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Bates, Imelda 
ORCID: https://orcid.org/0000-0002-0862-8199, Boyd, A., Smith, Helen ORCID: https://orcid.org/0000-0002-6252-3793, Aslanyan, G. and Cole, D.C.
(2013)
'A practical and systematic approach to collaborative institutional capacity strengthening based on evidence and experience' in 8th European Congress on Tropical Medicine and International Health & 5th Conference of the Scandinavian-Baltic Society for Parasitology, Copenhagen, 10-13 September 2013.
Abstract
Background
Formulating a general approach for planning capacity strengthening (CS) activities in low and middle income countries (LMICs) is complex because each programme is unique and quality evidence to guide planning is scarce. Funder commissioned CS evaluations may contain useful informationbut lessons have generally not been synthesized or shared. CS efforts usually begin with a ‘needs assessment’ but this starting point ignores two critical steps on the pathway to change - defining expected outcomes and describing the optimal capacity needed to achieve the outcomes.
Methods
We have used established research methods to extract information from peer-reviewed publications on CS
evaluations. We have also systematically analysed funding agencies’ reports of CS evaluations and surveyed and interviewed agencies’ representatives. We identified whether the evidence we extracted referred to CS of individuals, institutions or networks; we described the frameworks, indicators and processes used in the evaluations. We used this evidence combined with our extensive experience of CS in LMICs to design an evidence based, 5-step approach for planning and evaluating CS programmes. We tested this approach in different LMIC contexts and demonstrated its transferability. The 5-steps comprise: define the goal/objectives of the CS effort, describe the optimal capacity needed to achieve the goal/objectives, determine existing capacity gaps compared to the optimal, devise an action plan to fill the gaps with monitoring indicators, and adapt the plan and indicators as the programme matures.
Results and Discussion
We identified 593 peer-reviewed publications that focused on CS evaluations. 31 (5%) were primary studies; only four were from LMICs. Analysis of funding agencies’ reports showed that evaluation frameworks were diverse, usually not theory-based and were often geared towards monitoring funder’s own performance. Quantitative and qualitative monitoring indicators were used though few would meet SMART criteria, particularly at the institutional and network levels. We learnt that to manage expectations, avoid potential tensions and maximise learning, funders, evaluators and programme implementers should participate in CS planning and evaluation, and sustainability plans should be incorporated from the outset. Our evidence-based 5-step pathway involves ongoing participation of stakeholders and incorporates regular learning opportunities. It focuses on institutional processes as well as individuals and the wider system in which the institution operates. It defines the goal/objectives and describes the optimal capacity required prior to the needs assessment, and produces a measurable and flexible action plan to bridge capacity gaps.
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