Country Capacity Assessments and Accomplishments(cont...)

The major findings were a growing commitment to advocacy, more NCD policies and action plans, lack of capacity to develop an HRH workforce for NCDs and lack of public health institutions with leadership and expertise for planning and implementation, inadequate staffing in the government NCD lead unit, little legislation and minimal capacity to develop it, no national surveillance systems, few disease-management efforts, and few efforts in monitoring and evaluation.

This topic has taken a health systems approach to describe health system capacity in general, with a focus on elements that are important to NCDs. Rather than a comprehensive assessment, it focused on finding accomplishment that might be enhanced and deficits that could be addressed.

For this approach the Health Systems Assessment Approach: A How-To Manual from the United States Agency for International Development (USAID 2007) was adapted for the health sector capacity assessment, which was conducted during March–September 2009.

The Manual covers governance, health financing, health service delivery, human resources, pharmaceutical management, and health information systems. The WHO NCD capacity tools used for global surveys in 2000 and 2005 and a new surveillance assessment tool under development/implementation in 2009 and 2010 were extensively reviewed; suitable components were adapted for the tool. All country-based consultants used the same assessment tool, which included both objective and descriptive measures of capacity.