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Capacity building

For many organisations across development programmes, ‘capacity building’ has mainly referred to training events. However, SuNMaP went far beyond that to look at increasing the knowledge, skills and practices of those individuals and organisations – public, private and commercial - working in many different ways to combat malaria.

SuNMaP’s capacity building activities across all of these areas has been crucial to its success, and has embedded malaria control programmes within health planning, budgeting and implementing processes at national, state and local levels. 

SuNMaP’s plan

Copyright Susan Schulman/Malaria Consortium

At the start of SuNMaP’s programme in 2008, a baseline survey was conducted to explore the existing capacity of the National Malaria Elimination Programme (NMEP) and State Malaria Elimination Programme (SMEP) staff and field workers to deliver malaria control. The results pointed to inconsistency in training materials and poor adherence to policy recommendations on malaria control. As a result, SuNMaP worked with a variety of stakeholders to develop an ambitious strategy for capacity building.

Working across the public and private sectors, SuNMaP set out to improve the capacity of:

  • Health workers in the field to deliver proper malaria control
  • Programme management staff to manage all elements of their programmes more effectively
  • Systems at federal, state and local levels to develop, implement and review plans for effective malaria control and elimination. Actors involved in these capacity building activities include public and private providers of care, donors, civil society organisations and the commercial sector

SuNMaP’s programme implementation is based on three basic principles:

  • Consistency with national policies and strategic plan for malaria control and elimination
  • Stakeholder engagement and participation. This is essential for sustainability and achieving the programme’s objectives
  • Harmonisation – all agencies, organisations, projects and programmes supporting malaria control working together

What we accomplished

Copyright Malaria ConsortiumThe initial phase of service delivery training targeted health workers in selected facilities, with more than 23,000 trained by the end of the programme. Training modules were designed to be participatory and adaptable to levels of health care, and aimed to help participants understand prevalent misconceptions and barriers, identify linkages between the malaria transmission cycle and key malaria control interventions, and facilitate the widespread adoption of best practice principles for the treatment of the disease.

The development of new programme management training modules commenced one year later, and were designed to have wider application across all areas of health care. Six modules were developed for state and local government area (LGA) managers, comprising financial management and procurement; supply management; programme planning and budgeting; general management; integrated supportive supervision; and monitoring and evaluation.

SuNMaP provides technical assistance to both the NMEP and SMEP to encourage them to acknowledge the importance of capacity building and incorporate it into their activities. By building the capacity of the national and state programmes, they will be better able to lead malaria control efforts. This work involves increasing coordination and planning within federal, state and local authorities to develop operational plans for effective malaria control programmes.

Lessons learnt

Several key lessons emerged as a result of our capacity building activities:

  1. Capacity building interventions are generally well received and accepted by participants. Feedback from trainees regarding the standard of materials developed through SuNMaP’s participative approach was overwhelmingly positive. The use of group work, discussion and ‘learning by doing’ principles was seen as a benefit to the training sessions, engendering a greater sense of ownership among participants.
  2. Capacity building interventions are good value for money. The approach of expanding and adapting existing materials (in the case of service delivery modules) proved to be cost-effective. By training trainers, who cascaded their learning to health workers, large numbers of people were reached at a low cost. The ‘cluster approach’, whereby training groups are organised by type or location, was found to save time and human resources.
  3. Partners using the same tools reduces costs. Using one tool and sharing between all partners means that they spend less on development costs and the time required for roll out. Training partners to roll out shared tools also allows for faster attainment of universal coverage.
  4. Capacity building in malaria prevention and treatment has beneficial consequences for other areas of healthcare. Capacity building activities not only led to increased prevention and treatment of malaria, but also saw a rise in antenatal attendance by women – leading to improved maternal and child health.  In addition, programme tools developed for malaria had wider application and could be adapted to other areas of healthcare.
  5. Practical barriers limiting capacity building interventions. A number of factors can delay or interfere with capacity building activities. Some authorities may not view capacity building as a priority and hence not allocate funds, especially at the local government area level. It was also a challenge to get a variety of stakeholders and partners – each with their own capacity building objectives – to agree on a common approach. Supply and resource infrastructures need to be properly functioning in order to realise the benefits of capacity building.

Watch our video on capacity building on Nigeria below:

Recommendations

SuNMaP interventions in capacity building have led to knowledge and practice gains in the health systems of its ten focal states and beyond, but a great deal remains to be done throughout the rest of Nigeria. The NMEP has taken on responsibility for leading this process and will lead states in introducing capacity building initiatives going forward. As new malaria prevention and treatment technologies arrive in Nigeria, such as the relatively recent introduction of rapid diagnostic testing kits and artemisinin combination therapy drugs, new training protocols will need to be developed and rolled out. Capacity building is therefore a fluid process, and will require constant attention and action by the NMEP and its state and local partners to keep pace with new developments for tackling malaria.

 

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