Apologies for taking the month off from blogging. I was traveling and just plain busy when at home. Sometimes, it amazes me how quickly time passes. I was astounded to see that it has been a full month since my last post.
On my mind today is public health capacity building. I am working on a paper for a class regarding how public health capacity building can impact my community. I’ve had some problems writing this paper because I do not particularly want to address public health capacity in my rural, North Idaho, USA community. Instead, I am gathering data on different locations: Nigeria and Haiti in particular.
What *is* public health capacity building? A narrow definition that I like is, “The capacity to deliver specified, high quality services or responses to particular problems.” A broader definition is, “The capacity of a system to solve new problems and respond to unfamiliar situations.” [Definitions borrowed from Capacity Building to address the Social Determinants of Health, Stephan Van den Broucke, Department of International Health EU Expert Group on SDHI, Luxembourg, 24 November 2009 presentation.]
In the narrower definition of capacity building, there must be set criteria on particular competencies relating to specific skills, procedures and structures. Additionally, the results are linked to performance standards, competency assessment, and quality improvement. Alternatively, in the broader definition, capacity building is defined by more diffuse and complex criteria related to the ability of the public health community to think creatively, adapt to change, innovate and solve problems. The success or implementation of capacity building under the broader definition is significantly linked to leadership, service development, and team involvement.
These are the issues prevalent in public health capacity building. When I think through the issues related to maternal and infant mortality and how best to apply public health capacity building on a global basis, I am drawn to my long-standing conviction that the ability to affect public health in this particular subset is through information dissemination. To reach the masses, the public, those aspects of maternity and neonatal care that are performed at the community level must be addressed and strengthened. The capacity to decrease maternal and infant mortality/morbidity rates is in providing education and tools to the families and those most likely to be attending births, the Traditional Birth Attendants.
When we talk about capacity building, so much of the time, we are focused on building infrastructure and increasing the number of “skilled” providers. But, looking at the broader definition of capacity building, and keeping in mind the link to leadership, service development, and team involvement, there is certainly some credence lent to the concept of working from the bottom up to affect maternal and infant outcomes.