A System Analysis Approach to Strengthen Cardiovascular Disease Prevention Policy for Women in the Netherlands
An application and critical reflection of a multi-actor system diagram on a complex multi-actor health prevention problem
R. Huizer (TU Delft - Technology, Policy and Management)
S. Hinrichs-Krapels – Mentor (TU Delft - Technology, Policy and Management)
H.G. van der Voort – Graduation committee member (TU Delft - Technology, Policy and Management)
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Abstract
This thesis examines how a multi-actor system diagram can contribute to strengthening cardiovascular disease (CVD) prevention for women in the Netherlands. The analysis shows that sex-specific risk factors are insufficiently addressed and that responsibility for prevention is fragmented across multiple actors.
Four promising interventions are identified: sex-specific GP training, targeted smoking-cessation outreach, broader eligibility for the Combined Lifestyle Intervention (GLI), and safer physical-activity infrastructure. The system diagrams also reveal feedback loops, coordination failures, and gaps between policy intentions and practical outcomes.
The thesis proposes five recommendations to strengthen accountability for women-specific CVD prevention within existing responsibilities. Overall, the multi-actor system diagram is valuable for identifying systemic problems and leverage points, although it remains a simplified representation of a complex prevention system.