Liverpool School of Tropical Medicine, Liverpool, UK.
Health Res Policy Syst. 2011 Mar 28;9:14. doi: 10.1186/1478-4505-9-14.
Despite substantial investment in health capacity building in developing countries, evaluations of capacity building effectiveness are scarce. By analysing projects in Africa that had successfully built sustainable capacity, we aimed to identify evidence that could indicate that capacity building was likely to be sustainable.
Four projects were selected as case studies using pre-determined criteria, including the achievement of sustainable capacity. By mapping the capacity building activities in each case study onto a framework previously used for evaluating health research capacity in Ghana, we were able to identify activities that were common to all projects. We used these activities to derive indicators which could be used in other projects to monitor progress towards building sustainable research capacity.
Indicators of sustainable capacity building increased in complexity as projects matured and included- early engagement of stakeholders; explicit plans for scale up; strategies for influencing policies; quality assessments (awareness and experiential stages)- improved resources; institutionalisation of activities; innovation (expansion stage)- funding for core activities secured; management and decision-making led by southern partners (consolidation stage).Projects became sustainable after a median of 66 months. The main challenges to achieving sustainability were high turnover of staff and stakeholders, and difficulties in embedding new activities into existing systems, securing funding and influencing policy development.
Our indicators of sustainable capacity building need to be tested prospectively in a variety of projects to assess their usefulness. For each project the evidence required to show that indicators have been achieved should evolve with the project and they should be determined prospectively in collaboration with stakeholders.
尽管发展中国家在卫生能力建设方面投入了大量资金，但对能力建设效果的评估却很少。通过分析在非洲成功建立可持续能力的项目，我们旨在确定可能表明能力建设具有可持续性的证据。
使用预先确定的标准，包括实现可持续能力，选择了四个项目作为案例研究。通过将每个案例研究中的能力建设活动映射到以前用于评估加纳卫生研究能力的框架上，我们能够确定所有项目共有的活动。我们使用这些活动来得出可以在其他项目中用于监测建立可持续研究能力进展的指标。
可持续能力建设的指标随着项目的成熟而变得更加复杂，包括利益相关者的早期参与；明确的扩大计划；影响政策的策略；质量评估（意识和经验阶段）——资源得到改善；活动的制度化；创新（扩展阶段）——核心活动获得资金；由南方合作伙伴领导的管理和决策（巩固阶段）。项目在中位数为 66 个月后实现了可持续性。实现可持续性的主要挑战是员工和利益相关者的高周转率，以及将新活动融入现有系统、确保资金和影响政策制定的困难。
我们的可持续能力建设指标需要在各种项目中进行前瞻性测试，以评估其有用性。对于每个项目，需要展示已实现指标的证据应随着项目的发展而演变，并应与利益相关者合作前瞻性地确定。
