Boundary‐spanning actors in complex adaptive governance systems: The case of multisectoral nutrition

Abstract

A growing literature highlights complexity of policy implementation and governance in global health and argues that the processes and outcomes of policies could be improved by explicitly taking this complexity into account. Yet there is a paucity of studies exploring how this can be achieved in everyday practice. This study documents the strategies, tactics, and challenges of boundary‐spanning actors working in 4 Sub‐Saharan Africa countries who supported the implementation of multisectoral nutrition as part of the African Nutrition Security Partnership in Burkina Faso, Mali, Ethiopia, and Uganda. Three action researchers were posted to these countries during the final 2 years of the project to help the government and its partners implement multisectoral nutrition and document the lessons. Prospective data were collected through participant observation, end‐line semistructured interviews, and document analysis. All 4 countries made significant progress despite a wide range of challenges at the individual, organizational, and system levels. The boundary‐spanning actors and their collaborators deployed a wide range of strategies but faced significant challenges in playing these unconventional roles. The study concludes that, under the right conditions, intentional boundary spanning can be a feasible and acceptable practice within a multisectoral, complex adaptive system in low‐ and middle‐income countries.

Generating political commitment for ending malnutrition in all its forms: A system dynamics approach for strengthening nutrition actor networks

“…Another consistent finding in the literature is that NANs are more likely to be cohesive in the presence of leaders capable of managing complex relationships, conflicts, and competing interests among members, while increased cohesion can in‐turn reinforce the strength of leadership . Nutrition leaders enhance the strategic capacities (ie, “soft‐power” skills) of NANs and are thereby more capable of building internal cohesion and managing external commitment‐building activities across multiple sectors and levels . This resonates with the findings of a recent four‐country Sub‐Saharan Africa study that “boundary‐spanning actors” intentionally engaged in boundary‐spanning actions (eg, brokering, conflict resolution, coordinating, convening, diplomacy, framing, networking, and negotiating) are a feasible and acceptable approach to fostering policy action within complex multisectoral and multiagency nutrition governance contexts .…”

“…Nutrition leaders enhance the strategic capacities (ie, “soft‐power” skills) of NANs and are thereby more capable of building internal cohesion and managing external commitment‐building activities across multiple sectors and levels . This resonates with the findings of a recent four‐country Sub‐Saharan Africa study that “boundary‐spanning actors” intentionally engaged in boundary‐spanning actions (eg, brokering, conflict resolution, coordinating, convening, diplomacy, framing, networking, and negotiating) are a feasible and acceptable approach to fostering policy action within complex multisectoral and multiagency nutrition governance contexts . Strategic capacities include the creation of spaces and opportunities (eg, formalized governing bodies, conferences, workshops, and informal networking events) for members to share information, build consensus, and manage conflicts.…”

“…In our previous study, we demonstrated that the drivers of political commitment for nutrition are interdependent, context dependent, and dynamic—ie, they demonstrate systems features . As understanding of the complexity of public health and nutrition has matured, systems thinking has surfaced as a promising approach for informing action including policy development, program design, implementation, and governance . This emerging interest in systems responds to the growing awareness that actions to attenuate public health problems must engage with and respond to causal complexity.…”

“…18 As understanding of the complexity of public health and nutrition has matured, systems thinking has surfaced as a promising approach for informing action including policy development, program design, implementation, and governance. [22][23][24][25] This emerging interest in systems responds to the growing awareness that actions to attenuate public health problems must engage with and respond to causal complexity. "Soft-system" methodologies can also help inform policy and organizational decision making, by enabling structured dialogue between actors and the development of consensus positions on plausible causality and intervention.…”

Coordinating Nigeria's micronutrient deficiency control programs is necessary to prevent deficiencies and toxicity risks

“…These barriers are so significant that the author cautioned against nutrition interventions that require intersectoral coordination where these barriers exist. In fact, the challenges with government coordination have led some authors to refer to it as “an elusive goal.” Other coordination challenges include inadequate quantity and quality (skills) of responsible human resources …”