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Capacity Building and Health Systems Strengthening

Increasing the Role of Local Organizations in Health Systems Strengthening

In many countries, numerous NGOs, consulting firms, and university research institutes are engaged in providing technical assistance and training in the area of health systems strengthening. While many of these organizations have technically qualified staff, they often are not well managed or financially strong. These organizations are typically small with full time staff ranging from 5-15 employees. Leaders often lack the skills to create sustainable organizations that can grow and evolve and provide quality professional services over time. To address this issue, Health Systems 20/20 has come up with an innovative and cost effective approach to developing the capacity of local organizations by developing the skills of the leadership to guide the development of their own organizations.

The Health Systems 20/20 approach has two primary components – a skill-focused workshop to strengthen the capacity of the leadership to develop their own organizations and a structured follow-up process after the workshop. A systematic approach to developing the capacity of the leadership is often the missing link in many institutional capacity-building activities. A workshop approach reaches a much larger number of organizations than if direct technical assistance were provided to single organizations. Since many local organizations that provide technical assistance and training are small, it is not cost effective to strengthen them individually through a more intensive process of technical assistance.

Health Systems 20/20 organized a workshop for the leadership of 12 local organizations in Senegal from June 25-29, 2007. The workshop was delivered by one international trainer and a local co-trainer. The organizations included nine NGOs, two for-profit consulting firms, and one university research institute. The Health Systems 20/20 conceptual framework for capacity-building was the primary reference for the course. This framework defines six core institutional competencies:

• organizational development
• management systems
• resource mobilization
• organizational governance
• technical expertise
• technical assistance and training

Comments from Senegal Workshop Participants

“I admit I was a little skeptical about the workshop, yet I learned new things about resource mobilization and governance.”

“I now have a broader understanding of the issues that our institutions face.”

“The workshop helped me take stock of the challenges my institution faces and how to address them.”

“I found useful answers to my questions about how to help our institutions grow.”

“Rich content and varied methods.”

This workshop was, therefore, aimed at much more than leadership and management skills in that it provided a comprehensive framework that included all the core competencies of a successful organization. The specific workshop objectives were:

• Define the core competencies needed to ensure organizational effectiveness
• Identify and use key leadership and management practices in the context of organization development
• Define the components of a resource mobilization plan
• Analyze promising practices for the management of organizational systems
• Use the key steps of the consulting process to ensure the quality of technical assistance
• Identify ways of making organizational governance structures work more effectively
• Develop strategies for keeping staff current in key technical areas
• Develop a plan for improving each organization based on an assessment of its strengths and weaknesses

In order to assist in the application of the skills learned in the workshop, Health Systems 20/20 suggests a structured follow-up process consisting of one or more of the following elements:

• Organization of quarterly meetings after the workshop to exchange experiences in applying the skills learned in the workshop.
• Short follow-up workshops to go into more depth on specific topics.
• Modest level of individual follow-up with each organization, perhaps a day for each one.

• Local Organizations: 1) Strengthened capacity of leadership of local organizations to guide the development of their organizations. 2) Plans for applying what participants learned that can then serve as the basis for follow-up.
• USAID and other Development Partners: Mobilized and strengthened local market for technical assistance and training. In Senegal, the organizations formed an Organizational Development Network to provide a platform for ongoing organizational strengthening activities, explore partnership opportunities, and share information with one another on issues of common interest.

Health Systems 20/20 could implement this approach in any country where there is a critical mass of local organizations and where USAID would like to shift more responsibility for the provision of technical assistance to local organizations. The workshop could also be delivered on a sub-regional basis where three or four organizations from three or four countries participate. While the Senegal workshop included organizations that covered the full range of health areas, the workshop could also focus on organizations that work in just one area such as HIV/AIDS.

If you are interested in learning more about this approach, please contact Fred Rosensweig, Health Systems 20/20 Capacity Building Leader, at frosensweig@trg-inc.com or 301 347-5587.