Improving Performance Together: Twinning Partnership Between Medium and Low Performer Districts in Ethiopia

Mesele Damte Argaw 1 , 2 , Binyam Fekadu Desta 1 , 2 , Melkamu Getu Abebe 1 , Elias Mamo 1 , Tesfaye Gebru 1 , Wubishet Kebede Heyi 1 , Chala Gela 1 , and Temesgen Ayehu Bele 3
  • 1 USAID Transform: Primary Health Care, JSI Research & Training Institutes, , Ethiopia
  • 2 University of South Africa (UNISA), , Pretoria, South Africa
  • 3 Federal Ministry of Health (FMOH), Health Extension Program and Primary Health Care Services Directorate, , Ethiopia


This article describes the United States Agency for International Development Transform: Primary Health Care Activity supported a twinning partnership strategy, which was implemented between districts (woredas) in the different performance categories. This study presents the details of the partnership and the result observed in health systems strengthening in Ethiopia. The twinning partnership strategy was implemented with six steps. The established relationship helps the health systems to build the skill and capacities of the health workforce at primary healthcare entities. Both partner woredas improved their performances through the established win-win relationship and institutionalized the characteristics of a learning organization.

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