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PUBH6003 Prevention and Management of Childhood Obesity in NZ Assessment 1 Answer

Subject Code and Title
PUBH6003: Health systems and Economics
Assessment 1: Report
Applying Systems Thinking in Public health

1,000 words (+/- 10%)
Learning Outcomes
This assessment addresses the following learning outcomes:
  • Apply systems thinking and an intersectoral approach to public health issues.
Total Marks
100 marks


Public health professionals must work across various sectors and with key stakeholders such as other professionals and community groups in order to improve health outcomes. Often, these stakeholders have competing interests and conflicting ideas about health, and about what would be the most effective ways to meet public health needs and outcomes.

Stakeholders may not even share the same values related to improving public health. In some cases, using a systems thinking or intersectoral approach may pose many challenges for implementation.


To prepare for this assessment, choose one public health issue (e.g. obesity, a chronic disease) in any country for which it is obvious that a systems thinking approach has not been, or is not being, applied. Then in approximately 1000 words (+/- 10%):

  • Describe the public health issue.
  • Explain the roles of stakeholders, both within the health system and in other sectors in addressing this issue.
  • Drawing on research evidence, explain the obstacles that are preventing the application of a systems thinking approach to this issue.
  • Based on the literature, offer suggestions (e.g. new governance arrangements) for how a systems thinking approach could be applied to this issue.

Report Structure

Your report should follow the following structure. The word count includes the introduction, body and conclusion

Executive Summary
  • Purpose of report
  • Summary of Conclusion
  • Summary of Recommendation
  • Acts as a window to your report
  • 10% of word count
  • Answers the question
  • May include sub- headings
  • Carries the most marks
  • Summary
  • 10% of word count
May be in bullet point or continuous writing
  • Recommended strategies
  • Justification
APA 6th Edition Style


Childhood Obesity in New Zealand

Executive Summary 

In modern world obesity is considered as common health problem. In NZ, the percentage of obesity in child is growing speedily. Obesity is not a disease but it can create various healthcare problems which can be life threatening. The mortality rate is high in obese people due to their co-morbidity. Therefore, the prevention of obesity is an important aspect in develop countries. The stakeholders of the policy and programs of the country play significant role in prevention and management of the obesity. Obesity is a system problem that could be tackled from a system thinking approach. It can be considered as collaboration, modification, and utilisation of existing and global approach. The system thinking approach needs collaboration and cooperation for better outcomes. In this report we will discuss about the above stated points and try to evaluate the importance of prevention and management of obesity in NZ. It is concluded that the NZ governments require to collaborating with their stakeholders in implementation of system thinking approach in prevention of obesity in the country and consider the importance of the issue and take proper action in control the situation. The recommendations are developed to support the country and its situation. It can be assumed that the implementation of excess tax on sugar beverages and fast foods can decrease the obsession about the unhealthy foods. Furthermore, availability of healthy foods and drinking facilities in school canteen can motivate the children to replace their unhealthy behaviour with healthy ones. In addition, mandatory of labelling can educate the people about the correct food choices and motivate their healthy habits.   


Obesity is described as excess body weight compared to height of the individuals. The World Health Organisation declared obesity as epidemic in the world. New Zealand has the highest children obesity rate in Organisation for Economic Co-operation and Development (OCED) countries and the rates are increasing in last few decades (Health Navigator NZ, 2018). At present, 1 in 10 children are suffering from obesity in NZ (Health Navigator NZ, 2018). In this assignment we will discuss about the obesity in NZ and identify the role of stakeholders in this issue. Furthermore, we will find out the barrier of system thinking approach and the application of the approach for better results. 

Obesity in NZ

Excess consumption of calories and less expenditure can cause obesity due to deposition of excess calories in the body. In NZ, obesity is an important public health issue. In 2018-19, the rate of obesity was 11.3% in children (Ministry of Health NZ, 2019).  The rate of obesity is higher among the ethnic children compared to European children in NZ. The child obesity statistics is also concerning factors for the country. The socioeconomically deprived children were 2.7 times vulnerable to develop obesity than others(Ministry of Health NZ, 2019). It has been isolated that approximately 28.4% pacific children were obese in 2018-19(Ministry of Health NZ, 2019). At the same time 8.2% European children were obese in the country (Ministry of Health NZ, 2019). In NZ, the child obesity rate was increasing since 2011-12(Ministry of Health NZ, 2019). It is a concerning situation for the country as obesity is elevating the risk of hypertension, diabetes, cardiac problem, and mortality in affected children in their adulthood. It is also considering the fifth leading cause of death in the World. In developed countries, more than 30% of the children are suffering from obesity compared to developing countries (Çakmur, 2017)

Role of stakeholder 

In NZ, public and primary care approaches are required to prevent the obesity and then reserve the overweight in the community. The main aim of the government should be concentrated on prevention of obesity and management of obese people in the nation.  In management of obesity, the main agenda is to continue the weight loss process of obese by offering proper guidance and support. Contrariwise, prevention of obesity aims to avoiding the weight gain by health promotion and campaigning. The collaboration between the ministry of health and public health units like District Health Boards (DHBs) can foster the co-operation between the public health and primary care services. In this respect, health and education sector can work together in obesity management and prevention program in national and local levels. DHBs can collaborate with food manufactures, and retailers to increase the promotion and production of low fat foods for the nation. In addition, they can support the community based intervention program to reduce the obesity(NEW ZEALAND HEALTH STRATEGY, 2001). The infrastructural development and increase capacity of public health nutrition program requires participation from public and private stakeholders in implementing practical strategies and reduce the obesity in the country. The marketing and advertising authority of food products should be more responsible in promotion of the fast foods. They should motivate the young children to develop healthy eating habits. Furthermore, the food processing companies should incorporate healthy ingredients in their food production process to reduce the rate of obesity in the nation. The school and community healthcare facilities should incorporate health promoting initiatives for young children.              

System thinking approach in obesity

Several studies revealed that system thinking approach can able to eliminate obesity in children by promoting healthy eating style. In obesity, advertisement plays an important role. The advertisement can influence the eating habits of the children in some extent (Gerritsen et al., 2019). Advertisement of unhealthy food can decline the healthy eating habits and poor health outcomes in NZ young generation. It can also increase the burden on healthcare system and can have negative impact of economy of NZ. 

The common barrier in systems thinking approach is structural inconvenience of the nation which includes socioeconomic imbalance, changing environment, lack of food literacy, and cost of the healthy foods. As per the opinion of Adams et al. (2016), the system requires co-ordination and collaboration between the private, public, and political organisations to overcome the structural barrier (Gerritsen et al., 2019. Several studies signified that nutritional education in school curriculum can increase the awareness about healthy food items(Gerritsen et al., 2019). However, in NZ, nutrition education programs operated in schools which are situated in deprived areas as a result the system thinking approach in obesity prevention has faced difficulties. A study conducted in Netherlands identified that early weaning practice can increase the healthy food habits in young children (Gerritsen et al., 2019). In NZ, the parents are unable to implement such practice at the early age of the children, therefore, the nutrition education program in school do not receive such outcomes.              Another barrier is high price of fruits and vegetables in the country. In 2017, the high prices of vegetables were decreasing the consumption rate(Gerritsen et al., 2019). The poor socioeconomic people were unable to purchase seasonal vegetables. However, the fruits rate was stable after 2015 and now the vegetable rate are also becoming usual.  Additionally, the high density of unhealthy food campaign in poor socio-economic areas are creating barrier in system thinking approach of obesity(Gerritsen et al., 2019). The poor children are attracting towards the unhealthy foods and develop obesity.  

Improve the system thinking approach

It can be assumed that utilisation of global approaches can improve the services. Obesity is an epidemic which requires acceptance, interconnectivity, and cooperation among the stakeholders from the difference countries. The prevention and management of obesity requires multidisciplinary team for eliminating the barriers in system thinking approach. An effective system thinking approach can consider the whole scenario and crate collaboration and partnership between the stakeholders (Lee et al., 2017). In addition, engagement among the stakeholders can help in understanding the problem and embracing the exact complexity of the situation. System mapping and system modelling is essential for reducing the barrier. System mapping helps to understand the interaction and compatibility of the system and system modelling helps to recognise the essential components of system which needs to incorporate for better results (Lee et al., 2017). The collaboration between the stakeholders and community is important for smooth continuation of system thinking approach. The educational development of the community is necessary to create awareness about the obesity which increase the acceptance of prevention programs.    


At last it can be concluded that obesity epidemic has constantly spread in worldwide. In NZ, the increasing incident of child obesity has threatening the nation by elevating the economic and healthcare burden of the country(Malakellis et al., 2017). Thus, it is important to implement proper policies and intervention in prevention of obesity. The government should collaborate with the public stakeholders in this process to obtain better outcomes. The implementation of community based prevention program can have positive impact on the society regarding obesity. In addition, application of system thinking approach in community intervention can increase the effectiveness and can fight against the national crisis of obesity in NZ. 


  • Recommendation 1: Implementation of excess tax on sugar sweetened beverages and fast food can reduce the consumption and the revenue generated from such food items can be utilised in healthcare development and improve the health equality. The excess tax can increase the prices of the product which can reduce the consumption and selling revenues can be utilised to reduce the financial burden of the country. 
  • Recommendation 2: Implement the healthy food and drinking facilities in the school canteen which motivate the young children to take healthy and nutritious food instead of fast food items. The intervention can change the faulty food habits of the young children and reduce the risk of obesity in future. 
  • Recommendation 3:  Labelling the food items should be mandatory for all food items. It can educate the people about the ingredients of the foods and promote the healthy eating options. It can create awareness among the buyers and the manufactures can find out the alternative formulation to make the food healthier and nutritious.           
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