In 2018, more than 5 million children under the age of five died, and undernourishment was a key contributor to nearly half of those deaths. Malnutrition in children also results in the stunting of growth and low attainment in schools. And it is far more likely to affect those children that are the poorest.
Save the Children is working to address malnutrition through a range of programs. Its goal is to reduce and ultimately prevent malnutrition in children, including breaking the intergenerational cycle of malnutrition, so as to ensure that all children can realize their right to survive and reach their full potential.
Nutritional causal analysis examines the contributing factors that affect a community’s nutrition levels. Organizations that seek to reduce and prevent malnutrition, like Save the Children, use nutritional causal analysis to understand these factors and design appropriate interventions. This requires researching multiple sectors and systems, from agricultural and trade practices to sanitation and hygiene, education, care practices, gender norms, poverty, and access to health services. These drivers coexist and overlap, making it challenging to identify and prioritize the most important drivers in a given context and those most amenable to change through effective programming. Save the Children is exploring challenges related to nutritional causal analysis, and partnered with Tanzu Act to identify opportunities to improve this process.
Tanzu Act partners with nonprofit organizations at a discounted rate to drive social impact through designing and building technology with experts from VMware Tanzu Labs (formerly Pivotal Labs). The program contributes to VMware’s 2030 Agenda, a 10-year commitment to address critical challenges facing the global community that is focused on three business outcomes: trust, equity, and sustainability. This particular engagement falls within building equity by accelerating nonprofits' digital journeys.
Always start with the problems
While the Save the Children-Tanzu Act team realized early on that adapting an iterative approach to causal analysis had the potential to overcome many of the challenges we faced, we needed to first deeply understand the ecosystem and the problems within it. That would allow us to make sure we were tackling the most important problems and not ignoring parts of the system that could lead to any unintended consequences.
Nutritional causal analysis examines the contributing factors that affect a community’s nutrition levels
The team began by building a journey map of all the activities involved in designing a program to address malnutrition. Mapping out the steps—from the creation of a proposal all the way through to when a program finishes, and capturing all the stakeholders involved along with their activities, incentives, and the systems they operate in—allowed the team to identify assumptions around where problems were occurring in its existing causal analysis processes and program design.
Then, by making those assumptions around the problems explicit, the team was able to prioritize the problems according to those which could result in a deeper causal understanding—and, by extension, more effective program design—and those that were within the domain of Save the Children to address on its own, without Tanzu Act’s help.
The highest-priority problem that emerged was the inability of teams to systematically learn from past programs. As this is a wide-ranging, complex root problem to have, the next step was to build out a systems map around it to identify further subproblems that could potentially be addressed in order to make the subsequent causal analysis more effective. Anne LoVerso, the Tanzu Act team engineer on the project, explains the importance of taking a systems thinking approach.
Research can be done remotely
As part of understanding the root problem of not learning from past programs, the team needed to validate its assumptions through research with technical experts in areas with a high volume of programs, such as Somalia and Kenya. The team was already distributed, with the Tanzu Act members in New York and the Save the Children members in London, so interviewing people across multiple time zones—which needed to be conducted via Skype or traditional phone calls—was challenging to coordinate. The calls also needed to be time efficient because these people are very busy. To that end, the team created a structure around its remote research approach:
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Prepare a research script with key questions ahead of time
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Assign clear roles for the team, e.g., one person would ask the questions and someone else on the team would take notes
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Align with the participant on the purpose of the interview beforehand to set expectations
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At the start of the interview, clearly outline the goal and any next steps
After conducting multiple rounds of interviews and synthesizing the findings of the research, the team was able to pull out various insights, such as understanding the data sources the technical experts use to inform program design and any gaps in the analysis when identifying causal relationships and underlying causes of malnutrition. This helped the team generate key insight to evaluate subproblems.
Validated subproblems relating to the inability to systematically learn from past programs
Getting feedback from users is always the best way to understand whether a true need is being addressed. “All of the users we spoke to were really keen for us to realize this,” says Lilly Schofield, project lead at Save the Children. “It was good to get that reinforcement. There is an interest in this.”
What we found
Once problems were validated and there was a good understanding of the ecosystem, the team could start thinking about potential solutions to address the subproblems related to not systematically learning from past programs. The insights from the research led to three “How might we?” questions.
“How might we” questions generated from research insights
From there, the team came up with two concepts:
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A repository of past program data collected via standardized input from technical specialists to facilitate the finding and sharing of insights and key learnings from past programs.
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A tool that analyzes input data from primary and secondary sources and calls technical specialists’ attention to potential causal drivers of malnutrition in a particular region.
The team designed low-fidelity prototypes for how these concepts might work. While it’s tempting to create flashy, colorful designs, simple black-and-white drawings can be created faster and will generate useful feedback more easily as they focus the audience’s attention on the concept and not cosmetic choices, like color.
Concept for a repository of past program data
Concept for a tool alerting technical specialists to causal drivers of malnutrition
The Tanzu Act-Save the Children team worked to create these concepts based on a validated understanding of the problem space around nutritional causal analysis. The next step of the product development journey would be to test these concepts with technical specialists and get their feedback and iterate. However, due to the COVID-19 pandemic, Save the Children has rightly prioritized its work to focus on the pandemic response, and so have not yet taken this step.
Once the initiative is resumed and if the designs are validated through user testing, the team will be able to start writing code and creating these solutions. But the testing and iterating doesn’t stop there. In the same way NGOs need to learn from past programs to improve interventions that address malnutrition, the product teams will need to learn about the impacts their tools are having. Among the questions they should ask: Are technical specialists using the tool? Are we seeing the desired impact of more effective malnutrition programs? Are there any other changes to the sector that we had not foreseen?
What happens next
Many of the practices the Save the Children-Tanzu Act team followed on this project are also applicable elsewhere. As Save the Children’s Schofield noted, “Some of the approaches were nice ways to frame activities that I have been able to bring back to other teams.”
By combining the deep knowledge and expertise of NGOs like Save the Children in addressing some of the most important challenges of our time, such as malnutrition, with the problem-focused, iterative approach of product development, we hope to create sustained impact where it’s really needed.
Image courtesy of Eduardo Soteras Jalil/Save the Children.
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