The SBCC Capacity Ecosystem

OUTCOMES

High-quality SBCC programs are essential to achieve positive health and social impact. They can encourage couples to talk about family planning and birth spacing to increase the chances of a safe delivery and a healthy baby; create demand for voluntary medical male circumcision and condoms that help protect against the transmission of HIV; and increase the use of insecticide-treated bed nets, particularly by the most vulnerable members of the community, pregnant women and children under 5, to protect themselves against malaria. Yet for an SBCC program to succeed in contributing to these types of positive health and social outcomes, they must be effective.

Countries need the capacity to design, implement and evaluate state-of-the-art SBCC programs. It is also critical for sustainability and country ownership.

AND HOW DO WE REACH THAT OUTCOME?

From Outcomes, move another step to the left for Results.

RESULTS

Country capacity to design, implement and evaluate state-of-the-art SBCC programs requires a threshold of individuals with the skills and confidence to undertake SBCC.

These individuals should work in organizations that support effective SBCC interventions and those organizations should operate in systems that support effective SBCC.

SO IF THIS IS WHERE WE WANT TO GO, HOW DO WE GET THERE?

While there are many theories available, HC3 has selected three theories to help guide the conceptualization of capacity strengthening programs.

THEORIES

Experiential Learning Theory

Experiential Learning Theory (ELT) is a four-stage model that emphasizes the central role of concrete experience but also of reflection, conceptualization and adaptation or experimentation.

In other words, the learner not only actively engages in “doing” but is also systematically encouraged to reflect on the experience, to conceptualize what might be done differently and to adapt the learning to a new experience. This leads to a deeper integration of the learning.

ELT puts the learner at the center of capacity strengthening and reminds us that capacity strengthening must be ongoing and blend methods.

Institutional Economic Theory

Although associated with economics, Institutional Economic Theory (IET) draws largely from social science research. In this theoretical framework, an “institution” refers not to an organization, but rather to the formal or informal rules that structure human interaction.

In other words, institutions are the written laws but also the unwritten social rules that influence how people behave. In the overall application of these models to the SBCC capacity ecosystem, IET destabilizes the conceptualization of capacity strengthening as a simple transfer of technical skills.

Capacity strengthening is also both an inherently social and political process. IET thus highlights the need not only for technological innovation but social innovation such as the need for new types of leadership, collaborative processes and networks.

In addition IET theorizes the role of “transaction” costs, which are the costs of participation. In SBCC capacity strengthening, this concept can be applied to any obstacle practitioners or organizations face to fully engaging in the SBCC community whether as a result of lack of access to knowledge, resources or networks.

Complexity Theory

With Complexity Theory (CT), a complex system is defined as one in which many independent agents interact with each other in multiple (sometimes infinite) ways. One of the defining characteristics of complex systems is the inability to predict the outcome of any given change to the system. Because a system depends on so many intricate interactions, the number of possible reactions to any given change is infinite. Minor events can have enormous consequences because of the chain of reactions they might incite.

Conversely, major changes may have an almost insignificant effect on the system as a whole. Because of this, strong control of any complex system may be impossible. While it may have order, no one absolutely governs a complex system. Moreover, change is not linear with direct cause and effect relationships, but non-linear and cannot be predicted ahead of time.

In terms of SBCC capacity strengthening, this implies adopting a different mindset when confronted with complex environments. Capacity strengthening programs should seek to influence rather than predict change and to experiment with multiple interventions to see what “takes” in a complex environment.

To increase chances of impact we should take a systems approach and operate at multiple levels simultaneously.

NOW THAT WE UNDERSTAND THE THEORIES, WHAT’S NEXT?

Move up from the Theory bar to Levels of Intervention in the far left of the model.

LEVELS OF INTERVENTION – WHERE?

A capacity strengthening program may work at one or multiple levels. That decision is generally made by the donor prior to the start of the project but may expand into additional levels during the life of a project. Capacity strengthening interventions may be implemented at the Global, Regional, National, Subnational and Community Levels.

Examples:

Global: Examples at the global level include building SBCC competencies of international bodies such as WHO, UNICEF or an international NGO; organizing a global SBCC conference; developing virtual platforms for learning and global exchange; and advocating for SBCC.

Regional: Some opportunities for strengthening capacity at the regional level include building the capacity of transnational organizations working in SBCC, such as AfriComNet, or a high capacity SBCC organization providing consulting in multiple countries in a geographic area, and supporting forums for regional networking and information sharing.

National: At the national level, capacity strengthening typically focuses on key national agencies in the public sectors, or occasionally the private sector. Opportunities include bolstering systems for coordination, creating sustainable teaching and training programs, creating policy and guidelines, and building skills among a select group of SBCC leaders to manage national integrated, multi-level, multi-layered efforts.

Sub-National: At the sub-national level, capacity can be built at the regional or district health bureaus or among NGOs working in a particular region. Opportunities for capacity strengthening include improving coordination and implementation management skills.

Community: At the community level, capacity strengthening may focus on the skills to map intended audiences and vulnerable groups; the ability to identify and build the skills of traditional, religious and political leaders; understanding of community entry and mobilization processes; community action planning and recognition system; and reinforcing the capacity of outreach workers.

ASSESSMENT

Once the level(s) at which the capacity strengthening project will work are determined, an assessment needs to be conducted. It is necessary to understand the current level of capacity.

To assess means “to evaluate or estimate the nature, ability or quality of.” In other words, where are the intended recipients of the capacity strengthening now and where do they want to go? Depending on the objectives of the project or program, the assessment will vary. Assessments can be carried out at individual, organizational, and/or systems levels. For example, the assessment may focus on one or two identified partners, a diffuse network of community groups or the larger national system in which the project is working.

The assessment phase of a capacity strengthening program may begin even before the project has started. For example, the donor may have conducted its own assessment and that assessment will be reflected in the request for applications (RFA) or in guidance to the project.

For example, a USAID Mission in a particular country may identify the government agency responsible for national SBCC coordination as a critical beneficiary for capacity strengthening based on previous knowledge as well as the government’s own assessment. A capacity strengthening project may then continue the assessment phase by implementing a capacity assessment tool to gain more detailed information about the specific strengths and weaknesses of that agency. The project may also scan or “map” the larger environment to determine what other partners in the country are doing or contributing, and what gaps exist in the overall capacity of the system.

An assessment may include the implementation of a structured in-depth participatory assessment tool such as the HC3 SBCC Mapping Tool, the C-Change SBCC-CAT, the PROGRES-SBCC Tool or the USAID Organizational Capacity Assessment (OCA) tool. These types of tools are often used when intensive SBCC or organizational capacity strengthening is planned for a particular organization.

The assessment process is tailored to a specific context and will depend on a number of factors: the amount of information already available about the system, organizations and individuals; the expected level of capacity strengthening funded under the program; and time.

A rapid survey tool, for example, may be implemented in a crisis or epidemic situation. In other situations, qualitative methods such as discussions with partners combined with a document review may be used when multiple organizations are involved, when the focus is on the system and links among partners, or when less intensive capacity strengthening has been requested by the donor to any specific organization.

Assessment is both an art and science and skilled program managers employ the ideal mix of methods in order to develop an effective capacity strengthening plan.

In addition, before developing a capacity strengthening plan it is important to determine what kind of capacity strengthening is critical to the success of the recipient’s work and what competencies they require to do their job. Not every person or partner needs the same SBCC competencies.

For example, a government partner such as the Ministry of Health (MOH) may need an introductory level of SBCC in order to coordinate national SBCC activities and to establish public-private partnerships. MOH staff, however, will generally not need detailed knowledge on such topics as materials development or research. The staff of a local SBCC organization, however, will likely need expertise in most if not all aspects of SBCC. While this may sound common sense, it is important to set expectations with partners to focus capacity strengthening efforts to be as efficient and as effective as possible. Moreover, capacity strengthening interventions can be structured to address these different audience segments such as in a sequential way or through parallel approaches.

Asking a few critical questions can help clarify the type of capacity strengthening and related competencies that need building for the system, organization or individual to perform their SBCC functions effectively.

KEY QUESTIONS TO HELP REFLECT ON CAPACITY STRENGTHENING NEEDS AND COMPETENCIES

• Is it an individual, organization or system that needs capacity strengthening?
• Do they operate at the community, sub-national, national, regional or global level?
• If an individual, is he or she directly involved in the design, implementation and evaluation of SBCC programs?
• Does the organization directly implement programs that either focus on SBCC or incorporate elements of SBCC?
• If the organization is not directly involved in SBCC implementation, what specifically is their unique role in the national network of SBCC organizations?
• What is the individual or organization’s primary role – research or programs?
• What is the individual or organization’s primary function – policy or administration?

Still working at the system, organizational and individual levels, consider the competencies or what the beneficiaries of capacity strengthening will be able to do as a result of the capacity strengthening efforts. For the ease of this narrative, the focus is on SBCC competencies rather than on institutional development competencies. To review examples of institutional development competencies, see the PROGRES-SBCC tool or USAID OCA tool. See the table below to review the anticipated SBCC competencies at each level.

INTERVENTIONS: HOW?

Finally consider the interventions, or how, to build SBCC capacity at each level, so as to be able to build what (the competencies), and for what purpose or why (the results) – which ultimately lead to outcomes and eventually impact.

Systems Level: At the systems level, any SBCC capacity strengthening program should ideally strengthen the support to, and the connections and coordination among, individuals and organizations practicing SBCC. Consider the interventions that will support both the practice of an array of SBCC organizations and individuals and the connections among them. Strategically choose those interventions that will have the greatest benefit to overall capacity of the system. Examples of these interventions include:

• Develop coordination structures and mechanisms, such as supporting national coordinating bodies and technical working groups, and assist them to function well
• Ensuring a network of organizations competent in all aspects of SBCC programming
• Institutionalize the SBCC profession and roles such as expanding the number and types of SBCC positions and developing courses and curricula to professionalize SBCC
• Advocate for SBCC’s role in the health system and for SBCC resources
• Formulate SBCC policies, strategies and frameworks
• Establish virtual and face-to-face networking fora
• Create repository for strategies, media and materials