Public Health Capacity Building
by
Maria Isabel Loureiro
  • LAST REVIEWED: 25 May 2011
  • LAST MODIFIED: 25 May 2011
  • DOI: 10.1093/obo/9780199756797-0051

Introduction

Capacity building contains the concept of enabling—individuals, organizations, systems—for positive changes, strengthening their capacities to perform effectively in solving problems. The concept of enabling adopted as part of the definition of health promotion in the Ottawa Charter, integrates values associated with participation, knowledge exchange, ownership, equity, and sustainability. It goes from individual to organizational, community, national, and international levels. It is understood by different approaches, mainly concerning the interventions that can be invested in providing material aid or training skills. The main debates center on whether some of the interventions in health promotion are caring about strengthening the system or whether they are more systemic and sustainable dealing with building local and national infra-structures. Capacity building rests on the notion that change is the norm, because capacity depends on the ability to adapt to change.

Definition

Most authors agree that capacity building goes beyond simply training or providing technical assistance. It is considered a foundational strategy outlined in the Ottawa Charter for Health Promotion. The United Nations Development Programme and WHO Commission on Social Determinants of Health 2008 present the concept as the ability to face new challenges. Hawe, et al. 1999 refers to the sustainability of the background resources for health gains; Labonte and Laverack 2001 focuses capacity building on increasing abilities to address health issues. Germann and Wilson 2004 tries to apply the concept to health organization to develop an empowering and democratic partnership with the community. Gibbon, et al. 2002 question its meaning as being mainly a process or just addressed to achieve goals. Goodman, et al. 1998 brings the concept of capacity building close to public policy and civic participation. Blackwell and Colmenar 2000 understands capacity building as being very close to social capital.

  • Blackwell, A. G., and R. A. Colmenar. 2000. Community building: From local wisdom to public policy. Public Health Reports 115:161–166.

    DOI: 10.1093/phr/115.2.161

    Community building is a process in which people in a community engage themselves to focus on reinvesting in the community, building and sustaining social capital, promoting community participation, and strengthening families and neighborhoods.

  • Germann, K., and D. Wilson. 2004. Organizational capacity for community development in regional health authorities: A conceptual model. Health Promotion International 19.3: 289–298.

    DOI: 10.1093/heapro/dah303

    Organizational capacity for community development (OC-CD) is defined as “the potential ability of a health organization to develop an empowering and democratic partnership with a community, through which the community’s capacity to identify and address its priority health concerns is enhanced (p. 290).

  • Gibbon, M., R. Labonte, and G. Laverack. 2002. Evaluating community capacity. Health and Social Care in the Community 10.6: 485–491.

    DOI: 10.1046/j.1365-2524.2002.00388.x

    The authors ask the following questions: Is community (development, empowerment, and capacity building) a means to achieving a program end (often defined by the funding agency or practitioner)? Or is community (development, empowerment, and capacity building) an end in itself?

  • Goodman, R. M., M. A. Speers, K. McLeroy, S. Fawcett, M. Kegler, and E. Parker. 1998. Identifying and defining the dimensions of community capacity to provide a basis for measurement. Health Education & Behavior 25.3: 258–278.

    DOI: 10.1177/109019819802500303

    The authors define community capacity as “the cultivation and use of transferable knowledge, skills, systems and resources that affect community- and individual-level changes consistent with public health-related goals and objectives” and as the “characteristics of communities that affect their ability to identify, mobilize and address social and public health problems.”

  • Hawe, P., L. King, M. Noort, C. Jordens, and B. Lloyd. 1999. Indicators to help with capacity building in health promotion. Sydney: New South Wales Health Department.

    Defines capacity building as an approach to the development of sustainable skills, organizational structures, resources and commitment to health improvement in health and other sectors, to prolong and multiply health gains many times over.

  • Labonte, R., and G. Laverack. 2001. Capacity building in health promotion, part 1: For whom? And for what purpose? Critical Public Health 11.2: 111–127.

    DOI: 10.1080/09581590110039838

    Defines capacity building as the increase in community groups’ abilities to define, assess, analyze, and act on health (or any other) concerns of importance to their members.

  • United Nations Development Programme (UNDP). Capacity Building for Development Programme.

    The UNDP defines “capacity building” as an approach to development that gives people and organizations a greater ability to address new challenges.

  • WHO Commission on Social Determinants of Health. 2008. Closing the gap in a generation: Health equity through action on the social determinants of health. Geneva, Switzerland: World Health Organization.

    Identifies six priority areas of capacity building: policy development, organizational development, develop the information and evidence base, awareness raising, advocacy actions, partnership development, and leadership skills development.

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