LaFond Anne K, Brown Lisanne, Macintyre Kate
John Snow International, Arlington, VA 22209, USA.
Int J Health Plann Manage. 2002 Jan-Mar;17(1):3-22. doi: 10.1002/hpm.649.
Capacity improvement has become central to strategies used to develop health systems in low-income countries. Experience suggests that achieving better health outcomes requires both increased investment (i.e. financial resources) and adequate local capacity to use resources effectively. International donors and non-governmental agencies, as well as ministries of health, are therefore increasingly relying on capacity building to enhance overall performance in the health sector. Despite the growing interest in capacity improvement, there has been little consensus among practitioners and academics on definitions of 'capacity building' and how to evaluate it. This paper aims to review current knowledge and experiences from ongoing efforts to monitor and evaluate capacity building interventions in the health sector in developing countries. It draws on a wide range of sources to develop (1) a definition of capacity building and (2) a conceptual framework for mapping capacity and measuring the effects of capacity building interventions. Mapping is the initial step in the design of capacity building interventions and provides a framework for monitoring and evaluating their effectiveness. Capacity mapping is useful to planners because it makes explicit the assumptions underlying the relationship between capacity and health system performance and provides a framework for testing those assumptions.
能力提升已成为低收入国家卫生系统发展战略的核心。经验表明，要取得更好的健康成果，既需要增加投资（即财政资源），也需要有足够的当地能力来有效利用资源。因此，国际捐助者、非政府机构以及各国卫生部越来越依赖能力建设来提高卫生部门的整体绩效。尽管人们对能力提升的兴趣日益浓厚，但从业者和学者对于“能力建设”的定义以及如何评估能力建设尚未达成共识。本文旨在回顾发展中国家卫生部门在监测和评估能力建设干预措施方面的现有知识和经验。它借鉴了广泛的资料来源，以制定（1）能力建设的定义，以及（2）一个用于描绘能力和衡量能力建设干预措施效果的概念框架。描绘是能力建设干预措施设计的第一步，并为监测和评估其有效性提供了一个框架。能力描绘对规划者很有用，因为它明确了能力与卫生系统绩效之间关系的潜在假设，并为检验这些假设提供了一个框架。
