programs

Tools for Rapid Evaluation of Facility-Level Nutrition Assessment, Counseling, and Support

Tools for rapidly assessing the capacity of health facilities to implement nutrition services for pregnant women, children, and people living with HIV

Assessing the nutrition landscape through a systems lens

Through webinars, research, and partnerships SPRING has been able to share lessons learned, and help others incorporate nutrition across multiple sectors.

Defining Scale-Up of Nutrition Projects

This working paper defines scale-up and the types needed for effective and sustainable programming. It also provides a starting point for discussions on measuring the effectiveness of scale-up efforts and key principles for wide-scale nutrition program implementation.