SEARCH · PubMed Health

Results for “Capacity Building”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

PubMed1996

Is public health ready for reform? The case for accrediting local health departments.

Reform of the governmental public health system in the United States has been stymied by changes in political, economic, and medical care landscapes since public health was called to action by the Institute of Medicine report in 1988. Despite a new national health objective calling for 90 percent of the population to be served by a local health department effectively addressing public health's three core functions by the year 2000, capacity building initiatives have not been deployed extensively, and there is little likelihood of reaching the year 2000 objective. A national program of accrediting local and state health departments could energize public health capacity building. Accreditation would build on recent initiatives in states like Washington and Illinois, promote wider use of the Assessment Protocol for Excellence in Public Health, and facilitate reform of the public health system around public health's core functions. Key questions addressing the why, how, and who of such an initiative set the stage for consideration of a national accreditation program.

Accreditation↗

PubMed2005

Toward a comprehensive strategy for effective practitioner-scientist partnerships and larger-scale community health and well-being.

This article articulates joint priorities for the fields of prevention science and community psychology. These priorities are intended to address issues raised by the frequent observation of natural tensions between community practitioners and scientists. The first priority is to expand the knowledge base on practitioner-scientist partnerships, particularly on factors associated with positive outcomes within communities. To further articulate this priority, the paper first discusses the rapid growth in community-based partnerships and the emergent research on them. Next described is an illustrative research project on a partnership model that links state university extension and public school delivery systems. The article then turns to the second, related priority of future capacity-building for diffusion of effective partnership-based interventions to achieve larger-scale health and well-being across communities. It outlines two salient tasks: clarification of a conceptual framework and the formulation of a comprehensive capacity-building strategy for diffusion. The comprehensive strategy would require careful attention to the expansion of networks of effective partnerships, partnership-based research agendas, and requisite policy-making.

Community Mental Health Services↗

PubMed2002

Closing the gap: building the capacity of non-government organizations as advocates for health equity.

Seeking achievement of health equity has underpinned national government and global health policies for decades. However, major difficulties and challenges faced in the practice of achieving 'Health for All' has led to a recognition of the need to broaden the focus of efforts to improve health equity. Civil society groups have been identified as key stakeholders in attempts to achieve health equity, and the importance of strengthening their capacity to influence relevant government policy and practice has been highlighted. This paper presents the results of a qualitative study which examined the role of organizations outside government in advocating for health equity, and the capacities and conditions that were related to their success. In-depth, unstructured interviews were conducted with 26 non-government organizations (NGOs) who were active in three important health policy debates in Australia. The grounded theory method was used to direct data collection and analysis, and member checking was employed to ensure soundness and build ownership of the findings. Effective advocacy was found to be a dynamic process characterized by flexibility and opportunism within a framework of longer term goals. Two key ways of working were identified--in partnership and in conflict with government, with shifts in emphasis in response to organizational strengths and a changing environment. A number of domains of capacity, which together are termed 'capacity for advocacy', were also identified. It is clear that NGOs can learn a great deal from each other, but there needs to be investment by governments, international agencies and NGOs themselves if advocacy for health equity is to be strengthened.

Australia↗

PubMed2000

Evolution of a comprehensive tobacco control programme: building system capacity and strategic partnerships--lessons from Massachusetts.

BACKGROUND: Since the passage of a voter approved state referendum in 1992 to establish a 25 cent increase on the excise tax on cigarettes and smokeless tobacco, Massachusetts has received an average of $40 million annually for its tobacco control programme. This funding allowed Massachusetts to expand and develop its tobacco control programme to become one of the most comprehensive in the world. OBJECTIVES: The development of the Massachusetts Tobacco Control Program is outlined, focusing on three stages of development: formation, strategic partnership building, and shared leadership. METHODS: The development of management structures, programmatic infrastructure, communication and partnership networks, and advisory structures are tracked throughout the three phases. RESULTS: The use of pre-existing public health resources, implementation of a strong training component, a geographical management structure, the creation of public and private partnerships, and the development of a shared leadership model contributed to building consensus and provided the foundation for coordinated approaches to tobacco control. CONCLUSION: Other states and countries can use lessons learned from Massachusetts about the organisational development of a comprehensive tobacco control programme as they embark upon similar efforts.

Humans↗

PubMed2005

Social science research in malaria prevention, management and control in the last two decades: an overview.

In the recent past, considerable progress has been made in understanding how human behavior and social organization, macro- and micro-level economic processes, and health and political systems affect responses to malaria at global, national, community, household, and individual levels. Advances in malaria-related social, behavioral, economic, evaluation, health systems, and policy (social science) research have resulted in improvements in the design and implementation of malaria prevention, management and control (PMC) strategies. Indeed, the past two decades chronicle dramatic advances in the implementation of evidence-based interventions, drawn not only from biomedical but also from social science research. Malaria awareness-raising, advocacy, case management, and prevention efforts have reaped the benefits of social science research and as a result, many programs are implemented and evaluated in a more effective manner than in the past. However, the pace at which findings from social science research are integrated into program and policy implementation is unsatisfactory. Additionally, examples remain of programs that fail to utilize findings from social science research and as a result, achieve minimal results. Furthermore, there is a sizeable body of knowledge that is underutilized and which, if assimilated into programs and policies, could accelerate progress in malaria PMC. Examples include information on meaningful community participation, gender, socio-economic status, and health systems. Regrettably, although social science input is necessary for almost all interventions for malaria management and control, the numbers of scientists working in this area are dismal in most of the key disciplines-medical anthropology; demography; geography and sociology; health economics and health policy; social psychology; social epidemiology; and behavior-change communication. Further, skills of program workers charged with implementation of interventions and strategies at country level are most often inadequate. The Special Program for Research and training in tropical diseases (TDR) and the multi-lateral initiative on malaria (MIM) have remained in the forefront of capacity building for this area of research, but additional efforts are needed to bring more applied social scientists into the fold. Their skills are necessary to ensure that social science findings get to program planners and implementers in a useful form that allows for more rapid and appropriate integration of the results into malaria PMC programs and policies. A re-thinking of the current focus within capacity building efforts is proposed.

Communication↗

PubMed2001

Informing river management policies and programs with science.

Conventional wisdom has it that we already have enough science to address the problems causing degradation of our environment, including rivers. This is not true. However it is the case that we could be using existing knowledge better, and that we could be doing more to learn the lessons from the huge sums being spent on river restoration and management. Informing good policy and practical on-ground management with R&D outputs has proven to be is difficult, but essential. This paper reviews some of the history of water and river management in Australia and how perceptions of rivers have evolved. It discusses the challenge of enhancing the linkages between science, policy and practice in river management. It outlines the knowledge exchange, R&D and capacity building strategies of the National Rivers Consortium--a new initiative whose founding partners are LWRRDC, the MDBC, CSIRO Land and Water and the Western Australian Waters and Rivers Commission. This strategic collaboration between policy makers, river managers and scientists brings together organisations with responsibility and expertise to improve the health and management of Australian rivers. The National Rivers Consortium is making a major investment in knowledge exchange and capacity building, based on direct personal contact and learning by doing. The Consortium is establishing a program of training activities targeting river managers and policy makers, based on the best available science and high quality information products. It will support river managers as they plan and implement river restoration and protection projects. The paper concludes with a discussion of the key knowledge gaps that remain impediments to the better management of Australia's unique and diverse river landscapes.

Australia↗

PubMedDate not supplied

Implementing and assessing organizational practices in local health departments.

One of the most difficult forms of public health practice to characterize involves governmental public health agencies, especially at the local level. A lack of consensus within the public health community as to the purpose and content of organizational public health practice inhibits efforts to increase the capability of public health to address effectively its core functions of assessment, policy development, and assurance. Meaningful capacity building efforts must establish both benchmarks and expectations for the organizational practice of public health. Those markers must be established so that the impact of practice on outcomes and health status can be examined. A model identifying 10 organizational practices was established through the work of the Centers for Disease Control and Prevention (CDC) in collaboration with national practice organizations. Early applications of the model to public health capacity building activities have been effective. Among the applications have been approaches to surveillance of health department practice, certification of local health departments using practice guidelines, and development of leadership within the public health enterprise. Although results are promising, use of the model requires additional external examination and validation, as well as acceptance and consensus within the public health community. The development of organizational practice guidelines for public health agencies may be useful in further efforts to characterize and measure public health practice and its impact on the public's health.

Government Agencies↗

PubMed2006

Developing capacity to protect human research subjects in a post-conflict, resource-constrained setting: procedures and prospects.

The capacity-building strategy used by a US-based research organisation, the Pacific Institute for Research and Evaluation (PIRE), to strengthen the system for the protection of human research subjects and the infrastructure of its international collaborating partner, the University of Liberia, are discussed. To conduct the much-needed biomedical and social science-based research-related activities in the future, this partnership is expected by PIRE to gradually evolve over time to strengthen the capacity of the local investigators and administrators of the University of Liberia. Accordingly, a unique opportunity to share technology and resources with a post-conflict, resource-constrained country is created by this partnership. This capacity-building model to strengthen the protection of human subjects in research can also be replicated in similar resource-constrained international settings and, accordingly, our experiences and limitations are shared in this paper.

Culture↗

PubMedDate not supplied

A regional integrated information system to assure maternal-child health services: a progress report.

Priorities for improving the health of our nation include rebuilding the public health infrastructure through increasing assessment, policy development, and assurance capacities in our communities. Capacity building necessitates formalizing and strengthening public health practice linkages to achieve Year 2000 objectives. Determining progress in achieving objectives requires development of public health infrastructure surveillance and data system capabilities. The Tracking Center of Tracking and Outreach Program for St. Louis (TOPS), through unique collaboration among academic and practice partners, laid the foundation for a Regional Integrated Information System (RIIS) by developing a centralized maternal-child health data base for prenatal and pediatric care providers. The RIIS model provides an example of a capacity building system designed to provide public health surveillance, assessment, planning, and evaluation capabilities. Medical Subject Headings (MeSH): health information systems, prenatal care, immunization, maternal-child health care, public health surveillance.

Child↗

PubMedDate not supplied

Developing cancer control capacity in state and local public health agencies.

In 1986, the National Cancer Institute began a major grant program to enhance the technical capabilities of public health departments in cancer prevention and control. This effort, commonly referred to as "capacity building" for cancer control, provided funding to support eight State and one local health department. The program focused on developing the knowledge and skills of health department personnel to implement intervention programs in such areas as smoking cessation, diet modification, and breast and cervical cancer screening. The grants ranged from 2 to 5 years in length, with funding of $125,000 to $1.6 million per grant. The total for the program was $7.4 million. While the priorities set for these grants were nominally similar, their capacity building activities in cancer prevention and control evolved into unique interventions reflecting the individual needs and priorities of each State or locality. Their experiences illustrate that technical development for planning, implementing, and evaluating cancer prevention and control programs is a complex process that must occur at multiple levels, regardless of overall approach. Factors found to contribute to successful implementation of technical development programs include* commitment of the organization's leadership to provide adequate support for staff and activities and to keep cancer prevention and control on the organizational agenda,* the existence of appropriate data to monitor and evaluate programs,* appropriately trained staff,* building linkages with State and community agencies and coalitions to guide community action,* an established plan or process for achieving cancer control objectives,* access to the advice of and participation of individual cancer and health experts,* an informed State legislature,* diffusion of cancer prevention and control efforts,and* the ability to obtain funds needed for future activities.

Community Participation↗

PubMed2006

Community, social capital and Indigenous health in the Northern Territory.

OBJECTIVE: The objective of this paper is to explore the discourse of 'community' and its offshoots, 'social capital' and 'community capacity building', in the contexts of health service delivery to, and the health status of, Indigenous people in the Northern Territory of Australia, and to link this discourse to the wider context of social control and the management of diversity in a multicultural society. DESIGN: The discourse is subjected to critical theoretical and historical analysis and comparisons are drawn between this and similar discourses in the immigration and settlement area. RESULTS/CONCLUSIONS: The constitution of Indigenous society as a series of 'communities' and the orientation of primary health care policy towards 'capacity building' has the effect, if not the intention, of depoliticising Indigenous health, whilst reproducing, legitimising and mystifying relations of white dominance and permitting the maintenance of a health service delivery system for Indigenous people which, in relation to need, is grotesquely underfunded and incapable of making serious inroads into the appalling health problems of the Indigenous population.

Delivery of Health Care↗

PubMedDate not supplied

The CEFP. Building evaluation capacity.

The infusion of evaluation activity brought about by the American Cancer Society Collaborative Evaluation Fellows Project (CEFP) is a remarkable contribution to cancer prevention and control. Many lessons learned from the CEFP process are potentially beneficial not only to the American Cancer Society, but also to other organizations that seek to draw upon the success this project. One lesson for organizations that care about effectiveness and accountability is that, when outcomes matter, investments in evaluation become essential. By viewing evaluation in its larger context within the American Cancer Society, the CEFP delivers more value than the sum of findings from its individual studies. Especially pronounced are the contributions of the CEFP toward promoting organizational learning, generating useful products, and forming collaborative partnership--all of which are requirements for building an effective and sustainable evaluation system.

Cooperative Behavior↗

PubMed1999

Using practical quality improvement approaches and tools in reproductive health services in east Africa.

BACKGROUND: A nonprofit, nongovernment organization, AVSC International provides technical assistance worldwide, including a range of reproductive health services and quality improvement (QI) approaches and tools. Current activities in East Africa involve several hundred sites, including referral hospitals, district-level hospitals, and individual family planning clinics. THE QI PACKAGE: AVSC and its local partners developed Client-Oriented, Provider-Efficient Services (COPE), a problem-solving process and set of tools to involve all levels of site staff members in assessing and improving the services. The COPE tools--self-assessment guides, client interview guides, client flow analyses, and action plans--promote involvement, ownership, and commitment to the QI process. Facilitative supervision and whole-site training complemented AVSC's traditional approaches of medical monitoring and informed choice. Facilitative supervision encourages supervisors and managers to consider staff members as internal customers, whose needs they must meet for staff to be able to meet the needs of external customers (clients). Whole-site training was developed to meet the needs of staff members and providers, who needed to function as a team responsible for providing high-quality services. CASE STUDY: A government hospital that has adopted the entire package of QI approaches, has used the Quality Improvement Quotient self-assessment surveys to track its progress in several elements of high-quality care, including management and supervision, safety, and information and client--provider interactions. For example, maternity ward staff learned how to pass on to their clients information about clients' rights and family planning methods through posters, pamphlets, sample contraceptives, and health talks. LESSONS LEARNED: AVSC's work with local organizations suggests a number of lessons learned, including the following: easy-to-use tools that promote staff involvement and ownership are essential in the QI process, QI requires considerable staff development and capacity building at all levels, and although the QI approaches were initially introduced for a relatively narrow field of services, they are applicable to and have increasingly been used in other departments and wards. (It is difficult, may be impossible, and certainly undesirable, to limit QI activities to one ward or service.) CONCLUSION: Activities in East Africa have shown that QI is possible even in very resource-poor settings. The same principles have guided the process in all the different programs, with some adaptation of the tools used. AVSC program activities are to continue to disseminate the experiences of sites implementing the package of tools and approaches, to advocate for investment in supervision and management capacity building as a means to support continuous quality improvement, and to further study the impact of the QI approaches on service quality.

Adult↗

PubMed2004

Promoting sexual and reproductive health and rights in Nigeria through change in medical school curriculum.

Significant developments have occurred in the field of sexual and reproductive health and rights (SRHR) globally in the last decade. However, this is yet to translate into improved status of SRHR in developing countries. One of the strategies recognised worldwide for addressing the poor status of SRHR is human capacity building at all levels. A pilot work conducted in two federal university medical schools identified a major gap in knowledge among medical students on issues related to SRHR. This called for a review of the curriculum to enable the incorporation of relevant and topical issues. This article describes the processes leading to the adoption of the Nigerian medical schools' sexual and reproductive health and rights curriculum. The exercise culminated in the identification of internal and external stakeholders and needs of the Nigerian medical schools in teaching reproductive health. The participation of lecturers (bottom-up approach) brought about a sense of ownership of the document and promoted the broad consultation and participation of all participants. It also identified capacity building and the need for evaluation as a basis for further review.

Adolescent↗

PubMed2002

Expectations of stakeholders regarding home care provision in rural Namibia.

As in many countries, the disease pattern in Namibia has changed, health problems are increasing and outweigh the capacity of the existing health resources. Government health facilities in Namibia have limited capacity to accommodate all sick people, especially those who are chronically and terminally ill. Many hospitals in rural Namibia are overcrowded, patients sleep on the floors and, in some cases, children share beds. Morbidities relating particularly to AIDS, chronic conditions and other physical and emotional disabilities are likely to require long-term home care. In most instances, the health system is also not prepared to provide home care, nor provide the support that is required by the caregivers of disabled, chronically sick people. To ease the burden of care felt by the state at health facilities, the Ministry of Health and Social Services in Namibia has, on several occasions, called upon the community and other stakeholders in health care to assist in caring for their loved ones at home (NBC, 1996; MOHSS, 1996). The purpose of the study was to develop and describe a model for capacity building for quality home care in rural Namibia. This article focuses on the first phase of the bigger study, namely the expectations of stakeholders regarding home care provision in rural Namibia. A qualitative, exploratory and descriptive case study design was used. Five cases were purposively selected and thirty stakeholders were interviewed. Data were analysed using a combination of the approaches of Tesch and Morse and Field. To ensure trustworthiness, triangulation and other measures of Lincoln and Guba were used. The expectations were categorised into structures, process and outcome-related expectations. Stakeholders in rural Namibia appear to have dependency tendencies and still expect all resources and services to be provided by someone else, be it the government, the church, the headman and/or any other non-governmental agencies. There is a need empowerment and capacity building in the community and awareness must be created of the responsibility of the community in dealing with home care provision.

Attitude to Health↗

PubMed2006

Achieving sustainability of community-based dengue control in Santiago de Cuba.

Achieving sustainability is one of the major current challenges in disease control programmes. In 2001-2002, a community-based dengue control intervention was developed in three health zones of Santiago de Cuba. New structures (heterogeneous community working groups and provincial/municipal coordination groups inserted in the vertical programme) were formed and constituted a key element to achieve social mobilization. In three control zones, routine programme activities were intensified. We evaluated the sustainability of the intervention strategy over a period of 2 years after the withdrawal of external support. Data on maintenance of effects, level of institutionalization and continuity of activities through capacity building were collected via documental review, direct observation, questionnaires, key informant and group interviews and routine entomological surveys. The intervention effects, evaluated through larval indices and behavioural change indicators, were maintained during the 2 years of follow-up. In the intervention area, 87.5% of the water storage containers remained well covered in 2004 and 90.5% of the families continued to correctly use a larvicide, against 21.5% and 63.5%, respectively in the control area. The house indices further declined from 0.35% in 2002 to 0.17% in 2004 in the intervention area, while in the control area they increased from 0.52% to 2.25%. Institutionalization of the intervention, assessed in terms of degrees of intensiveness (passage, routine, niche saturation), was reaching saturation by the end of the study. Key elements of the intervention had lost their separate identity and became part of the control programme's regular activities. The host organization adapted its structures and procedures accordingly. Continuous capacity building in the community led to participatory planning, implementation and evaluation of the Aedes control activities. It is concluded that, in contrast to intensified routine control activities, a community-based intervention approach promises to be sustainable.

Animals↗

PubMed2002

Malaria control reinvented: health sector reform and strategy development in Colombia.

The consequences of health sector reforms on control of malaria were analysed using Colombia as an example. One of the most complex health sector reform programmes in Latin America took place in the 1990s; it included transferring the vertical vector-borne disease control (VBDC) programme into health systems at state and district levels. A series of studies was undertaken in 1998-2000 at the national level (Ministry of Health Study), at the state level (Departamento Study) and at the health district level (District Study) using formal and informal interviews among control staff and document analysis as data collection tools. A government-financed national training programme for VBDC staff - which included direct observation of control operations - was also used to analyse health workers' performance in the postreform period (longitudinal study). The results showed that some shortcomings of the old vertical system, such as the negative aspects of trade union activity, have not been overcome while some positive aspects of the old system, such as capacity building, operational planning and supervision have been lost. This has contributed to a decrease in control activity which, in turn, has been associated with more malaria cases. Malaria control had to be reinvented at a much larger scale than anticipated by the reformers caused by a whole series of problems: complex financing of public health interventions in the new system, massive staff reductions, the difficulty of gaining access to district and state budgets, redefining entire organizations and - in addition to the reforms - introducing alternative strategies based on insecticide-treated materials and the growth of areas of general insecurity in many parts of Colombia itself. However, positive signs in the transformed system include: the strengthening of central control staff (albeit insufficient in numbers) when transferred from the Ministry of Health to the National Institute of Health, the opportunities offered by the Basic Health Plan (PAB) for new planning initiatives and intersectoral co-operation and the integration of malaria diagnosis and treatment into the general health services (associated with a decrease of malaria mortality). The potentials of the new system have not yet been fully exploited: capacity building, communication and management skills need to be improved and it require guidance from the national level.

Colombia↗

PubMed2001

[Basic assessment of needs for training in evidence-based medicine in Slovakia].

BACKGROUND: The health care reform in Slovakia produces a desire for greater responsibility for and control of strategic decisions and to be better able to evaluate international knowledge and experience in the specific national social and professional contexts. Evidence based medicine (EBM) provides an increasingly organised and accessible database of international knowledge in health and health care, capable of informing decisions at the macro and micro levels. AIM: The aim of this pilot study was to assess education, training and other capacity building needs in EBM and evidence based health care. METHODS: This study was primarily qualitative and based on a triangular approach, which included: (1) The analysis of the situation in pre- and postgraduate education in Slovakia aiming to the estimation of needs in EBM and critical appraisal skills training; (2) The analysis of questionnaires distributed in a sample of 50 medical doctors and university educated public health workers undergoing a postgraduate training; (3) The discussion in focused groups. RESULTS: The findings and analysis uncovered a gap in knowledge and experience of EBM approaches, particularly of searching for evidence, utilising information technology, of undertaking critical appraisals of the validity and quality of external evidence and of knowledge of English. On the other hand the findings revealed a high access to information including the Internet access at the workplace, an increasing awareness of the need for up-date information, a demand for training and potential opportunities for action. CONCLUSIONS AND RECOMMENDATIONS: The effective implementation introduction of EBM approach would require changes in broader political, cultural and behavioural contexts, including changes in pre- and postgraduate systems of professional and managerial education, changes in professional and managerial attitudes and changes in emphasis in skills and capacity building and improvements in knowledge management systems at the national level.

Education, Medical↗