Health Promotion International, Vol 13, 285-295, Copyright © 1998 by Oxford University Press
P Hawe, L King, M Noort, S Gifford and B Lloyd
A series of six focus groups was held with health promotion workers to
explore the meaning and experience of 'capacity-building', a term which is
used variously in the literature. The research is part of a participatory,
practice-based project to develop outcome indicators in capacity-building.
Capacity-building was defined as seeking to develop health promotion skills
and resources, and also problem-solving capability, at five levels: the
individual; within health care teams; within health organisations; across
organisations; and within the community. While workers had little
difficulty in identifying outcomes of capacity-building, indicators of
quality or good process were more difficult to articulate. This was partly
because capacity-building was described as an invisible, even secret
process. Capacity-building is hidden from funders and administrators
because it is not generally regarded as a legitimate project activity; that
is, it is not directly linked to risk factor behaviours in priority areas
such as cancer, heart disease and injury control. Capacity-building is also
hidden from other workers in order to make it more effective. This is
particularly the case with health promotion workers working within what
they perceive to be hostile climates, such as health care settings
experiencing funding cut backs. The invisibility of practitioners'
capacity-building work has implications for quality control guiding theory,
practice ethics, peer support, worker morale and funding mechanisms in
health promotion.Key words: capacity-building;
community development; health care settings; health promotion;
reorientation
ARTICLES
Working invisibly: health workers talk about capacity-building in health promotion
Department of Public Health and Community Medicine, Edward Ford Building A27, University of Sydney, Sydney NSW 2006, Australia; Health Promotion Unit, Central Sydney Area Health Services, Service Development Unit, Nepean Hospital, Wentworth Area health Services, Australia; School of Nutrition and Public health, Faculty of Health and Behavioural Science, Deakin University, Australia; Corresponding author
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