ABSTRACT
Capacity building is based on the premise that transformation can only be sustainable when it is initiated, planned and implemented in close collaboration with those who stand to benefit. Building capacity is an objective as well as an approach and a methodology. It provides support to organisations and individuals in reaching their stated objectives. In the health sector, the ultimate goal of capacity building is a sustainable health system Thus, any activity, project or change in environment that improves the ability of a health system to bring about positive health outcomes is considered a capacity building intervention. Building capacity is an ongoing process: there is no final destination. Nor is there a universal standard – a single ‘right way’ – that all organisations should operate. Each organisation faces different circumstances. An organisation’s capacity needs at any particular moment will depend on a wide variety of factors, including the extent of erosion taking place in capacity components. Staff turnover and the failure to update technology systems are common examples of such capacity-eroding forces. In Zimbabwe’s health system, for example, brain drain of qualified health staff accelerated following the disputed reelection of President Robert Mugabe in 2008. The erosion of Zimbabwe’s health systems’ ‘structural capacity’, coupled with the effect of international sanctions on ‘performance capacity’ 1 have precipitated major problems in the entire health system, leading to reversals in life expectancy, 3,000 HIV/AIDS-related deaths every week, absolute poverty rate of 80 per cent, ongoing cholera epidemic, public distrust in health systems and acknowledgment in 2008 by Douglas Gwatidzo, chairman of the Zimbabwe Doctors for Human Rights that: ‘In recent months we have seen a dramatic deterioration of our health-care system. Virtually everything to do with health is failing to perform at even the minimum expected standards.’ 2
