The comparative and objective measurement of health promotion capacity-building: from conceptual framework to operationalization

Abstract

The aim of this study was to analyse and test a theoretical generic health promotion capacity-building framework with empirical data on primary health care. The framework consists of seven dimensions: commitment, management, monitoring and needs assessment, resources, common practices, participation and other core functions. The data were collected in 2014 from all the health centres in Finland, of which 156 (99%) submitted their data. The data were scored by the quality of activities on a scale from 0 to 100, where 100 stands for desirable quality. Individual indicators were nested into subdimensions, which in turn were nested into the dimensions of the theoretical framework. Variables were clustered using the dimensions and subdimensions as initial partitions. The internal consistency of dimensions and subdimensions was tested with standardized Cronbach's alpha both before and after the clustering analysis. The results showed that although the internal consistency of the dimensions was high in the initial classification, it is possible to get even more consistent dimensions. The internal consistency of the initial classification varied from 0.62 in participation to 0.93 in common practices. In the clustering analysis, 45 out of 203 indicators were assigned to a dimension different from the initial partition. The biggest gain in internal consistency was achieved in the subdimension of systematic mass communications by relocating two indicators. This study suggests that it is possible to assess the health promotion capacity-building of organizations in a coherent way with comparable and objective indicators. These analyses also show that the number of indicators can be reduced. It would be interesting to see how the framework works in other governmental structures or political contexts.

Benchmarking Drug Regulatory Systems for Capacity Building: An Integrative Review of Tools, Practice and Recommendations

“…The description of 43 articles is presented in Table 1 . 11 - 15 , 18 - 20 , 26 - 60 The research design included literature review (n = 3), 28 , 32 , 49 expert interview (n = 1), 48 empirical analysis (n = 2), 43 , 52 comparative analysis (n = 7), 12 , 15 , 35 , 42 , 47 , 58 , 59 retrospective analysis (n = 2), 19 , 41 questionnaire (n = 10), 14 , 20 , 26 , 27 , 37 - 40 , 55 , 56 description analysis (n = 6), 11 , 13 , 33 , 36 , 45 , 60 and mixed methods (n = 12). 18 , 29 - 31 , 34 , 44 , 46 , 50 , 51 , 53 , 54 , 57…”

“… 18 , 30 , 35 , 50 , 54 , 57 Additionally, 5 studies were designed to analyse the drug review process. 19 , 31 , 34 , 40 , 47 Two studies focused on measuring the effectiveness of capability building in healthcare, 43 , 60 while 3 studies concentrated on post-marketing surveillance, 51 , 52 , 55 particularly regarding the circulation and safety of drugs. One study aimed to enhance the vaccine regulatory system in China, 32 another aimed to evaluate the level of adherence to good review practices (GRevP), 46 and 1 study aimed to identify the allocation of resources for capability building.…”

“… 26 , 48 At the operation level, 7 studies were designed to identify the problems of the drug review process in the target area, 20 , 29 , 31 , 38 , 44 , 58 , 59 of which four studies focused on the new drug registration process. 25 , 43 , 57 , 58 The remaining 4 studies aimed to assess the regulatory functionalities related to pharmacovigilance, 28 , 37 vaccines 11 and clinical trials. 12 …”

“…Among the 43 included studies, 15 studies covered multiple regulatory functions 11 , 13 , 15 , 18 , 20 , 27 , 32 - 34 , 42 , 44 , 45 , 50 , 54 , 57 while the remaining 28 studies focused on only 1 function when evaluating the regulatory capacities of NRAs. 12 , 14 , 19 , 26 , 28 - 31 , 35 - 41 , 43 , 46 - 49 , 51 - 53 , 55 , 56 , 58 - 60 Apart from 6 of the studies 11 , 13 , 18 , 27 , 32 , 42 which fully adopted the 9 GBT indicator categories when evaluating the functions of interest, the remaining studies adopted only some of the GBT indicator categories and sub-indicators whenever deemed relevant by the researchers. In 5 studies, 12 , 15 , 29 , 33 , 34 a combination of indicators from different benchmarking tools or programmes were used as measurements of the regulatory capacities.…”