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

Abstract

Summary Generating political commitment for ending all forms of malnutrition represents a key challenge for the global nutrition community. Without commitment, the policies, programs, and resources needed to improve nutrition are unlikely to be adopted, effectively implemented, nor sustained. One essential driver of commitment is nutrition actor network (NAN) effectiveness, the web of individuals and organizations operating within a given country who share a common interest in improving nutrition and who act collectively to do so. To inform new thinking and action towards strengthening NAN effectiveness, we use a systems dynamics theoretical approach and literature review to build initial causal loop diagrams (CLDs) of political commitment and NAN effectiveness and a qualitative group model building (GMB) method involving an expert workshop to strengthen model validity. First, a “nutrition commitment system” CLD demonstrates how five interrelated forms of commitment—rhetorical, institutional, operational, embedded, and system‐wide—can dynamically reinforce or diminish one another over time. Second, we present CLDs demonstrating factors shaping NAN effectiveness organized into three categories: actor features, resources, and capacities; framing strategies, evidence, and norms; and institutional, political, and societal contexts. Together, these models generate hypotheses on how political commitment and NAN effectiveness could be strengthened in future and may provide potential starting points for country‐specific conversations for doing so.

Achieving Food System Transformation: Insights From A Retrospective Review of Nutrition Policy (In)Action in High-Income Countries

“…This omission has been identified previously in the literature on the political economy of nutrition as an impediment to implementing nutrition actions. 67,68 These observations support the need to ensure transparency, rigour and public scrutiny of government food and nutrition policy, regulatory and norm-setting activities to ensure they are adequately protected from undue commercial interest. 66 International Recommendations for Nutrition Policy Development and Recent Progress Recommendations by the WHO 9,57,66 and other authoritative organisations such as the Nutrition and Obesity Policy Research and Evaluation Network 69 are now used more actively to guide development to ensure that nutrition policies are comprehensive and multi-sectoral.…”

Ultra‐processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers

“…These include bottom-up civil society mobilization, top-down political commitment, protections against conflicts of interest in policy development and well-resourced monitoring, accountability and enforcement mechanisms. [178][179][180] However, worldwide policy responses are currently inadequate in both scope and strength. [181][182][183] According to the latest WHO monitoring reports, the large majority of reporting governments have unhealthy foods (6%), front-of-pack labelling schemes (25%; with just over half being mandatory), elimination of industrially produced transfats (37%), portion-size controls (16%) and school food standards (43%).…”

Star Trek Offers Insights That Illuminate Actor Engagement in Global Nutrition Governance Comment on "Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool"

“…Commercial entities or private-sector actors have access to advanced technology, knowledge and financial resources to address malnutrition in countries worldwide to promote healthy and sustainable food systems. [4][5][6] Commercial actors represent many Star Trek characters (ie, Humans, Changelings…”

“…Diverse actors influence nutrition policies and programs, food systems, and population health. [4][5][6] Friel et al 5 define global nutrition governance as "the process by which impact on nutrition by non-nutrition policies (ie, education, employment, health, environment and trade) is leveraged or mitigated by a network of actors. " They identified three prevailing global nutrition governance challenges: achieving policy coherence across many government sectors that affect nutrition; clarifying actor responsibility for nutrition; and developing effective mechanisms to hold all actors accountable for actions that impact nutrition.…”