The Capacity Development plan

This section offers tools and guidance for each stage of the capacity development process, whether in the context of overall health systems strengthening, civil society groups or specific programme areas. While developed through UNDP’s experiences of facilitating capacity development primarily in its role as interim Principal Recipient (PR) of programmes funded by the Global Fund, the process and tools can be adapted for different programme or policy objectives.

Success factors

From working with multiple countries carrying out capacity development processes, UNDP has identified common factors that are key to successful capacity development. These include:

• national support and ownership of the capacity development plan
• an objective assessment process to reach a common understanding of needs and recommendations.
• adapting the capacity development approach to the specific context and circumstances of the country and organizations involved.
• clarity of responsibilities, including who is responsible for implementing and evaluating the capacity development plan.
• planning and budgeting for capacity development: capacity development plans and budgets, which should be developed done as part of the initial programme development to support the implementation of health programmes.
• integration of capacity development plans with existing national plans and strategies, rather than seeing them as separate programmes.
• involving donors and stakeholders at the planning stage, to ensure coordination of various capacity development initiatives and cost sharing.
• resource mobilization, including a clear plan of all resources required in terms of both money and technical support
• regularly reviewing and updating of the capacity development plan to monitor progress and make necessary changes.
• ongoing and transparent communications and collaboration with all country stakeholders regarding the plan and its progress.

Just as programmes should be designed with the aim of achieving national goals and objectives to ensure a coordinated approach and the best use of all available funds, capacity development processes should seek to ensure alignment with national health strategies and disease-specific strategic plans.

UNDP’s approach

UNDP is able to bring together a wide variety of groups working in the health sector, from civil society organizations to government and donor groups. UNDP facilitates workshops and consultation meetings for groups to engage in country dialogue to ensure the views of all country stakeholders, from direct implementers to policymakers, are reflected. UNDP develops tools to suit the needs of all groups and provides examples of successful capacity development activities in different countries. The scoping and design stage entails a joint process to:

1. Analyse stakeholders: identify all stakeholders and their perspectives, levels of involvement, preferred methods of communication, and readiness for capacity development. In particular, attention should be given to key affected populations (KAPs) and how they can engage with the process.
2. Review institutional arrangements: clarify the institutional structure and arrangements for implementing health programmes, with lines of accountability, oversight roles and staff roles and responsibilities.
3. Define the capacity development team and roles: identify organizations and individuals to oversee, manage and support the capacity assessment and planning process and, if possible at this stage, also the implementation. This is particularly important if more than one
4. Plan and manage communications: ensure appropriate communications with the identified stakeholders, including through scheduling and conducting launches, meetings, workshops, newsletters, surveys, and electronic communications (websites, knowledge sharing systems, emails).

Guidance

The following points should be considered when scoping and designing the process.

• methods should be appropriate for the context. The most appropriate communications methods are dependent on the country, culture, organization(s), context and situation. For example, in some scenarios, a workshop may be more appropriate than a questionnaire given to individuals. Other alternatives include one-on-one discussions or small focus groups.
• there is a need for ongoing communications and engagement. Stakeholder engagement and consensus building should be conducted throughout the capacity assessment, planning, and implementation cycle, helping to ensure sustainable and coordinated capacity development.
• country ownership and partnership is critical. It is important that the organization(s) that are the focus of capacity strengthening are in charge of and committed to the capacity development programme. Sufficient time and effort should be invested in developing a strong partnership between UNDP and these organizations to ensure that objectives, roles and expectations are articulated, explored and clarified.
• it is helpful to identify agents of change. These are organizations, groups, or individuals that drive change by taking on roles to drive the capacity development process.

UNDP’s approach

UNDP helps to convene and facilitate the stakeholders of a health programme to:

1. Plan the assessment: identify how the assessment will be conducted, including whether it will be conducted with or without support from an external facilitator; the type of information-gathering method used, such as group meetings, workshops and one-on-one assessment meetings; and which organizations will be involved.
2. Confirm the scope of capacities to be assessed: review and update the specific skills and capacities to be assessed within each focus area. Depending on the country context, focus areas might include programme management, health information systems, procurement and supply chain management, financial management, and legal and policy environments.
3. Review existing documentary evidence: review and capture existing documentary evidence of current capacity from previous assessments, strategy documents and audit reports.
4. Conduct the assessment: capture strengths, needs and recommendations for each capacity.
5. Verify the assessment: review and confirm initial findings from further discussions with relevant partners and stakeholders.
6. Draft an assessment report if required: to consolidate the assessment results and develop draft conclusions.

Tools and guidance

UNDP has developed a set of capacity assessment tools that are tailored to the needs of ministries of health, large organizations such as international non-governmental organizations or networks, and local civil society organization (CSO) implementing partners. UNDP has also supported capacity assessment processes tailored to specific programme components, such as interventions for adolescent girls and young women and key populations.

Key considerations for conducting an effective capacity assessment can be found here.

UNDP’s approach

Once the needs of a programme and all relevant stakeholders are identified through the capacity assessment, UNDP supports the identification of capacity development activities and the development of baselines and targets to form the basis of the capacity development plan.

1. Identify interventions: the activities should be described in detail, noting the capacity strengths and weaknesses that have led to the proposed activity.
   
2. Define capacity development indicators: each capacity development activity should have a clear indicator to measure progress. Indicators should be relevant and feasible to measure.
   
3. Outline capacity development objectives: the plan should outline the overall objectives of groups of activities. For example, activities such as developing financial policies and procedures and training staff to effectively implement these procedures would contribute to the overall objective of strengthening financial management capacities and reducing risk.  Similarly, investing in renovating storage facilities at health clinics and designing and implementing an electronic logistics management information system would contribute to the objectives of improving the supply of health products and reducing wastage.
   
4. Develop an estimated budget: Once the activities are agreed, the budget should be developed using standard costing.

Tools and guidance

UNDP has developed templates for a wide variety of capacity development plans, including for civil society organizations (CSOs), national AIDS councils, ministries of health and programmes targeting specific key populations working in HIV, which can be found below.

The following points should be considered when completing the capacity development plan:

• Define appropriate indicators: defining indicators to measure changes in capacity is difficult, but they are key to measuring success. The number of indicators should be as few as possible, easily measurable, and SMART (specific, measurable, achievable, realistic and time-bound), and should consider both qualitative and quantitative progress where possible.
• Identify short-term objectives: to build confidence and experience and to demonstrate results and value, it is important to schedule and plan for some short-term objectives in the capacity development plan (typically within one year). These objectives can help to guide follow-on interventions.
• Aim to set long-term objectives: capacity development is a process of change, often involving multiple activities. There is a need for capacity development to be more explicitly woven into national programme management processes. In the long-term, clear objectives and milestones should be embedded into national health programmes.
• Coordinate with existing strategies and plans: capacity development plans should not stand alone but should be integrated into existing national strategies and plans.

UNDP’s approach

UNDP facilitates review workshops, bringing together all relevant groups, and provides template agendas to help guide the discussions. It supports the stakeholders in particular through the following actions:

1. Assessment verification: the assessment results and the proposed activities should be verified with appropriate stakeholders and partners.
2. Prioritize and schedule interventions and finalize the budget: it is important at this stage to prioritize capacity development objectives and activities, given that the available resources may not cover the full plan and that certain activities may be more crucial than others to the achievement of national strategic goals. Following the verification and the prioritization, the budget may need to be revised. Funds for capacity development management activities should be included in the overall budget. This should cover all coordination/management costs, monitoring and evaluation processes, and costs associated with the capacity development of staff.
3. Draft the capacity development plan report: it may be helpful at this stage to document the elements of the plan, to share with in-country partners and other donors.
4. Sign-off from national leaders: capacity development is nationally owned and the final approval for the plan should lie with the organization(s) being strengthened. The final approval to proceed should be obtained by the senior management of the organization(s) involved.
5. Launch the plan: it may be useful to hold a launch of the plan to ensure all relevant stakeholders are aware of the final focus and activities. This also contributes to the buy-in and coordination of the plan. If funds are still required (both financial and human resources) this may be an opportunity to approach donors.

Tools and guidance

Example templates for stakeholder review workshops and capacity development plan budgets are available in the key resources section below.

The following points should be considered when carrying out the stakeholder review and finalizing the capacity development plan.

• A plan is only of use if it is implemented. An important consideration of the stakeholder review is to ensure ongoing ownership and responsibility, to move the plan from the assessment and planning stage to the implementation stage. Implementation will only take place if a majority of stakeholders feel ownership towards the plan’s activities and objectives.
• Supporters and resisters should be considered. In defining a plan of change for any organization, there will be supporters and adversaries; the objective should be to engage both parties in a joint effort to agree on prioritized activities.
• Realistic schedules and timelines should be defined. Consideration should be given to the time required to review by all country stakeholders. In addition, obtaining funding for the plan may also take time. This can delay implementation by six months to a year after the completion of a capacity development plan.
• Donors may be able to offer in-kind resources as well as financial ones. Some donors may be able to offer in-kind support instead of money; this could include providing consultants or technical experts to carry out training or mentoring, or computer hardware or software packages to improve systems.
• Cross-organizational activities can help reduce costs. If multiple organizations are included within the plan, consider identifying cross-organizational activities. Often a capacity need is required by several different implementers. Sharing activities across organizations may help to reduce overall costs; for example, only one set of training tools will be required for multiple training sessions.

UNDP’s offer

Following the launch of a capacity development plan, UNDP supports the ministry of health and other stakeholders to:

1. Prepare for implementation: confirm the implementation arrangements, including who will monitor the day-to-day activities, how information will be shared about results, and management roles and responsibilities.
   
2. Confirm the capacity development oversight arrangements: identify who will oversee the implementation on a quarterly or semi-annual basis.
   
3. Implement the capacity development plan and conduct regular monitoring: manage inputs and resources to implement activities and ensure regular monitoring and reporting to management and the oversight group
   
4. Adapt the plan and alter course if necessary: adjust the programme as required during implementation to better achieve results.

Tools and guidance

UNDP has supported the implementation of capacity development plans in countries as diverse as Zimbabwe, Afghanistan, Sudan and Zambia, working in close partnership with national entities. Based on this experience, UNDP has developed a guide to monitoring and evaluating capacity development which brings together lessons learnt and offers ideas on best practices.

The following points should be considered during implementation.

• Capacity development needs can change over time. Capacity development interventions and schedules may need to be adapted, redefined and updated at many points during implementation, on account of changing needs of individuals and organizations within a changing environment. Therefore, the regular monitoring of indicators is important and the changing of plans is likely.
• There should be flexibility in the management of capacity development. Because capacity development is complex, and it can be difficult to measure changes in capacity, it does not necessarily fit well within the typical project management method of measuring numbers relative to budget. The primary need is for management to critically review both quantitative and qualitative progress and assess the changes in capacity as well as any new needs that have emerged.
• Strong communication on implementation is key. To improve effective communications during implementation between the various country stakeholders, a web-based knowledge sharing system can be considered to organize activity schedules, provide updates on deliverables and store reports.
• Existing stakeholder bodies should be leveraged for oversight processes. In the context of the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) programmes, Country Coordinating Mechanisms (CCM) can be one of the most effective mechanisms for the oversight of implementation of capacity development plans because of their focus on national ownership and because they consist of representatives from all key sectors and constituencies within countries. Creating a culture of dialogue among the different CCM members could result in more effective and efficient delivery of capacity development measures and should promote the sharing of good practices.

UNDP’s approach

UNDP carries out both informal reviews and formal evaluations of capacity development plans and supports processes to inform learning and next steps, such as planning for follow-on.

UNDP also develops case studies documenting capacity development processes over a number of years to show the changes in national health systems, such as improving health information systems and strengthening procurement and supply chains in Zimbabwe.

1. Prepare for evaluation: confirm the scope and timing of the evaluation, organize documentation, and select the evaluation team.
2. Manage the evaluation: brief the evaluation team, review inception reports, and review evaluation draft reports.
3. Leverage evaluation results: present and disseminate the evaluation results, share lessons learned and ensure the findings are used in future planning.

Tools and guidance

The sample terms of references below outline standard duties and responsibilities for a consultant to conduct a capacity development plan evaluation. Additional guidance and good practices can be found in the document “Monitoring and Evaluation of Capacity Development”.

The following points should be considered when evaluating a capacity development intervention.

• Use existing data and information. Evaluations should use information available from a variety of sources, such as reports from other donors on their support to programmes organizations.
• Integrate capacity development evaluations. Conducting evaluations of capacity development initiatives are no different to carrying out any other evaluation. Therefore, where possible, capacity development evaluations should be integrated with programme evaluations.