Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Community capacity building
or consistency. Over 50 years ago, the sociologist
Hillery, found over 90 different meanings of the term
“ community ” and concluded that the only commonality
between the meanings was that they were about
people. 1 In reference to “ community capacity building
” the term community has in the past been applied
to a specific geographical community. However, our
experience suggests, a broader definition of community
is typically used and that it may or may not have
a geographical boundary but may simply be a group
that shares a common goal interest or identity.
Box 27.1 Capacity building
definition from WHO glossary
Capacity building is “ the development of knowledge,
skills, commitment, structures, systems and leadership
to enable effective health promotion. It involves
actions to improve health at three levels: the advancement
of knowledge and skills among practitioners;
the expansion of support and infrastructure for health
promotion in organizations, and; the development
of cohesiveness and partnerships for health in
communities ” .
Capacity b uilding
Like community, “ capacity building ” also has various
meanings. Hawe et al described it as one of those
terms that is given to a loose or wide concept, where
professionals in the field can give an impression of
understanding and consensus of the concept but differ
in their definition. 2 Close inspection, however, reveals
similarities in the definitions. For example, NSW
Health defined capacity building as “ an approach to
the development of sustainable skills, organizational
structures, resources and commitment to health
improvement in health and other sectors, to prolong
and multiply health gains many times over ” . 3 Similarly,
Bush et al defined community capacity building as “ a
collection of characteristics and resources which,
when combined, improve the ability of a community
to recognise, evaluate and address key problems … the
work that is done to develop the capacity of the
network of groups and organizations ” . 4
Community c apacity b uilding in
h ealth p romotion
Within health promotion, community capacity building
has evolved from the traditions of community
development. Its roots can be linked to international
aid efforts and it shares its origins with the associated
concepts of community organization, community
action and community empowerment. 5 In essence,
rather than being a mere “ site ” for interventions,
the “ community ” is a resource for change. Community
capacity building first became prominent in the
health promotion arena in the mid - 1990s, although
its development can be tracked from the 1986
Ottawa Charter. 6 Elements of capacity building
clearly underpin the charter ’ s concept of empowerment
and subsequent declarations further articulate
capacity building. The Jakarta Declaration in 1997
specifically identified the need to “ increase community
capacity and empower the individual ” and
conveys both the rationale and requirements for
capacity building. 7
More recently, the Bangkok Charter called for all
sectors and settings to act to “ build capacity for policy
development, leadership, health promotion practice,
knowledge transfer and research, and health literacy ”
thus recognizing the need to integrate capacity building
strategies into health promotion. 8 Helpfully, the
term “ capacity building ” is now included in the World
Health Organization ’ s ( WHO ) Health Promotion
Glossary (Box 27.1 ).
9
The value in such a glossary is
that definitions are underpinned by a process of deliberation
including a literature review and expert feedback
which helps to provide at least a starting point
for developing health promotion interventions.
The glossary goes on further to say that capacity
building at the community level may include raising
awareness about health risks, strategies to foster community
identity and cohesion, education to increase
health literacy, facilitating access to external resources,
and developing structures for community decision
making. It is noted that for action at the community
level to be successful, there needs to be a social
and political response to secure support for such
interventions. Collectively, these components provide
a means by which “ stakeholders ” in health promotion
can consider how they may develop effective
interventions that link micro - level change at the individual
level, meso - level changes at the neighborhood
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