A diagrammatic approach to understanding complex eco-social interactions in Kathmandu, Nepal

As part of developing an international network of community-based ecosystem approaches to health, a project was undertaken in a densely populated and socio-economically diverse area of Kathmandu, Nepal. Drawing on hundreds of pages of narrative reports based on surveys, interviews, secondary data, and focus groups by trained Nepalese facilitators, the authors created systemic depictions of relationships between multiple stakeholder groups, ecosystem health, and human health. These were then combined to examine interactions among stakeholders, activities, concerns, perceived needs, and resource states (ecosystem health indicators). These qualitative models have provided useful heuristics for both community members and research scholars to understand the eco-social systems in which they live; many of the strategies developed by the communities and researchers to improve health intuitively drew on this systemic understanding. The diagrams enabled researchers and community participants to explicitly examine relationships and conflicts related to health and environmental issues in their community.