UNDP’s approach to capacity development for health

What is meant by capacity development?

UNDP defines capacity development as the process through which individuals, organizations and societies obtain, strengthen and maintain the capabilities to set and achieve their own development objectives over time. Capacity development is fundamentally about unlocking transformative change: change that is generated, guided, and sustained by those whom it is meant to benefit. In the context of UNDP’s programme and policy support for health and development, capacity development represents a fundamental component that cuts across all areas of its work at the global, regional, and country level. This includes particular emphasis on capacity development to improve the performance of national health systems, ensuring quality, equity, efficiency, accountability, resilience, and sustainability in the delivery of health services.

UNDP operates strictly in support, and within the framework, of national health plans and disease-specific national strategies, under the programmatic leadership of national health authorities and acknowledging the crucial role of civil society and the private sector. Promoting national ownership, developing capacity and strengthening national systems is the overriding objective of UNDP’s engagement. It therefore operates through existing country systems to promote national ownership, including national health information systems; procurement and supply chain systems; and public financial management systems. It helps governments to implement capacity development plans, to address priority gaps and build greater resilience and sustainability.

As part of promoting sustainability, UNDP does not implement health programmes itself, but rather, supports implementation by national governments, NGOs and private sector entities. In its role as interim Principal Recipient of Global Fund grants, for example, a primary focus is to build national capacities to enable the gradual and sustainable transition to direct government receipt of grants while strengthening broader systems for health. Greater national ownership is also promoted by ensuring programme performance indicators are aligned to national strategies.

Where does UNDP come in?

With its global reach, broad mandate, and integrator role, UNDP is uniquely positioned to support the kind of systemic and structural change at the scale required to bring about sustainable, institutional transformation of local, regional, and global systems for health. UNDP’s broad country presence and diverse experiences supporting governments to implement complex health programmes have allowed it to develop expertise and frameworks to support functional capacities identified as critical for an efficient health system. These include, for instance, having trained and motivated health workers, a well-maintained infrastructure, and a reliable supply of medicines and technologies, backed by adequate funding, strong health strategic plans and evidence-based policies.

This website details UNDP’s approach, processes, and tools for capacity development 1) within the context of health programme implementation and management, and 2) in support of building resilient and sustainable health systems at national and sub-national levels. All UNDP health programme implementation support is complemented by capacity development for health systems. In some countries, UNDP’s support focuses only on health systems strengthening activities, through provision of technical assistance to ministries of health. For example, through government financing agreements with ministries of health in numerous countries, UNDP supports the procurement of health products whilst providing end-to-end capacity building to enhance national supply chain systems.

The UNDP-Global Fund partnership: a key catalyst of capacity development

Among the key vehicles through which UNDP is able to provide robust, end-to-end capacity development support to countries is its partnership with the Global Fund. When UNDP is called on to manage Global Fund-funded HIV, TB, malaria, and health systems strengthening programmes as a Principal Recipient of grants in countries facing special implementation challenges, a priority of its engagement is to develop the capacities of governments and/or civil society to take over the programmes when circumstances permit. The partnership’s contributions to make health systems more resilient and help countries strengthen laws and policies not only supports the HIV, TB, and malaria response, but the capacity of the health system more broadly to work towards universal health coverage. See the UNDP-Global Fund Partnership page for more information.

Under health programme implementation, UNDP’s support includes the development of frameworks for effective programme management, monitoring and oversight, training of implementing partners including civil society and national coordinating bodies, assistance with assessing capacity gaps and developing capacity development and programme transition plans, and support to domestic financing of health programmes. Core focus areas for UNDP’s interventions to strengthen the resilience and sustainability of national health systems include support to the development of national strategies, health management information systems, procurement and supply chain management systems, public financial management and internal audit systems, human resources for health, community systems, environmental sustainability, and support to harness digital technologies and innovation.

This multidimensional support to health systems is all the more crucial in the context of emerging global health threats, humanitarian crises, fragile states, and other challenging operating environments. UNDP’s health implementation support is focused in countries that are characterized by weak governance and poor access to health services, which require dedicated programmes to develop capacity. UNDP takes a risk-informed approach to help governments address poor health programme performance and quality, reduce inefficiencies, and raise transparency and accountability in the health sector. This includes by leveraging its existing risk management tools and frameworks. The expansive nature of UNDP’s core development mandate also enables it to serve as a bridge between sectors, actors and levels of action, helping countries translate far-reaching goals into concrete programmes and measurable impact on the ground. Its work to bridge the nexus between humanitarian action and long-term development likewise helps to eliminate silos and strengthen countries’ resilience to shocks. In this way, UNDP’s capacity development support for health systems benefits from an existing network of multi-stakeholder partnerships, cross-sector policy engagement and implementation expertise, and the ability to tap into global lessons and resources whilst providing highly contextualized and evidence-based action on the ground.

Guiding principles

The following principles guide UNDP’s approach to capacity development for resilient and sustainable systems for health:

  • Respect for and promotion of human rights and gender equality that embodies fairness, integrity, and transparency, as set out in the United Nations Charter.
  • Building national ownership, capacity and resilience for effective and sustainable responses to HIV, health and related development challenges.
  • Meaningful engagement of people living with HIV, key populations, other excluded groups and affected communities is essential for effective governance.
  • Being risk-informed to effectively cope with and recover from conflict, natural disasters and other humanitarian crises.
  • A commitment to continually build the evidence base for action.
  • Ensuring programme delivery based on value for money, facilitating services of the right quality, level and cost.
  • Fostering multi-sectoral action to tackle interconnected development challenges. This includes promoting national responses to non-communicable diseases that extend beyond a focus on health services to also include policies in finance, agriculture, environment, urban planning, education and other ‘non-health’ sectors.

Through these principles, UNDP has built a comprehensive and sustainable approach to capacity development for health based on experience in over 50 countries, largely in partnership with the Global Fund. It is built on a participatory process and an applied methodology developed and tested on the ground. The approach ensures that capacity gaps are identified and analysed and feed into prioritized capacity development plans and interventions, which are implemented and monitored against performance indicators.

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