Intelligence Step 5 - Capacity Analysis Capacity Analysis Without capacity, the most innovative and brilliant interventions will not be implemented, wont be effective and commonly fail to achieve aims A failure to assess capacity increases the chances that existing resources, ideas, skills, commitment etc will not be identified nor utilised, compromising intervention effectiveness and public health nutrition (PHN) practice

Capacity Analysis

What is Capacity? Capacity is term of jargon commonly used in the health promotion literature. Put simply capacity is the ability to carry out stated objectives In PHN practice, capacity is the ability of individuals, groups, organisations, communities, workforce and systems to perform effective, efficient and sustainable action to achieve nutrition-related health outcomes

What is Capacity? Capacity building is the process by which individuals, groups, organisations and societies increase their ability to understand and solve problems in a sustainable manner Capacity building is an essential and central component of PHN practice There are several key attributes of capacity building in practice: a continuous process contributes to better performance and the achievement of objectives works towards the establishment of a sustainable local health system where the community are competent to address health problems operates at numerous levels (individual, organisational and systematic level Capacity Analysis

A Capacity Framework The domains of capacity building in PHN practice provide a focus for assessing, planning, implementing and evaluating capacity building strategies in practice These domains are presented in a tiered framework: Foundation: leadership, resourcing and intelligence Core strategic domains: partnerships, organisational development, project management quality, workforce development and community development Pinnacle: capacity and sustainable PHN outcomes Capacity Analysis

Leadership Intelligence Resourcing CAPACITY Sustainable Public Health outcomes Core strategic domains: - Partnerships - Organisational development - Project management quality - Workforce development - Community development Capacity building framework

Capacity Analysis Assessing Capacity for Capacity Building Effective capacity building links local community experts with practitioners with technical and capacity building expertise The exchange of identified and valued knowledge between groups aids the development of trust and enhanced community engagement. Capacity analysis can, in itself, lead to capacity building by engaging and empowering community stakeholders Capacity analysis enables capacity building strategies to be integrated into existing structures, positions and accountability processes that are more likely to be sustained

Capacity Analysis Challenges in Measuring Capacity The key issues and challenges in measuring capacity include: Multiple understandings of terms - shared terminology cannot be assumed when working at multiple levels or across sectors data collection and analysis issues Evolving understanding of capacity – the definition and nature of capacity is evolving measurement tools can be lengthy and complex Invisibility of capacity building - Community empowerment is explicit in health promotion creating a culture of invisibility around capacity building difficulty in recognising, describing and measuring capacity building Dynamic contexts - contextual aspects can influence the measurement of capacity: staff turnover, health system renewal, conflicting perspectives, conflicting personalities etc

Capacity Analysis Challenges in Measuring Capacity Time course for change – enhanced capacity is a long-term outcome Building and trust and dealing with sensitive issues - The relationships underlying these multiple connections depend on trust appropriate questions and sharing of sensitive information without breaching confidentiality or trust poses a measurement challenge Snap-shot measurements – quantitative measurements provide only single account in time Validity and reliability of quantitative measures – no gold standard to measure capacity – the external validity, generalizability of findings is difficult Attribution for change in capacity – difficulty identifying successful elements of the capacity building strategy independent of other intervention strategies

Capacity Analysis StrategyMeasurement issue addressed Utilise participatory processes as intervention Multiple understandings of terms Evolving understanding of capacity Building trust and dealing with sensitive issues Acknowledge the contextInvisibility of capacity building Dynamic context Incorporate mixed methods (qualitative and quantitative) Invisibility of capacity building Dynamic contexts Time course for change Building trust and dealing with sensitive issues Snap-shot measures Validity and reliability of quantitative methods Attribution for change in capacity Strategies to address key capacity measurement issues

Capacity Analysis Build on previous phases of community and stakeholder engagement Multiple understandings of terms Building trust and dealing with sensitive issues Establish validity of quantitative measures Validity and reliability of quantitative methods Establish trustworthiness of qualitative intelligence Multiple understanding of terms Evolving understanding of capacity Time course for change Building trust and dealing with sensitive issues Snap-shot measures Be flexible and adaptableDynamic contexts Multiple understanding of terms Building trust and dealing with sensitive issues Identify intervention contributions i.e. intervention specific evaluations Attribution for change in capacity Strategies to address key capacity measurement issues continued

Capacity Analysis Tools for Analysing Capacity Deciding the analysis approach and the tools to be applied requires an initial examination of the contextual factors that impact on tool selection Many of the tools used in capacity analysis can draw upon intelligence already collected from the previous steps in the intelligence stage of the public health nutrition intervention management bi-cycle Some useful capacity analysis strategies include: Document analysis Focus group discussion Force field analysis

Capacity Analysis Tools for Analysing Capacity There are a number of tools available to assess and discuss the capacity of an organisation including: Participatory, results-oriented self-evaluation (PROSE) - compares capacities across a set of peer organisations for benchmarking and networking among the organisations Organisational capacity assessment tool (OCAT) - identifies an organisations strengths and weaknesses creating a baseline for capacity strengthening interventions Scorecards - a list of characteristics or events against which a Yes/No score or a numerical score is assigned These tools are best completed by organisational members and an external assessment to balance subjective perceptions

Capacity Analysis Assessing Training Needs Up-skilling health and community-based professionals in nutrition (workforce development) is one of the most common capacity building strategies used in PHN Assessing training needs can identify gaps in competency amongst front-line health workers to focus the capacity building effects of continuing education Training needs can be examined by various techniques including knowledge surveys, interviews etc

Capacity Analysis Capacity building strategies are central and continuous to PHN practice, where many intervention strategies that can be used are capacity building strategies (such as workforce development, intelligence gathering etc). One of the most important initial and formative strategies (that has a critical role in capacity assessment and evaluation) is the Project Management Committee. Forming a Project Management Committee formally includes key stakeholders in assessment, decision making and accountability, and aids capacity assessment/building: Engages the stakeholders Helps identify and mobilise community resources Shares responsibility Increases access to intelligence Helps organise stakeholder so that they pull together rather than in different directions.