Table 3 Recommendations for evaluation of capacity-building interventions suggested by this review

• It would be preferable to implement and evaluate specific interventions in isolation wherever possible, in order to ensure that the impact of individual components of more multifaceted programs can be assessed.

• The use of a systematic evaluation framework incorporating defined process, output and outcome indicators and external reviewers where possible, is recommended.

• It is recommended that intervention programs devise instruments to assess the mental health system strengthening competencies of stakeholders before and after participation.

• Identification of the optimum duration of training for the target group of mental health policy-makers and planners in different LMIC settings is crucial, given the tension between delivering adequate content and feasible roll-out to busy professionals.

• The impact of staff turnover in course leadership positions on the outcome of capacity-building interventions requires further investigation.

• In-depth qualitative evaluation, including use of formal case study methodology, interviews and focus groups with staff who did and did not participate in the intervention, service users, carers and community members may provide valuable insights into mechanisms of impact, but may be more locally relevant.

• Recent proposals that capacity-building interventions should be assessed according to their effect on access to, interaction with and receptivity to research evidence, at the level of the individual, the organization and the institution should be explored with specific reference to mental health policy-makers and planners.