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Overview: Capacity development planning process for health programmes

Whether in its role as an implementing partner managing large-scale HIV, TB, and malaria programmes funded by the Global Fund or as a technical assistance partner for health systems strengthening interventions, UNDP prioritizes the capacity development of national entities and systems for health. Leveraging its global experience, UNDP has established a systematic approach to capacity development based on a model of end-to-end support tailored to the country context and needs of partners. Its framework for capacity development starts with a participatory multi-stakeholder process to scope the priorities and conduct a comprehensive capacity assessment that informs the development of capacity development plan. UNDP then works closely with national stakeholders, making tools and guidance available, to support the implementation and monitoring and evaluation of the capacity development plan.

Purpose

Capacity development interventions should be based on a comprehensive understanding of how a system is currently working, what areas need support and how to prioritize investments according to the cross-cutting building blocks for resilient health systems. These could include developing and implementing health information systems, training staff in analysing data, developing policies and procedures for strong financial management, and improving the supply and distribution of key health products.

A valuable mechanism for applying a holistic and systematic approach to strengthen systems for health and the capacity of key stakeholders is the establishment of a nationally owned capacity development plan. In the context of its support to health programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) and the emphasis on enabling transition of grants to national entities when circumstances permit, UNDP works closely with governments and/or civil society organizations to develop costed capacity development and transition plans. These plans help partners to prioritize, implement and monitor capacity development investments and can serve as a tool to advocate for additional resources in key areas.

Refer to the page on Conducting the Capacity Assessment for related tools and templates.

UNDP’s approach

Whether in its role as an implementing partner managing large-scale HIV, tuberculosis and malaria programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) or as a technical assistance partner for strengthening systems for health, UNDP prioritizes the capacity development of national entities and systems for health. Leveraging its global experience, UNDP has established a systematic approach to capacity development based on a model of end-to-end support tailored to the country context and the needs of partners. Its framework for capacity development starts with a participatory multi-stakeholder process to establish priorities and conduct a comprehensive capacity assessment that informs the development of the capacity development plan. UNDP then works closely with national stakeholders, making tools and guidance available, to support the implementation and monitoring and evaluation of 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.
Nationally owned, multi-donor capacity development planning in Chad

UNDP supports capacity development planning in Chad to build resilient and sustainable system for health and transition the management of Global Fund grants to national entities. Historically, different partners working on HIV, tuberculosis, and malaria led to separate capacity development efforts. Since 2021, the MoHP and UNDP have been co-Principal Recipients of the Global Fund malaria grant. Under this model, the partners are allocated responsibilities based on their strengths, while PMU capacity is further strengthened. The aim is to fully transition the Principal Recipient role in the future.

With UNDP support, Chad’s Ministry of Health and Prevention (MoHP) created a Programme Management Unit (PMU) to coordinate capacity development and development assistance efforts nationally. Drawing on technical assistance from partners, UNDP contributed resources to develop, implement and monitor a comprehensive multi-donor capacity building plan, which promotes shared responsibility and accountability for outcomes. UNDP helped convene United Nations agencies, bilateral and multilateral partners and international non-governmental organizations to harmonize activities and investments.

Coordinating partners enabled the Government of Chad to finance three health system components: a health information system, procurement and supply management and human resources. Chad’s health information system, the Technical Assistance System (DAT), has been spearheaded by Expertise France. The DAT supports the autonomous daily management of external grant activities and capacity development plan implementation through an Expertise Channel (technical), Projects Channel (financing catalytic initiatives) and Accelerator Channel (innovating in the fight against pandemics).

Under procurement and supply management, Against Malaria Foundation has partnered with UNDP to purchase 6.8 million long-lasting insecticide treated bed nets (LLINs) in 2023. The bed nets were delivered across seven provinces with the highest malaria burden in Chad. As a funding partner, the Global Fund funded all other costs besides the LLINs, such as transport and distribution. The Global Fund and the national government also raised funds to cover other provinces, ten and two provinces, respectively, to cover 19 provinces and 18.9 million people with 11.6 million LLINs in total.

Human resource support included UNDP coaching four national counterparts, French technical assistance funding for four international experts within the PMU and a progressive transfer of responsibilities for grant management. In 2018, the PMU became Sub-recipient of the Global Fund malaria grant, for which UNDP has been interim Principal Recipient since 2008. In January 2019, the MoHP became Principal Recipient of the Global Fund’s HIV, tuberculosis and health system strengthening grant, with technical assistance from the French 5% Initiative.

Learn more about Chad’s co-Principal Recipient model here: UNDP GFPHST Webinar ‘Innovative approaches to capacity development in GF-financed health programmes’