Praxis Note 11. Capacity building in an AIDS-affected health care institution: Mulanje Mission Hospital, Malawi

It is increasingly clear that capacity building for those civil society organisations (CSOs) working in contexts of high HIV/AIDS prevalence presents specific challenges and costs. However, there have been few documented experiences which explore these challenges and costs and suggest ways to address them appropriately.

This Praxis Note is an attempt to fill that gap. It will initially provide an overview of the impacts of HIV/AIDS on the Malawi health care system and on the organisational capacity of Mulanje Mission Hospital (MMH). It will then describe the experiences and lessons learnt from the first four years of capacity building at MMH, a CSO in rural Malawi owned by the Church of Central Africa Presbyteria Blantyre Synod.

This capacity building programme was designed to address capacity deficits and erosion caused by HIV/AIDS attrition. As the programme was implemented, it evolved in response to an environment of HIV/AIDS prevalence. Less emphasis was placed on external training courses and increasing attention given to short-course inputs and distance learning. The initial focus on technical training was broadened to take more of an organisation-wide approach including management, structure and systems development.