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Changing the system to end acute malnutrition

We have been working on a systems change project to solve acute malnutrition but working in systems is never easy.

The problem

Acute malnutrition in urban India is a complex problem. It's not just a matter of giving people more food, there are various reasons why babies are born without the nutrition they need to survive and thrive including;

  • Not providing the right kind of food at the right time
  • Not having access to better and more nutritious food (cost as well as physical access)
  • Mothers education and behaviour
  • Community behaviour, culture and norms
  • Role of the family and their education and understanding of nutrition
  • Sanitation and disease prevention (or lack of it)

And these are just a few of the challenges that mothers, families, communities and experts face when trying to intervene and prevent acute malnutrition.

The numbers are huge, 25.5 million children in India who are wasted by lack of nutrition. I can't even use a concert stadium analogy to illustrate how big of an issue this is!

As part of our Acute Malnutrition prevention lab we had a go at mapping the problem cycle below to illustrate the problems that need to be addressed to reduce the incidence of acute malnutrition. You can also download our problem brief here which the team at Vihara developed.

Acute Malnutrition Problem cycle

Our acute malnutrition problem cycle

This needs innovation

The Children's Investment Fund Foundation fund many excellent projects and programmes to treat and prevent acute malnutrition in India and these will continue.

What they also wanted to do was to look at was how to bring innovation and cross sector partnerships into the development of new solutions, to deliver acute malnutrition prevention or to scale current solutions.

From a Nesta perspective, we knew that we could bring a group of smart and dedicated people into a room and come up with many ideas and support ideas to scale. This accelerator approach has been tried and tested across the world and as innovation experts we research and run these processes often.

What we also knew was that it was going to take something different for this complex issue, more systemic approach to tackling the issue and developing a portfolio of solutions that would knit together to solve the problem, crucially working across sectors and using the unique assets of the different organisations involved.

Nesta has published work on systems innovation in the past and we attempt to work in a systems way on most of our programming but it's often a hard to grasp concept.

What is the systems approach?

With our partners Vihara and the lab participants, we worked to map the ecosystem of acute malnutrition prevention. When looking at a system like this it can feel very overwhelming and it's hard to know where to start.

Acute Malnutrition ecosystem

Our acute malnutrition ecosystem diagram

The next step was to look at the unique capabilities and assets of our potential lab participants, the areas where innovation could be most beneficial (as opposed to a pure scaling or funding need) and then identify several sub systems which you can see identified in the diagram below.

Potential sub systems

Diagram showing a breakdown of the potential sub systems

This process is not comprehensive like a full research piece but is designed to be organic and added to, and informs the development of the lab.

The key when taking a systems approach is to have the theory of change and to link that theory of change to a part of the system, so that you can see how your work is contributing (or not) to the whole change needed, in this case, ensuring that no Indian child is wasted.

The challenge of thinking in systems

Thinking in systems is hard. It's human nature to want to reduce hard things down to basic problems or to pinpoint an easy intervention. The problem with doing this is that you might find yourself working on areas that won't make the most impact and there could be unintended consequences of your intervention. More often than not, non-systems approaches do not 'learn as they go' and are unable to adapt to the changing dynamics of what is happening around them. A system based approach recognises that everything we do to create social change doesn't exist in a vacuum.

Thinking in systems can feel very esoteric, jargony and most importantly it can feel too big to do anything about. This can lead to participants losing motivation. It's very hard to feel like you have control when the system problems are so big.

How are we making it easier for all the partners

To make working in systems for our participants easy, we not only introduced them to the system and interrogated it as a group, we also worked with them to break it down. The lab included standard workshop components of coming up with ideas (ideation), identifying assets, coming up with new business models and plans, as well as some core partnership development components to ensure cross sector engagement. This constant breaking down to manageable pieces and then building up to see the bigger picture has worked well for the lab so far.

Results so far

In a few short months we have:

  • Brought people together that have never worked together before
  • Formed cross organisational and cross sector teams who are working together daily
  • Formed four or five concepts which connect together, as a portfolio, to create a systems change
  • Built business models around those concepts and are now moving to prototyping stage.

We don't know if these concepts will work to contribute towards the acute malnutrition prevention sector and ultimately to saving lives but we do know that this vital social research and development is important for any sector.

What has surprised us is how much work the teams have done in such a short space of time on top of their day jobs which shows a real desire to contribute to this challenge.

It has also been surprising to see how quickly and easily the teams have been able to work together and support each other across teams and concepts. This bodes well for the development of the ventures and the portfolio.

Of course a system doesn't change in just a few short months! We will be working over the next 18 months - 2 years to develop this further with the lab participants and ideally test and design in two urban locations to test what works.

Find out more about our Acute Malnutrition Lab.

You are also welcome to join our demo day in Dehli the afternoon of June 26th, by joining remotely via Zoom.

Author

Kate Sutton

Kate Sutton

Kate Sutton

Head of Corporate Social Innovation

Kate is responsible for managing Nesta's Corporate Social Innovation and Inclusive Growth work

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