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Introduction

System thinking is defined as a broad paradigm which considers inter-relationships between various components of a system, boundaries and perspectives for catering health issues through collaborative practices (Rosas, 2015).  In system thinking, the health promotion of people four components namely knowledge, models, organization and networks have been used by stakeholders (Rosas, 2015).   In this assessment, the concept of system thinking has been explored by implementation of this approach in addressing the issue of obesity. The assessment has been initiated with description of the issue, followed with roles of stakeholders, barriers in the application of system thinking and various strategies for effective implementation of this approach in addressing the issue of obesity. 

Description of issue

Obesity is considered as one of the major public health issue worldwide and a very significant factor behind limited life expectancy of people in modern world. According to Harbuwono, Pramono, Yunir  and Subekti (2018),  to obesity is defined as the abnormal and excessive building of fat in the body leading to increased BMI >= 25 kg/m2.  It has been reported that approximately 39% of adults above than 18 years old are obese in the world which accounts for  2.1 billion of population (WHO, 2018). Obesity is a major health concern in Australia as well and approximately 5 million Australian adults are suffering from obesity which accounts for nearly 27.9 % of total population of Australia (Heart Foundation, n.d.). Since 1995, 49% of increase in obesity prevalence has been noticed in Australia and nearly 28.4% of men and 27.4% of women are suffering from obesity in the country (Heart Foundation, n.d).  According to Jiang, Lu, Zong, Ruan and Liu (2016), obesity is a major factor behind the onset of various chronic diseases like type 2 diabetes mellitus, coronary diseases, hypertension, respiratory complications, hyperlipidemia, prostate cancer and many other complications. Hence, it is very important for the stakeholders to address the issue and control the complication of obesity as soon as possible for enhancing the health outcomes of people of Australia.  

Roles of various stakeholders

The stakeholders are defined as the people who are directly or indirectly affected by any action or are involved in any project for achieving a set goal mutually, for the benefit of all (Bjørkquist, Ramsdal & Ramsdal, 2015). The various stakeholders for health promotion of people sufferings from obesity are healthcare professionals, community groups or workers, people, service providers and policymakers. The roles and responsibilities of stakeholders in addressing the issue are varied in health systems and other related sectors. The major roles in which stakeholders are engaged within health systems to include provision of health education, promotion of healthy diet and nutrition, motivation of people for enhancing physical activities, advocacy, strengthen people for controlling risk factors behind obesity, proposing behavioral interventions, communication, encouragement of people to participate in their health promotion and enhancing adherence of people for controlling their health outcomes (Bjørkquist et al., 2015). On the other hand, the roles of stakeholders in other sectors for addressing the issue of obesity would be formulation of health policies, implementation of policies, creation of a supportive environment, conduction of camps for promotion of health, procurement of resources, preparation of grant proposals, funding, advocacy, channeling of communication, planning health promotion activities with legal stakeholders  and recruitment of health professionals for addressing the issue on priority basis (Barry et al., 2012).

Barriers in application of system thinking

According to Huang, Brownson, Esposito, Green and Homer (2013), in order to prevent chronic health issues like obesity, there is huge interest has been developed in the application of system based approach in the field of public health.  It has been stated that one of the major obstacles which are hindering the application of system thinking approach in addressing the concern of obesity is lack of strong leadership and engagement of various stakeholders in achieving the improved health outcomes of the patient (Huang et al., 2013).  The lack of engagement of local community groups in various activities associated with obesity prevention is also a major factor which can limit the effective application of system thinking approach (Bagnall et al., 2019). The devotion of limited time for the development of trust and therapeutic relationships between all stakeholders for achieving the better health outcomes is also a major barrier in implementation of system thinking to address the issue of obesity (Bagnall et al., 2019).  The lack of good governance, supportive environment, consistency in language, shared values, cultural sustainability, effective policies and finances are also certain obstacle which prevents the application of system thinking application in mitigating the issue of obesity (Bagnall et al., 2019).  

Strategies for the application of system thinking

There are various strategies which can be implemented for the effective application of system thinking in addressing the issue of obesity.  According to Owen et al. (2018), for the application of system thinking a strong leadership is required to be demonstrated by the stakeholders who can encourage the other people to devote time and actively participate in the promotion of preventive measure for obesity. The second approach would be is arrangements of new governance in which the issue of obesity can be highlighted and mentioned as a high priority health concern in government policies and encouraging elements of governance to take adequate measures for addressing the issue instantly (Owen et al., 2018).  The third strategy would be improvement in collaborations with agencies engaged in production of food to comply with the set standards for delivery of healthy food to people (Malakellis et al., 2017). The fourth strategy is motivating people to adhere to healthy food regimens and physical activities in order to control various risk factors behind the progression of obesity (Malakellis et al., 2017).  The fifth strategy is to encourage the policymakers for providing adequate resources for improving physical activities among people and healthy food options in order to create a supportive environment (Malakellis et al., 2017).

Conclusion

From the assessment, it has been found that system thinking is an inter-relational approach which can address the issue of obesity effectively. The various roles of stakeholders for the prevention of obesity are education, promotion, advocacy, motivation of people behavioral interventions, procurement of resources, funding and channeling. The various barriers in the implementation of system thinking in mitigating the issue of obesity include lack of engagement of local community groups, good governance, shared values, effective policies and finances. The strategies for effective implementation of this approach are encouraged people to devote time, arrangements of new governance, improvement in collaborations, motivating people and motivate policymakers for creation of a supportive environment.

References

Bagnall, A. M., Radley, D., Jones, R., Gately, P., Nobles, J., Van Dijk, M., ... & Sahota, P. (2019). Whole systems approaches to obesity and other complex public health challenges: a systematic review. BMC Public Health, 19(1), 8.

Barry, M. M., MacDonald, L., O Sullivan, M., Sixsmith, J., Doyle, P., & Mahmood, S. (2012). Public health stakeholders perceived status of health communication activities for the prevention and control of communicable diseases across the EU and EEA/EFTA countries. Retrieved from https://pdfs.semanticscholar.org/4c97/ef8936ee41d026d0769287c2d383c077da83.pdf

Bjørkquist, C., Ramsdal, H., & Ramsdal, K. (2015). User participation and stakeholder involvement in health care innovation–does it matter?. European Journal of Innovation Management, 18(1), 2-18.

Harbuwono, D. S., Pramono, L. A., Yunir, E., & Subekti, I. (2018). Obesity and central obesity in Indonesia: evidence from a national health survey. Medical Journal of Indonesia, 27(2), 114-20.

Heart Foundation. (n.d.).  Overweight and obesity statistics. Retrieved from https://www.heartfoundation.org.au/about-us/what-we-do/heart-disease-in-australia/overweight-and-obesity-statistics

Huang, M. T. T. K., Brownson, P. R., Esposito, L., Green, L., & Homer, C. (2013). Next steps in obesity prevention: applying the systems approach. Childhood Obesity, 9(1), 11-14.

Jiang, S. Z., Lu, W., Zong, X. F., Ruan, H. Y., & Liu, Y. (2016). Obesity and hypertension. Experimental and Therapeutic Medicine, 12(4), 2395-2399.

Malakellis, M., Hoare, E., Sanigorski, A., Crooks, N., Allender, S., Nichols, M., … Millar, L. (2017). School-based systems change for obesity prevention in adolescents: outcomes of the Australian Capital Territory “It”s Your Move!’. Australian and New Zealand Journal of Public Health, 41(5), 490–496.

Owen, B., Brown, A. D., Kuhlberg, J., Millar, L., Nichols, M., Economos, C., & Allender, S. (2018). Understanding a successful obesity prevention initiative in children under 5 from a systems perspective. PloS One, 13(3), e0195141.

Rosas, S. R. (2015). Systems thinking and complexity: considerations for health promoting schools. Health Promotion International, 32(2), 301-311.

WHO. (2018). Obesity and Overweight. Retrieved from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

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