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This article addresses the questions of why some communities have more ability than others, why some communities are more capable at accessing resources, at influencing decision makers, are better organised and are better able at mobilising themselves towards empowerment. The difference in ability can be attributed to the level of knowledge, skills and competencies or capacity that a community has and which it can draw upon to address its concerns about the lives and health of its members. This article discusses a qualitative tool that has been extensively used in health promotion programmes to build community capacity and empowerment. The article defines the key concepts and unpacks capacity building into nine specific 'domains'. The article goes on to describe how the 'tool' can be implemented by practitioners to build and measure capacity and empowerment. The article provides an actual example from practice on the use of an innovative form of visual representation of the findings of the measurement.

Health promotion often presents a tension between "bottom up" and "top down" programming. "Bottom-up" is associated with community empowerment and begins on issues of concern to particular groups or individuals and regards an increase in overall control as an important element of the health outcome. "Top-down" is associated with disease prevention efforts and begins by seeking to involve beneficiaries on issues defined by health agencies. It regards improvements in health behaviours or bio-medical indicators as the important outcome and community empowerment is viewed simply as a means to the end of health behaviour change. The tension between these two approaches is not unresolvable, and this article presents a framework, the "parallel-track", intended to assist health promotion practitioners to systematically accommodate community empowerment goals within "top-down" health programming.