Complexity Demands Agility: Operationalizing Agile Principles To Address Complex Public Health Challenge Of Malnutrition Management

The challenge in managing malnutrition lies largely on its multifactorial causation with complexities arising from interactions of multiple systems and their constituents. Based on the experiences gathered from designing and developing an Information and Communication Technology (ICT) enabled malnutrition management platform in India, we advocate that agile methods can be a good fit to address complex public health problems and thus improving usability and adoption rate. Agile methodologies have proved to be accommodative of heterogeneous stakeholders’ requirement and non-linear dynamics in complex systems. In our attempt to operationalize agile principles in such complex dynamic settings, we present a three step approach to navigate through the ‘What’, ‘Who’ and ‘How’ elements of complexity - What are the contextual complexities of the problem studied and what could be a desirable and feasible solution? Who are the relevant stakeholders? How do we navigate and mediate through heterogeneous systems and stakeholders? We propose a 5F framework - of ’factoring in’ perspectives of stakeholders, filtering and prioritizing their needs, facilitating adoption, feasibility check and follow-up to ensure effective usage and adoption. The paper adds to the accumulated knowledge on the role of institutional intermediaries in dealing with complex public health problems. We argue that the intermediary role and the process of intermediation depends on the type of stakeholders, functionality and the contextual requirements of the applications.