Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
Global Obesity Centre, Deakin University, Geelong, Australia.
Obes Rev. 2019 Nov;20 Suppl 2:30-44. doi: 10.1111/obr.12871. Epub 2019 Jun 27.
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.
为消除各种形式的营养不良现象而调动政治意愿,是全球营养界面临的一个关键挑战。没有政治意愿,就不可能制定、有效执行和持续提供改善营养所需的政策、方案和资源。政治意愿的一个重要驱动因素是营养行为体网络(NAN)的效能,即网络内的个人和组织为改善营养而共同努力,他们在特定国家内共同运作。为了提供新的思路和行动,以加强 NAN 的效能,我们使用系统动力学理论方法和文献综述,建立了政治意愿和 NAN 效能的初始因果关系图(CLD),并采用专家研讨会的定性组模型构建(GMB)方法来加强模型的有效性。首先,一个“营养承诺系统”的 CLD 展示了五种相互关联的承诺形式——修辞、体制、业务、嵌入和系统——如何随着时间的推移动态地相互加强或减弱。其次,我们展示了塑造 NAN 效能的 CLD,这些因素分为三类:行为体特征、资源和能力;框架策略、证据和规范;体制、政治和社会背景。这些模型共同提出了关于如何在未来加强政治意愿和 NAN 效能的假设,也可能为各国就这一问题进行对话提供潜在的起点。
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