Browsing by Subject "Capacity building"

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    Developing institutions for the Clean Development Mechanism: African perspectives
    (Taylor and Francis, 2005) Winkler, Harald; Davidson, Ogunlade; Mwakasonda, Stanford
    The clean development mechanism (CDM) requires developing countries to set up designated national authorities (DNAs). The DNA should be designed to both attract investment and to establish an effective regulatory framework for project approval—including assessment to ensure that CDM projects contribute to national sustainable development objectives. Since CDM investment flows to Africa are uncertain, however, countries cannot risk large investments in institutional infrastructure and need to build on existing institutions. This article examines the critical functions that a DNA has to fulfil, and outlines several institutional models. It concludes that models that minimize institutional cost by drawing on existing institutions for environmental impact assessment and promotion of foreign direct investment are likely to be the best starting-point for DNAs in many African countries.
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    Impact of systematic capacity building on cataract surgical service development in 25 hospitals
    (2017) Judson, Katherine; Courtright, Paul; Ravilla, Thulsiraj; Khanna, Rohit; Bassett, Ken
    BACKGROUND: This study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. The intervention involved eye care non-governmental organizations or high-performing eye hospitals acting as "mentors" to underperforming eye hospitals- "mentees" in 10 countries. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes. METHODS: This is a before and after observational study of the impact of this multi-dimensional process on hospital and individual productivity and financial sustainability after 4 years. Mentee hospitals reported data monthly using a standardized template. Key indicators included cataract surgery volume, cataract operations per surgeon, the proportion of direct paying cataract surgical patients, intervention program costs per additional surgery and cost per mentor. RESULTS: By the end of the study period, the hospitals experienced a 69% average increase (range: -63% to 690%) in cataract surgical volume over baseline with 12 hospitals showing increases over 100%. Twenty-three hospitals experienced a 59% average increase in the number of cataract surgeries per surgeon with 10 hospitals showing increases over 100%. The proportion of paying patients increased in 8 of the 14 hospitals reporting this data. The average mentoring cost per additional surgery for these 25 hospitals was $5.39. An average of $36,489.99 was spent per mentor per year to support their work with mentees. CONCLUSIONS: The intervention resulted in proportionally similar increases in cataract surgical volume and productivity across diverse settings in three distinct geographic regions. Its wide applicability and moderate cost make it an attractive means to rapidly and substantially increase eye care services to meet VISION2020 goals.