Capacity Development in HIV Programming

The HIV/AIDS pandemic has given urgency to the need for rapid assessment and capacity development, particularly in high prevalence countries. The epidemic is eroding existing human and material resources, while the functions of available resources are also changing–often in response to a far broader, more urgent, range of needs. Resources need to be allocated in the planning process to develop the capacity for an expanded and comprehensive response to HIV/AIDS prevention, care and mitigation.

Capacity development can be defined as a process in which human resources, as well as organizational and operational capabilities of institutions, are improved to better perform priority functions. The overall purpose of capacity building in expanded and comprehensive responses to HIV/AIDS is to ensure effective design, implementation, coordination and management of wide-scale prevention, care and support efforts. Capacity development comprises some or all of the following six components:

• Human capital: This involves the development of human skills capacity, and the effective use of managerial, professional and technical staff, and volunteers. It includes identifying the right people to be trained; developing and delivering training strategies that are responsive to the needs of the target audience; providing an appropriate learning environment for training and education; ensuring in-service/field supervision for continued skills transfer; and, especially in the case of HIV/AIDS, longer term mentoring for directional, emotional and moral support.

• Organizations and their management: This addresses how organizations, their culture and management styles influence the use, efficiency and retention of skilled human resources.

• Public sector institutional context: This looks at how the policy and institutional environment affect civil service and government operations, and the spillover effect in the private and non-profit sectors. It includes the roles and responsibilities of different sectors in the context of decentralization, for example, as well as laws and regulations that affect hiring, promotion, and remuneration policies.

• Networks and linkages: This includes multi-sectoral alliances and networks of the public and private sectors to optimize resources and broaden the coverage of actions.

• Social capital and community participation: Social capital refers to the processes between people that establish networks, norms and social trust, and facilitate coordination and cooperation for mutual benefit. Community organization and participation concern complementarity of action, and strengthening social accountability and advocacy systems.

• Contextual environment: This refers to the socioeconomic, cultural and political settings that facilitate or constrain the functional capacity of individuals and organizations. One example is the degree of political acknowledgement and support for HIV/AIDS activities.

Sustainable capacity development requires creating new or employing existing system, through which one or more of the above components can be operationalized on a sustainable basis. Adopting a participatory process to develop a strategy and approach to capacity development is as essential to eventual success as the strategy itself. It is important that members of the target audience for capacity development participate in identifying and prioritizing needs; selecting the most appropriate methodologies, media and materials; and matching needs and available resources to the methods and general approaches adopted. Examples of general approaches to capacity development include:

• Pre-service training and continuous education: There should be an emphasis on developing curricula, course content and materials for integrating HIV into health, education and other sectors. Mechanisms are also needed to support long-term personnel training and staff retention, such as completion of degree programs.

• In-service training, particularly support for the development of regional training institutions: In-service training needs to be responsive to the evolving needs of participants and delivered by institutions that can provide integrated packages of technical, management and leadership training.

• Support for the development and use of national/regional consultants: Training technical support providers is essential to support HIV programming at both governmental and non-governmental levels. National and regional expertise helps provide more culturally appropriate support.

• Targeted technical assistance: This includes helping program managers gain access to specific types of short-term expertise, from both national and international sources.

• Twinning for training: Institutional and program twinning is an under-utilized, though highly effective, form of capacity development. International and regional South-South technical cooperation and networking requires building institutional frameworks and funding opportunities to operationalize exchange programs that respond to corresponding needs and experiences among participating partners.

• Distance Learning: Existing distance learning mechanisms provide a ready-made delivery mechanism for capacity building in HIV/AIDS programming. They also have been largely underused to date. Capitalizing on this delivery system involves understanding the networks, media, and learning methodologies employed in a given setting, or by a given sector, as well as their outreach and potential for curriculum development/adaptation, including integration of HIV/AIDS specific issues.

Resources

1. Eade D, Hewitt T, Johnson H, eds. Management and Capacity-Building; Development and Management. Experiences in Value-Based Conflict. A Development in Practice Reader, in association with The Open University. January 2000.
2. Eade, Deborah. Capacity-Building: An Approach to People-Centered Development. An Oxfam Development Guideline. 1997.
3. Measuring capacity building in health and population programs: summary of meeting held by MEASURE evaluation, November 16-17, 1999, Arlington, VA. University of North Carolina at Chapel Hill: Carolina Population Center. 2000.
4. Fort, Alfredo L. Capacity building in training–a framework and tool for measuring progress. University of North Carolina at Chapel Hill. School of Medicine. Program for International Training in Health (INTRAH) PRIME technical report 16. 1999.
5. Waters, Hugh. Regional initiatives for capacity building in the health sector. Washington, D.C.: Academy for Educational Development, Inc. (AED). 1995.
6. Eastmond, Dan. Realizing the promise of distance education in low technology countries. Educational Technology Research and Development 2000; 48:100-111.
7. Willis, B. Distance Education: strategies and tools, Englewood Cliffs, N.J.: Educational Technology Publications. 1994.
8. The International Centre for Distance Learning (ICDL) as an information service for all commonwealth countries, particularly LTCs. The ICDL database http://www.icdl.open.ac.uk/icdl/database lists thousands of distance courses, programs, institutions, and scholarly documents about distance education.
9. The International Extension College (IEC) in Britain started in 1971 with correspondence education projects in Africa: Mauritius, Lesotho, Botswana, and Nigeria. It consults with governments to conduct feasibility studies, set up distance education programs, and evaluate program effectiveness.