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Roles for state-level local health liaison officials in local public health surveillance and capacity building.

In 27 state health agencies, local health liaison units or officials (LHLOs) are formally assigned responsibility for fostering a close working relationship between the state health agency and local health departments (LHDs). Yet in most other states, other agency staff carry out these responsibilities informally. Even where formal LHLOs exist, the assigned functions and specific activities vary, with little consistency across states other than serving as a potential or, in most cases, a real and vital linkage between LHDs and the state agency. This linkage places the LHLO in a unique position to have extensive knowledge, data, and information on LHD activities and to play an important role in assessing and improving local public health practice. This report examines aspects of the LHLO-LHD relationship in terms of potential LHLO roles in LHD practice surveillance and capacity building. Surveys of LHLOs and LHDs indicate that both support the development of surveillance tools to measure LHD effectiveness as a means to enhance capacity building efforts. Although LHLOs may not know or have the specific information immediately available to assess local public health practice for LHDs in their state, they report being able to obtain the information if necessary and with sufficient time. Further, LHDs are willing to share information concerning local public health practice with their state health department, particularly with their state LHLO. These findings suggest that LHLOs could be extensively involved in surveillance strategies beyond merely collecting and aggregating information provided by LHDs.

Administrative Personnel↗

Strategies for community-based organization capacity building: planning on a shoestring budget.

Community-based organizations often capacity build to successfully enable themselves to be adaptable and responsive to constantly changing environments. However, community-based organizations are stretched for time, staffing, and funding, and the added obligation of regularly performing management planning tools, such as strategic planning, needs assessments, program evaluations, or market demand forecasting, strain limited resources. Through case studies, this article illustrates how collaborations between universities and community-based organizations can result in the development of successful management planning tools through the use of geographic information systems and secondary resources. Such collaborations produced maximization of production and effectiveness in an environment characterized by limited resources.

Community Health Services↗

Capacity building for health promotion and chronic disease prevention--Nova Scotia's experience.

The purpose of this paper is to report on the capacity building efforts that took place during the dissemination research phase of Heart Health Nova Scotia (HHNS). HHNS, a health promotion research team, is funded by Health Canada and the Nova Scotia Department of Health. It is located in Halifax, Nova Scotia, a province of 937,000 people situated on the east coast of Canada. It has been a member of the Canadian Heart Health Initiative since its inception in 1989. The first phase of the program, Demonstration, was successfully completed in December 1995 (Heart Health Nova Scotia, 1995). In 1996, HHNS entered its second phase, Dissemination Research, which was conducted between April 1996 and March 2001 in the Western Health Region of Nova Scotia. This was completed in collaboration with organizations, community groups, and government agencies who joined HHNS to form the Heart Health Partnership (HHP) (Heart Health Nova Scotia, 2001). The main aim of this phase of the initiative was to build and research organizational capacity for health promotion and chronic disease prevention.

Diffusion of Innovation↗

Evaluation results of the CDC/ASPH Institute for HIV Prevention Leadership: a capacity-building educational program for HIV prevention program managers.

OBJECTIVE: The goal of this research was to evaluate changes over time in the capacity of participants of the CDC/ASPH Institute for HIV Prevention Leadership (Institute), a capacity-building program for HIV prevention program managers in minority-based, community-based organizations. Capacity was defined as the application of new skills and knowledge to participants' jobs and confidence in using those new skills and knowledge to strategically manage and apply "best practices" to their HIV prevention activities. METHODS: This is a longitudinal study involving measuring scholar capacity at three points in time: pre-Institute, post-Institute, and 6 months' post-Institute. Only responses from participants who completed all three surveys are included in this final analysis of the data (N = 94). RESULTS: Results indicate that participants from 3 years of the Institute (2002-2004) increased their capacity in HIV prevention programming and strategic planning and management. Significant changes were seen in the frequency and self-efficacy with which participants conduct several HIV prevention programming activities. Participants also reported conducting strategic planning activities at more appropriate intervals and were significantly more confident in conducting these activities. CONCLUSION: The Institute has positively and significantly increased the capacity of participants to conduct more effective HIV prevention programs on a national level.

Administrative Personnel↗

The 'Voices' project: capacity-building in community development for youth at risk.

We report three cycles of an 'action research' project aimed at increasing the capacities of young people at risk in a rural Australian town. Drawing on an 'experience-based' approach to risk assessment and the concept of collective efficacy, we aimed to provide a group of 10 young people with a safe and uncensored space within which to voice their own concerns about the risks and problems confronting them. Their stories were then made public through theatrical performance. The purpose of the article is to demonstrate the dynamics of capacity-building in marginalized communities as a means of producing the political changes required for improving health outcomes in a setting previously opposed to such a strategy.

Adolescent↗

Transdisciplinary research: research capacity building in developing countries at low cost.

Transdisciplinary research within the context of The Medical Research Council Programme on AIDS (MRCPA) has proven to be a way of research capacity building requiring relatively few additional costs. In developing countries where funds for specialised training are not always or easily available, encouraging multidisciplinary research teams is worthwhile, particularly for grooming into research relatively junior national researchers by providing them with opportunities to work with more senior international scientists.

Acquired Immunodeficiency Syndrome↗

Assessing the HIV prevention capacity building needs of community-based organizations.

Community-based organizations (CBOs) have been providing HIV prevention services to priority populations for many years. Recent research suggests that CBOs could benefit from capacity building to strengthen their public health prevention knowledge and skills, including ability to access and use behavioral science to guide prevention efforts. A cross-sectional survey of 316 CBOs was conducted to assess desire and preferences for training, support for training at the organizational level, motivation for training at the individual level, barriers to training, and factors associated with the perceived need for training. Results suggest the need for a national training initiative to increase CBO capacity.

Analysis of Variance↗

Rapid assessment and response studies of injection drug use: knowledge gain, capacity building, and intervention development in a multisite study.

OBJECTIVES: We evaluated the World Health Organization's rapid assessment and response (RAR) method of assessing injection drug use and its associated health problems, focusing on knowledge gain, capacity building, and whether RAR leads to the development of interventions reducing the health effects of injection drug use. METHODS: Data were derived from RAR studies conducted in Beijing, China; Bogotá, Colombia; Greater Rosario, Argentina; Hanoi, Vietnam; Kharkiv, Ukraine; Minsk, Belarus; Nairobi, Kenya; Penang, Malaysia; St. Petersburg, Russia; and Tehran, Iran. RESULTS: Substantial gains in knowledge and response capacity were reported at all of the study sites. Before RAR initiation, prevention and intervention programs had been absent or inadequate at most of the sites. The RARs resulted in many new or modified interventions; 7 sites reported 24 health-related interventions that were subsequently developed and influenced by the RARs. CONCLUSIONS: RARs, which require relatively little external funding, appear to be effective in linking assessment to development of appropriate interventions. The present results add to the evidence that rapid assessment is an important public health tool.

Health Knowledge, Attitudes, Practice↗

Capacity building in health economics opportunities for training in developing countries.

This paper provides an overview of the opportunities available for training in health economics in the regions of Africa, Asia and Latin America, following a WHO forum on Capacity Building in Health Economics held in Geneva in December 1995. It describes in brief the training opportunities available throughout Asia, Africa and Latin America. It then gives a detailed resume of courses available for students and professionals at Chulanlongkorn University, Thailand, the University of Cape Town, South Africa and the University of the West Indies, Trinidad. It also describes the international and regional networks which have developed and now provide further opportunities for training. The final section of this paper looks to the future and suggests that although continued financial and academic support will be needed from the countries of the North, the development of regional capacities in health economics should be as much as possible through regional resources, and regional strategies should be a priority.

Delivery of Health Care↗

Building capacity in the Mongolian health sector: a training methodology based on identified needs assessments.

Mongolian health care is moving from a centrally planned hierarchical basis towards greater decentralisation as part of overall sector wide reform. To identify key needs of health personnel to help to build capacity, we undertook research aimed at assessing priority training areas. The research results indicated gaps and weaknesses in many technical areas, but also significant problems in terms of how Mongolian health organizations function, including rigid structures, isolated management, and little internal communication. These features militate against optimal agency effectiveness. This paper discusses how specific training programs were developed based on quantitative research and an overarching organisation improvement theme emphasizing openness; communication; and participation to maximize the benefits of skills transfer and capacity development.

Education, Continuing↗

World Health Organization's TEACH-VIP: contributing to capacity building for youth violence prevention.

Youth violence is a major public health problem in every region of the world, yet it is especially prevalent in specific settings. Youth homicide rates exceeding 10.0/100,000 occur most often in countries that are low or middle income, or which are experiencing rapid economic or social change. Particularly in low- and middle-income countries, the capacity to develop and implement the comprehensive, multisectoral strategies to prevent youth violence is only just emerging. The prevention of youth violence requires multidisciplinary approaches and a variety of trained professionals. A public health approach to training in the area of injury prevention focuses on providing professionals and paraprofessionals a common understanding of essential skills and knowledge. One important benefit of this is that it addresses a major gap in current public health training that until recently has devoted relatively little attention to injury prevention. Another benefit is that it allows professionals from a variety of backgrounds to work together more effectively to reduce injury. This article will provide a broad overview of youth violence in low- and middle-income countries and will discuss the existing level of capacity within healthcare and public health sectors for responding to these problems. It concludes with a discussion of next steps for increasing capacity and a profile of the World Health Organization (WHO) training curriculum on injury and violence prevention called TEACH-VIP, an acronym for Training, Education, and Advancing Collaboration in Health on Violence and Injury Prevention, as one important effort undertaken by WHO and global injury partners to build capacity.

Adolescent↗

Research capacity building and collaboration between South African and American partners: the adaptation of an intervention model for HIV/AIDS prevention in corrections research.

This article examines a partnership between researchers from the United States who are involved in corrections health issues and scientists from South Africa who conduct prison health research, a previously underresearched area in South Africa. The article discusses some of the challenges as well as opportunities for knowledge and skills exchange via capacity building and collaboration strategies. Through historical and contemporary perspectives, it also discusses barriers and benefits of collaboration when forging links between researchers from developed and less developed nations. A focus on conducting public health research in South Africa, and on HIV/AIDS studies in particular, is placed within the context of the 2001 document of the Council on Health Research for Development. The South African prison health study represents a collaborative between the South African National Health Promotion Research and Development Group of the Medical Research Council, the South African Department of Correctional Services, and Emory University in Atlanta, Georgia. The article illuminates the process of adapting a model for a postapartheid prison study from one designed for use in the American correctional system.

Cooperative Behavior↗

Capacity building to improve women's health in rural China.

The Women's Reproductive Health and Development Program (WRDHP) is an ambitious attempt to operationalize two important tenets of health development thinking within a rural reproductive health context. First, it is important for communities to participate in decisions about the services and programs that affect them. Secondly, the complex nature of healthcare is best addressed by intervention processes which call for a multi-functional approach to planning and coordination. In both planning and intervention approach, the WRHDP recognizes the social, cultural and economic realities that affect women's efforts to secure the health and well-being of themselves and their families. The focus of the WRHDP is on capacity-building within a rural reproductive health environment, in this case Yunnan Province in rural China. Rather than using international donor funding to provide a specific intervention, the WRDHP used Ford Foundation funding as a lever to encourage community investment in environmental resources that affect health, to improve the technical skills of individuals within the existing health bureaucracies, and to promote structural changes within existing health and development bureaucracies to support interagency collaboration and community empowerment within the region's health and development agencies. This article describes how the WRHDP created new methods for provincial and local agencies to overcome obstacles and work with one another to improve women's health. It also describes the processes used in the rural areas of Chengjiang and Luliang counties to assess local conditions and needs, and the supported and expanded local efforts in improving woman's reproductive and family health that resulted from the processes.

China↗

Processes and capacity-building benefits of lay health worker outreach focused on preventing cervical cancer among Vietnamese.

The authors organized a lay health worker (LHW) outreach program with Vietnamese women that produced significant increases in Pap testing. The program was conducted by five partner agencies and 50 LHWs and involved 1,005 women. This article reports on the roles of the agencies and coordinators, the selection of LHWs, the processes LHWs used in identifying and recruiting participants, the ways they conducted their outreach work, and their strategies for maintaining participation. The article also reports on the LHWs' perspectives about how they benefited and what they found to be most rewarding and challenging about being a LHW. Based on the analysis of this information, the authors present a conceptual framework for understanding how different contextual factors shape the processes and capacity-building benefits of LHW outreach, describing four contextual domains that shape LHW outreach: the sociocultural domain and organizational domain, which overlap in the programmatic domain, all of which are framed by the structural domain. This analysis provides an approach for understanding how lay health work is shaped by a broader context.

Asian↗

Capacity building for integrated family-centered practice.

The profession of social work has made distinctive and important contributions to individual, family, and community social welfare, because it has avoided the excessive reductionism found in other helping professions. Unlike these other helping professions, social work has addressed economic and occupational needs of individuals, families, and their communities in a unique way. As a new century dawns, it is appropriate to look back and reflect and then to look ahead toward continuing challenges and emergent needs of individuals, families, and their surrounding communities. This article highlights some social work legacies and how they will help inform 21st century practice. Drawing on lessons from the past, several examples illustrate the kinds of strategies that might inform integrative social and economic foundations for practice, policy, and human well-being. The importance of these and other income-support and capacity-building strategies is featured against the challenges associated with welfare reform, new mandates for systems change, and what some see as the "reinvention" of the welfare state. The analysis concludes by describing some of the implications for professional education, research, practice, and their relationship.

Employment↗

Capacity building in environmental health research in India and Nepal.

The Fogarty International Training and Research Program in Environmental and Occupational Health at UC Berkeley concentrates on two major environmental health issues in the Indian subcontinent: arsenic in drinking water in West Bengal, India, and indoor air pollution in India and Nepal. Local trainees and researchers have had the opportunity to work on related research. Concerning arsenic in drinking water, projects included studies of skin lesions, pulmonary effects, reproductive outcomes, and child development, as well as mitigation approaches to reduce exposures. Activities in the indoor air pollution project have emphasized quantifying exposures to smoke from cooking and heating as well as their associations with tuberculosis and eye disease. Training has focused on developing skills necessary to address these problems. The training emphasizes in-country mentoring of trainees related to their research projects, and intensive short courses at partner institutions. The focus of capacity building in environmental health research in countries in economic and environmental transition should be on country-based research projects with embedded training efforts.

Air Pollution, Indoor↗

A process evaluation of the National Cancer Institute's Data-based Intervention Research program: a study of organizational capacity building.

This paper reports on a qualitative process evaluation of the Data-based Intervention Research (DBIR) program, that was funded by the National Cancer Institute (NCI) and operated in 21 states and the District of Columbia. The goal of DBIR was to build a foundation within state health agencies to ensure the translation of cancer control science into practice. NCI's objective reflected the readiness of cancer control research for public health application, the paucity of cancer control activity within public health settings and the recognition that state health agencies could play a critical role in the effective transfer of research results into public health practice. The qualitative process evaluation reported in this paper is based on one case study of four DBIR programs. The present study indicates that the four state health agencies executed the DBIR program with fidelity. Also, the four states offered a balanced assessment of NCI's role in enabling the state agency operation of DBIR, providing numerous citations illustrating how NCI successfully facilitated organizational capacity as compared to fewer mentions of ways NCI was less than successful. Thus, in funding the DBIR model, NCI was successful in raising state health agency capacity to implement cancer prevention and control programming. Implications for capacity building in state health departments are discussed.

Humans↗

Biodiversity prospecting in Nigeria: seeking equity and reciprocity in intellectual property rights through partnership arrangements and capacity building.

The regulation of genetic materials in Nigeria for the isolation of biologically active compounds and/or their exportation from the country fall under the purview of several government departments and parastatals. In principle, biological resources are considered similar to any other natural resource with different levels of stake holders. Specific restrictions, however, apply to the export of food crops. Nigeria is a traditional society where most of biodiversity belongs to what could be appropriately classified as public domain. It has therefore not been easy to carve out property rights from what is generally regarded as communal resources. Private access and occupancy of land and tenure are derived mainly from rights of membership of kindred groups or as custodian of "family' inheritance. The multi-state federal structure allows for negotiations to be conducted mainly at the level of the various State Government Departments responsible for forest resources, and the Federal Government providing the necessary policy guidelines and regulations. The Bioresources Development and Conservation Programme (BDCP), an international NGO based in Nigeria, has adopted an innovative model for biological prospecting based on establishing strategic partnerships and capacity building.

Conservation of Natural Resources↗