What is health promotion capacity? A relational perspective.

Abstract

In organizational health promotion research, health promotion capacity is a central concept that is used to describe the abilities of individuals, organizations, and communities to promote health. The purpose of this paper is to discuss the theoretical underpinnings of the literature on health promotion capacity building and, further, to suggest an alternative theoretical perspective which draws on recent developments in organizational theory. The paper begins by a critical discussion of the capacity building literature, which is juxtaposed with the relational perspective of contemporary organizational theory. The theoretical argument is developed in reference to the case of Danish municipal health promotion agencies, drawing on secondary sources as well as ethnographic fieldwork among public health officers. The capacity building literature tends to reify the concept of capacity. In contrast, this paper argues that health promotion capacity is constantly defined and redefined through processes of organizing. The case study suggests that, faced with limited resources and limited knowledge, health promotion officials attain a sense of capacity through an ongoing reworking of organizational forms. Organizational health promotion research should look for the organizational forms that are conducive to health promotion practices under shifting social circumstances. This paper makes explicit an inherent theoretical tension in the capacity building literature and suggests a novel theoretical framework for understanding organizational capacity.