Building Capacity at the Community Level to Improve Health Equity

“Our collective future depends on all communities having equitable opportunities for health, wellbeing and economic vitality,” says Lisa Waddell, MD, MPH, chief medical officer at the CDC Foundation. “That’s why our partnership with community-based organizations is so important.”

Community-based organizations (CBOs) are public or private nonprofit organizations that provide specific resources or services to the community or a target population within the community. Their collective goal is to improve the health, well-being and overall functioning of a community so its members can survive and thrive—before, during and after a pandemic.

As the COVID-19 crisis began to unfold in 2020, the CDC Foundation recognized the urgent need to support CBOs across the country in their grassroots emergency response efforts to educate, vaccinate and promote equitable access to care. A major source of Foundation support has come in the form of what’s known as technical or capacity-building assistance.

True to its name, capacity-building assistance refers to services and activities that help organizations build capacity to strengthen their operations and sustain critical programs and projects.

Sometimes, a CBO has received funding and needs tips or assistance with organizational strategies to fulfill the terms of a grant. At other times, a CBO just needs a sounding board or access to a particular resource or toolkit, or a warm introduction to a potential partner, such as a local health department. At the CDC Foundation, technical assistance officers work with the CBOs to assess and address their unique needs, challenges and opportunities.

“A lot of times CBO staff are apprehensive to ask for capacity-building assistance because they think it shows weakness, but it really shows you just want to be better and do better,” said COVID-19 CBO Director Marilyn Watkins, DrPH, MPH. Watkins was executive director of a CBO in Mississippi for more than 20 years, so she understands the landscape. “If we are going to provide funding to CBOs, we need to be providing capacity building as well. My mantra always is that you leave a place better than you found it.”

Examples of CBA in Action

Watkins selected a team of technical-assistance and program officers with a variety of skillsets from coalition-building, to facilitating partnerships with CBOs and non-governmental organizations, to procurement. “We have the experience the CBOs need because we’ve done it or seen it all ourselves,” she says.

Here are just a few examples of capacity building in action:

In Alabama, the Montgomery Area Wellness Coalition needed strategies to increase partner involvement and accountability in coalition activities relating to its COVID-19 education and vaccination initiatives. Technical Assistance Officer T’Juan Rucker provided resources and materials on coalition development and maintenance strategies.

As a result, the coalition now holds monthly meetings and has initiated coalition membership drives to ensure strong representation from targeted populations. With the increased involvement from their coalition partners, they have been able to work and build relationships in geographic areas including Tuskegee that were initially hard to access due to a history of mistrust. A new partnership with a well-respected local health care provider led to a series of mini vaccination clinics where nearly 50 people were vaccinated for COVID. “T’Juan gave us the push we needed in the right direction; after that we’ve been hitting the ground running,” said Carmela Fleming, health equity alliance program coordinator at The Wellness Coalition.

BABY B.A.C.K. INC. (BBI), a community health and wellness organization in Syracuse, NY, requested support to establish a partnership with the Onondaga County and the New York State Health Departments. The CBO wanted to become involved in vaccination pop-ups and clinics in the community and learn how to obtain funding for its programs. Technical Assistance Officer Lead Jo-Ann Hoye arranged and hosted introduction meetings between BBI and both local and state health departments and provided information on ways to prepare the organization to receive funding.

These meetings resulted in BBI being invited to join the Onondaga County Health Department’s COVID Community Task Force and a partnership to provide community outreach and awareness and increase vaccination rates. The CBO also implemented suggestions regarding ways to become “fundable” and recently received a grant of $125,000. “Thanks to the CDC Foundation, my agency was able to connect with local departments of health, to provide education, outreach and vaccine administration in black and brown communities in Syracuse,” said President and CEO Gerald Seals. Last year, technical assistance from the CDC Foundation played a role in the development of a BABY B.A.C.K. video promoting a #MaskOn2021 Challenge for K-6 students in New York State. The agency received a prestigious Communicator Award of Excellence from the Academy of Interactive and Visual Arts for that engaging video. Watch the BABY B.A.C.K. video promoting a #MaskOn2021 Challenge:

For the Philadelphia-area chapters of Alpha Kappa Alpha Sorority, Inc., what began as a small capacity-building assistance request early in the pandemic has grown in scope and scale—and impact. AKA initially asked for guidance on a series of ‘COVID Conversations,’ then sought to expand their volunteer efforts with other partnership opportunities. The CDC Foundation connected them with the Montgomery County Immunization Coalition (MCIC) which collaborates with their partner organizations to host COVID-19 vaccination clinics.

In turn, MCIC requested capacity-building assistance to provide updated information for their volunteers (AmVAXadors) on vaccine hesitancy, increasing vaccine uptake for parents and children, and COVID-19 tools. The CDC Foundation arranged a learning session with subject matter experts from the Centers for Disease Control and Prevention (CDC). MCIC then invited immunization coalitions from other states to join the event, which was attended by about 90 people.

The one capacity-building assistance request from the AKAs served as a catalyst to reach immunization coalitions nationwide.

Extending the Reach

The CDC Foundation’s capacity-building efforts extend beyond the one-on-one connections with CBOs. For instance, the Foundation hosts a series of national webinars on COVID-related topics such as testing, mitigation strategies, combating misinformation and promoting vaccination confidence and uptake, particularly in communities disproportionately impacted by COVID-19.

On the webinars, national and local experts discuss the latest information, resources and guidelines from CDC as well as emerging news on treatment options and access. The webinars also provide CBOs and their partners an opportunity to share perspectives and galvanize the crucial work they do as trusted influencers in cities, towns and neighborhoods across the country. In post-webinar surveys, nearly 98 percent of respondents, on average, indicated they learned a new concept or information applicable to their work.

The webinars are archived on a CDC Foundation resource page for CBOs. In addition, a monthly newsletter keeps CBOs advised of new information and resources to—as Watkins puts it— “help them do what they need to do” to keep their communities healthy, safe and vibrant.

This article is supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $68,939,536 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS or the U.S. Government.