UNDP and capacity development
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Capacity Development is central to all of UNDP’s work, with a focus on developing national systems for health, to ensure that country infrastructure, systems, and procedures are enhanced.
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 a particular emphasis on capacity development to improve the performance of national systems for health, ensuring quality, equity, efficiency, accountability, resilience, and sustainability in the delivery of health services.
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.
A comprehensive capacity-development strategy of enhancing national systems for health, rather than a siloed approach focused on training and technical assistance alone, creates greater resilience and long-term sustainability of health sector investments.
Why does UNDP focus on capacity development?
The 2030 Agenda provides an opportunity to take steps to build better systems for health, particularly in progress towards the SDG 3 target for Universal Health Coverage (UHC). As articulated by WHO, UHC encompasses all components of the health system: service delivery systems; the health workforce; health facilities and communications networks; health technologies; information systems; quality assurance mechanisms; and governance and legislation, among others.
Long-term, sustainable progress towards these cross-cutting development targets thus requires supportive policy environments and robust systems for health, with adequate capacity and resources to deliver services effectively and reach those left behind. This includes the capacity to coordinate policies, interventions, financing, and monitoring of outcomes across sectors to address health as a whole-of-system issue.
To build resilience and to ensure greater 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.
In supporting countries’ progress on UHC, UNDP recognizes that a cross-cutting focus and strong multisectoral partnerships are critical. UHC requires the protection of human rights, promotion of gender equality, and empowerment of women and girls to ensure that all populations have equal access to safe and affordable medicines, vaccines, and other basic health services.
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 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.
Among the areas of expertise where UNDP provides end-to-end capacity-building support for national entities is health procurement. As well as offering direct procurement services to governments through pooled procurement, where international competitive bidding through long-term agreements (LTAs) ensures value for money and a reduction in costs, UNDP helps to boost the capacity of national systems for health procurement across the supply chain. This includes working with national entities to ensure they have a central role in forecasting and quantification of health products, as well as using national storage and distribution channels.
The UNDP Strategic Plan 2018-2021, and the supporting UNDP HIV, Health and Development Strategy 2016-2021, provide the strategic direction for capacity development for resilient and sustainable systems for health as part of UNDP’s development mandate.
Guiding principles for UNDP capacity development
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 i
UNDP plays a key role in ensuring attention to HIV and health within broader governance and rights initiatives, including offering support for municipal level actions on SDGs, sustainable responses for health and HIV such as improving the sustainability of AIDS financing, sustainable health procurement, strengthening of national human rights institutions and increasing access to justice for key populations. UNDP also promotes specific action on the needs and rights of women and girls as they relate to HIV.
Meaningful engagement of people living with HIV, key populations, other excluded groups and affected communities is essential for effective governance
UNDP works to empower and include marginalized populations who are disproportionately affected by HIV, such as sex workers, men who have sex with men, and people living with HIV, in decision-making processes for policy and the design of programmes for health.
UNDP also supports the strengthening of national and local oversight supported by civil society organizations, which helps to address risks, improve the delivery of services, and remove human rights barriers. Civil society and citizen involvement in oversight mechanisms for public service delivery are essential to ensure that all communities are active, have a voice and are equal partners in planning and monitoring services.
Fostering multisectoral action to tackle interconnected development challenges
UNDP helps countries to mainstream attention to HIV and health into action on gender, poverty and the broader effort to achieve and sustain the Sustainable Development Goals.
For example, UNDP works with countries to understand the social and economic factors that play a crucial role in driving health and disease, and to respond to such dynamics with appropriate policies and programmes outside the health sector. This includes promoting national responses to non-communicable diseases (NCDs) i that extend beyond a focus on health services to include policies in finance, agriculture, environment, urban planning, education and other “non-health” sectors.
Building national ownership, capacity and resilience for effective and sustainable responses to HIV, health and related development challenges
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.
Being risk-informed to cope with and recover from conflict, natural disasters and other humanitarian crises
By identifying, assessing and developing mitigating actions, UNDP, working with stakeholders and partners, can take a risk-informed approach to address poor performance and quality, reduce inefficiencies, and tackle corruption in the health sector. It adopts a proactive approach to risk management, leveraging its existing risk management tools and frameworks to help governments to improve the quality and performance of health programmes and systems.
A commitment to continually build the evidence base for action
UNDP supports efforts to increase data and evidence for effective action on health. In the context of its support for health programme implementation, its capacity-development process is informed by robust assessments of the capacities of ministries of health and civil society partners. Through participatory methods to identify needs and plans, UNDP helps to define capacity-development activities, baselines and targets to allow for strong monitoring and evaluation.
At the policy level, UNDP works with partners like WHO to address data gaps with respect to national health-related targets and indicators and supports the capacity strengthening of national statistical systems for health. As underlined by the SDGs, robust data and measurement frameworks are critical for health programmes and policies to reach those left farthest behind and effectively track progress on health-related goals, in alignment with progress in other sectors.
Ensuring programme delivery based on value for money, facilitating services of the right quality, level and cost
UNDP’s principles for guiding health procurement include: i) provide the best value for money; ii) embody fairness, integrity, and transparency; and iii) engage in effective international competition.
UNDP’s unique offering to partners
UNDP’s experience supporting joint efforts to strengthen systems for health in over 50 countries, along with its broad country presence and trusted relationships with governments and other partners, have allowed it to develop a comprehensive approach to capacity development grounded in its unique comparative advantages as a development partner.
Key characteristics of UNDP’s approach and entry points for its support to promote more resilient and sustainable systems for health include:
Strengthening integration between policies and programmes
End-to-end support for health implementation
Ensuring robust law, rights and policy frameworks to support systems for health
Promoting coherent national health policies and strategies
Applying lessons learned from broad expertise in programme management
Coordinating joint action for holistic solutions
Leveraging innovation to accelerate sustainable health outcomes
UNDP support in challenging operating environments
An important area where UNDP develops capacity in is challenging operating environments.
These are countries that are characterized by weak governance and poor access to health services and require dedicated programmes to develop capacity. UNDP works to provide integrated support for policy development and programme implementation, as well as the strengthening and improved use of weak national systems for health.
UNDP globally also serves as an operational platform for UN agencies and donor partners. UNDP is currently providing support to systems for health in 60 countries, totalling US$1.3 billion in signed agreements. UNDP’s management enables health partners and programmes to integrate and operate effectively and efficiently in difficult operational contexts.
Capacity development health - focus areas
In close cooperation with national stakeholders and partners, UNDP prioritizes the following focus areas