In recent years, concern about the sustainability of the local services and structures that are critical to health system performance has focused attention on strengthening internal capacity in developing country health systems. Despite increased attention to capacity building, there is little consensus on the best way to define various capacity-building approaches or measure their effectiveness. This paper presents the results of a USAID-sponsored activity to define appropriate methods and indicators for monitoring and evaluating capacity building in the health sector. Based on a review of published and unpublished literature and discussions with health professionals, the paper reports the “state of the art" in capacity measurement, proposes a conceptual framework for mapping and measuring capacity, and reviews indicators and tools for evaluating the effect of capacity building interventions. We propose a general and broad definition of capacity building that includes the following four principles. Capacity building in the health sector: is a multi-dimensional, dynamic process; leads to improvements in performance; contributes to the sustainability of health systems; and can be conducted and measured on four levels of society – health system, organization, health professional and client. The addition of "client" to this definition is new and reflects the importance of clients in shaping the nature of health services and sustaining demand for them. Existing tools for assessing capacity focus mostly on organizational and health professional capacities. Few of these tools are used, or have been validated for, monitoring and evaluation purposes. Draft guidelines for monitoring and evaluating capacity building are discussed.
Learning Objectives: At the end of the session, participants will be able to 1. Use a conceptual framework to map elements of health system capacity; 2. Discuss state-of-the-art approaches to measuring capacity building in the health sector; 3. List three tools used for evaluating capacity building efforts
Keywords: Evaluation, Developing Countries
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: This work was completed under the MEASURE Evaluation project by the JSI Research and Training Institute and Tulane subcontacts. Indicators and assessment tools discussed in the paper are those of USAID CAs, as submitted by them
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: JSI R & T is a subcontractor to the Carolina Population Center, UNC Chapel Hill in the MEASURE Evaluation Project funded by USAID under a Cooperative Agreement.