Application of Systems Thinking to Dent Child Malnutrition: A Palghar District, India Case Study

Abstract

Child malnutrition is an important low-and middle-income country (LMIC) issue influenced by biological and socio-economic factors. The solution is dependent on the stakeholders and interactions between them. The multidimensionality and context-dependency of causative factors make system thinking-based approach, namely network analysis, an effective tool to map the decision-making on countering child malnutrition. The study used Palghar district, India, as a case study to perform the stakeholder network analysis for identifying the various stakeholders who were targeted by actions and initiatives of district administration. The network analysis was performed for three temporal phases, namely Phase I (pre-2014), Phase II (years 2014–2017) and Phase III (2017 onwards). The study found that both network density of the system and child nutrition status have increased temporally. The study found an increase in network density due to an increase in the number of stakeholder groups targeted, implementation of new actions/initiatives and expansion of existing actions/initiatives to other stakeholders. A significant increase in focus towards the stakeholders influencing the socio-economic environment of the child is found in Phase III as compared to Phase II. Further, the study found that family and elite group have started featuring as prominent stakeholder targets for various actions. The study concludes that a greater incorporation of system-thinking approach in decision-making could help in effectively addressing child malnutrition and similar healthcare issues.