Creating capacity building interventions that work
19 Nov 2018
Many of us are involved in building the capacity of the clients we serve within a variety of function or topic areas, be it infection control, health promotion or health equity. We regularly offer webinars, onsite consultations, workshops and other supports with the intent and assumption that we were building the capacity of our clients. But how do we know if our capacity building efforts are having the desired or intended impact? What if they’re not? And what is the appropriate level of impact to expect? Should we be planning our programs differently?
Intrigued by these questions, Public Health Ontario conducted two systematic reviews to determine the effectiveness of capacity building interventions relevant to health promotion and public health. These reviews were recently published in BMC Public Health.
What is capacity building?
The World Health Organization (WHO) defines capacity building as the development of knowledge, skills, commitment, structures, systems, and leadership to enable effective health promotion. To do this effectively, we need to work at three levels: individual, organizational and community. Typically, capacity building services include the provision of scientific and technical assistance, webinars, training workshops, and knowledge products–services offered by Public Health Ontario.
Theories, models and frameworks used in capacity building interventions relevant to public health: a systematic review
This article focuses on the theories, models and frameworks that underpin capacity building initiatives. A good theory provides a clear explanation of how and why specific relationships lead to specific events and how individuals, groups and organizations behave and change. Using theories, models or frameworks as a foundation for developing capacity building interventions can provide a road map for studying programs, developing appropriate interventions, and evaluating their effectiveness. The systematic review identified twenty-eight theories, models and frameworks and of this number, five were most frequently cited. The article concludes that there is a need for the use of theories, models and frameworks to be intentionally used and explicitly referenced to develop capacity building interventions.
Effectiveness of capacity building interventions relevant to public health practice: a systematic review
This article reviews the effectiveness of six types of capacity building interventions using eight outcome measures. The literature found improvements for each intervention type in one or more capacity building outcome, though mainly in terms of individual-level outcomes. Recommendations in the article include considering which outcomes are of highest priority when designing capacity building interventions.
Implications for Practice
Overall, the two systematic reviews support the effectiveness of capacity building interventions to increase knowledge, skills, self-efficacy, changes in practice/policy, application and perceptions of system-level capacity. However this evidence exists mainly at the individual level. It is important to note that the available literature was moderate in quality and showed a range of methodological issues. This points to a need to strengthen evaluation of capacity-building interventions, not only to ensure greater consistency with evaluations but also higher-quality evaluations. For example, future evaluations should assess outcomes at organizational and systems levels, include objective measures of effect, assess baseline conditions, and evaluate the feature that are most critical to the success of interventions, particularly for multi-strategy interventions.