Twinning Partnership Network: A Learning and Experience-Sharing Network Among Health Professionals in Rwanda to Improve Health Services

Celestin Gasana; R. Taylor Williamson; Ursin Bayisenge; Jean Claude Rukundo; Modeste Gashayija; Edward Kamuhangire; Corneille Ntihabose; Joy Atwine; Theophile Nsengiyumva; Solange Hakiba; Bienvenu Niyongabo

doi:10.9745/GHSP-D-23-00280

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Rwanda Health System
Source: Rwanda Ministry of Health.

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TABLE 1.

Twinning Partnership Examples

Goal and Description	Outcome
Twinning partnerships among 8 districts in Ethiopia in 2018 to improve performance of district health systems in Ethiopia.¹⁶	High-performing primary health care units saw their mean score rise from 17.96 to 23.32. Woreda management standards improved from 6.42 to 8.15, and model villages increased from 11.58 to 20.85. Overall, district health system performance improved from 50.97 to 72.07.
The Ministry of Health in Tonga and St. John of God Hospital in Ballarat, Australia, had a 25-year twinning partnership that encouraged open discussion and collaboration.¹⁷	Enhanced skills transfer, learning, and improved health care practices.
Twenty-six organizations that focused on HIV support in Canada partnered with HIV projects in several low- and middle-income countries to strengthen capacity of both HIV-focused organizations and projects.¹⁸	Identification of communication and cultural barriers, improved programming, new skills in developing partnership agreements, integration of international perspectives into routine work, and improved information exchange.
ANEMO partnered with the African Palliative Care Association from Uganda to strengthen ANEMO's human and institutional capacity to implement, monitor, and evaluate programs.¹⁹	ANEMO developed a new governance structure, enhanced strategic planning, and improved professional practices. ANEMO also incorporated effective palliative care methods learned from Uganda, which enhanced their ability to manage and sustain HIV programs.

Abbreviation: ANEMO, Associação Nacional dos Enfermeiros de Moçambique.

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TABLE 2.

Key Events in the Twinning Partnership Network Development Process, Rwanda, August 2021–February 2023

Event	Purpose	Participants	No. of events
Co-design	Refine and customize the approach to Rwandan context	MOH, hospitals, DHMTs	2 (1 for DHMTs and 1 for hospitals)
Twinning launch	Launch the partnerships and develop twinning partnership plans for each participating institution	DHMTs, hospitals, MOH, USAID-RIHSA	1 workshop (split into 4 sessions based on the number of participants, 10 DHMTs/hospital per session)
Coaching (both virtual and in person)	Provide coaching and review progress, challenges as well as document best practices and lessons learned	DHMTs and hospital	3 coaching sessions per each member (1 virtual and 2 in-person coaching)
Learning and experience-sharing	Share experience across the wide TPN	MOH, DHMTs and hospitals	4 virtual workshops organized (topics of interest identified by TPN members)
Provincial learning events workshop	DHMTs and hospitals in the same province to meet, learn, and share experience	DHMTs, hospitals, MOH	4 workshops (1 per province)

Abbreviations: DHMT, district health management teams; MOH, Ministry of Health; RIHSA, Rwanda Integrated Health System Activity; TPN, twinning partnership network; USAID, U.S. Agency for International Development.