What exactly is capacity development?
Capacity development as a field has changed quite a bit, especially in the past two decades. Even today, if you were to bring five experts together, they might each give you a different definition of what capacity development means for them. The things they would agree on, I think, are that the sector has refocused on local systems, local leadership, and local priorities. That capacity development is a process, rather than an event, and that capacities are developed through diverse approaches.
For Malaria Consortium, capacity development is a collaborative process that allows us to use different components of our organisational expertise to test and identify the effective ways of strengthening the ability of individuals, and organisations, to contribute to the improved performance of their health systems. We recognise the existence of local systems and their existing capacity. It is why we approach capacity development from the partnership perspective, working in close collaboration with governments, organisations and communities to jointly assess their capacity goals and needs, and to select locally relevant solutions. It is this strategy that I believe can best deliver sustainable results. At Malaria Consortium, we have an internal community of practice that brings together staff who are engaged in capacity development to facilitate sharing and learning so that we can do capacity development well.
Capacity development and universal health coverage
Universal health coverage (UHC) requires strong, well-performing health systems. Ensuring that primary healthcare services are available, affordable, accessible, and acceptable also calls for a strong, competent cadre of health workers capable of delivering quality health services to all who need them. The level of health worker performance corresponds to the quality of ongoing support they receive. This goes beyond training, and necessitates proper tools, supplies, supervision, and adequate remuneration. The capacity of health workforces to deliver quality services to all who need them, when they need them, thus depends not only on the skills of the individuals, but also on the performance of local systems, institutions, and on adequacy of national policies to safeguard inclusion and equity.
Innovations from the COVID-19 pandemic
A key component of capacity development involves partner engagement and building and cultivating relationships. This has been considerably more difficult because of COVID-19, especially as meetings became virtual, and unstable connections and varied level of skills in using videoconferencing technologies interfered with the quality of remote interactions. Working together and problem-solving virtually is not the same as doing it in person. This also applies to training.
Simultaneously, the pandemic has forced us to look at using the tools and technologies we have in different ways. We have been able to facilitate learning exchanges, collaborate, and even train others synchronously despite the challenges, and we keep expanding how we use mobile technology, for example to provide ongoing support to community health workers. In Mozambique, where we have previously co-developed a national mobile health platform (upSCALE) to strengthen community health systems and better support community health workers, we are now using the platform as a tool for supportive supervision, on-the-job training and we even piloted a COVID-19 learning module, to help navigate new challenges imposed by the pandemic.
Whilst many of us, myself included, are itching to return to in-person interaction, at least in some degree, we have come to appreciate that a lot of the remote work is probably here to stay. As we navigate the new realities, where relevant, we need to explore and use technology in new ways to also improve performance.
I imagine the challenge will be to find the right combination of in person and virtual support and collaboration, so that we do more and better, reach more people and provide tailored and effective performance improvement solutions (at possibly lower cost?). This again comes back to the need for systems thinking and local context responsiveness, so that we do not leave out those without current access to the technology.
What am I excited about in 2022?
I am intrigued by the localisation and local capacity development direction the sector, and many institutional donors, are making commitments to. It will be interesting to see how it will be implemented in the end. The USAID’s Local Capacity Development Policy draft was circulated for public input in January 2022, and is the final policy is expected to be issued later this year. Malaria Consortium, with its local staffing structures and global research and technical expertise, is already well positioned to contribute to making these ideas operational. That is an exciting potential.
Blanka Homolova is Malaria Consortium’s Capacity Development Specialist in London
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