Strengthening Systems Resource Review

Despite global progress, efforts to alleviate malnutrition are often hampered by a shortage in number, skills, and geographic coverage of a workforce for nutrition. This article reviews the findings of the March 2014 Castel Gandolfo workshop on the importance of developing the capacity of a global cadre of nutrition professionals. Workshop participants identified several requirements for developing a workforce for nutrition that can contribute to achieving the forthcoming Sustainable Development Goals.

Since 1992, the number of undernourished people in the world has remained about the same; however obesity has quickly become a major public health concern around the globe. This article organizes the multitude of factors that have contributed to dietary and nutritional changes in recent history into two categories. The first set captures the important developments over the last 20 years in technology, globalization, population, urbanization, and other sociodemographic dynamics. The second set identifies the range of government policies that impinge on diets.

This paper documents the Alive & Thrive project’s efforts to scale-up infant and young child feeding interventions in three countries from 2009 to 2013. Systems strengthening is seen as essential to achieving population-level nutrition improvements due to rapid geographic expansion and increasing burdens on service delivery systems. This study draws from experience in Bangladesh, Ethiopia, and Vietnam to provide clear direction on approaches to capacity building and implementation of large-scale nutrition programs in diverse cultural and epidemiological contexts.

Strong leadership has been identified as a common element of success within countries that have made rapid progress in tackling child and maternal undernutrition. This study of 89 individuals identified as influential within child and maternal undernutrition policy and programming in Bangladesh, Ethiopia, Kenya, and India sheds light on why particular individuals have been effective in contributing towards positive changes in nutrition policy and describes how they operate in the wider policy/political sphere.

In recent years, the concept of "scaling up nutrition" has become routinely espoused within the nutrition community. However, with such proliferation, there is a need for greater coherence and consistency with regard to the scope, purpose, and essential processes of scaling-up. In this research brief, Transform Nutrition shares a list of specific elements that are critical factors for successful scale-up.

A reliable estimate of nutrition spending is critical for effective planning to address the interrelated causes of undernutrition. This study builds on the definition of nutrition-sensitive investments, programs, and interventions to produce a global estimate of resources that have been committed to improving nutrition through multi-sectoral approaches that address underlying determinants of nutrition. The authors present a novel methodology that tracks donor commitments for nutrition-sensitive activity globally and across development sectors.

Because the obesity epidemic is the result of a complex system of factors, addressing it requires a systems approach. Factors within the realms of behavior, environment, policy, economics, physiology, and culture have all been identified as contributors to obesity. This video maintains that a systems science approach is necessary for tackling the multivariate dynamics of the epidemic and allowing for the formulation of a unified strategy for combatting childhood obesity.

The international community has a target to end all forms of malnutrition by 2030. This article puts forth 14 recommendations to achieve this goal. Embracing a systems-thinking approach; the recommendations range from taking action in the private sector, to engaging politicians, striving to end conflict, and leveraging existing institutions in civil society. The authors believe that when people understand the central role nutrition plays in life, more sectors will get involved in addressing the challenge.

USAID's Office of Health Systems released this landmark report which presents evidence linking health systems strengthening (HSS) interventions to measurable impacts on health outcomes for the first time. Health systems strengthening was found to improve health system outcomes such as service utilization, quality service provision, uptake of healthy behaviors, and financial protection. The report draws on evidence identified in 66 systematic reviews, which together cover more than 1,500 individual peer-reviewed studies on the effects of HSS interventions on health status and outcomes.

This article makes the case for country-owned programs with sound leadership and resource management; even in variable financial, political, and environmental circumstances. Malawi is put forth as an example of a country which has had great success in taking charge of its Neglected Tropical Disease program implementation. These successful country-owned public health initiatives come in different guises around the world, but at the heart of every successful one is an integrated, multi-sectoral approach.

In this blog, a USAID Development Specialist discusses the organization’s shift in analytical framework from the value chain to the market system. Moving forward, USAID plans to implement their programs through a systems facilitation approach that prioritizes collaboration, learning, and adapting (CLA) for effective development at all levels. Since market systems are human systems, they are complex and adaptive. The systems facilitation approach and CLA build in local ownership from the start and allow development actors to try things, see what effect they have on the system and adjust until the desired outcome is reached.

When evaluating development interventions for their contributions to sustained development, it is essential to monitor how systems change over time. Traditional monitoring methods can measure the effects of each discrete intervention, however capturing how those interventions are contributing to strengthening the local system and promoting sustainable results requires monitoring approaches that are grounded in systems thinking and responsive to the complexity of systems dynamics. Presented in a report on a meeting to discuss this topic, USAID has developed and begun to test a framework designed to focus monitoring on five key attributes of systems.