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In an increasingly complex, rapidly changing world with a growing inequality gap, capacity building (CB) could function as an essential instrument for improving population health in a resilient and sustainable way. The PH community has been engaged in CB for decades, but there is little empirical evidence about the effectiveness of the efforts. Most evaluations focus on the individual level disregarding the complex, dynamic and multidimensional nature of CB. The aim is to provide an overview of CONFIDE’s 4-level evaluation framework - individual, organizational, network and system - and to share the findings and learning from the first 18 project months. The progress A participatory, multilevel evaluation approach is used in CONFIDE. Existing evaluation models/tools, adapted to the project needs, are used to evaluate the interventions; Kirkpatrick’s 4-level model guides the assessment of the training program’s effectiveness and impact, social network analysis for the networking interventions and organizational capacity and sustainability tools to evaluate the performance of the C4EHPs. Data collection has been conducted via surveys and document reviews at multiple time points. The preliminary findings show that, on the individual level, the trainees perceived increased knowledge and skills in the three PH fields. On the organizational level, human resources to deliver PH-related training in the participating Tunisian universities have been developed. On the network level, challenges have been encountered in building partnerships beyond the medical field. On the system level, significant delays have occurred in the establishment of the C4EHPs mainly due to the centralized administrative processes in Tunisia. Conclusions While the project’s CB process is still at an early phase, the current findings indicate that the diversity of the activities used has contributed positively to the enhancement of the beneficiaries’ existing capacities in PH.

How does capacity building in public health work? Insights from the midterm evaluation of the CONFIDE project