Working and Achieving in Partnership: Demonstration of CLA Approach

During the last few decades, there have been notable improvements in the general health conditions of citizens living in low income countries. Despite this, in some countries, and particularly in Ethiopia, there is still limited access to quality and equity for essential health services. This case presents the performance improvement experiences of the USAID Transform: Primary Health Care Activity, a six-year bilateral project funded by the American people through USAID in preventing child and maternal deaths and enhancing health system resilience thorough culture of collaboration, learning and adaptation for better health outcomes. The Activity has been implementing an innovative performance and quality improvement tool in 106 districts with 53 local twinning partnerships established through collaborating, learning, and adapting (CLA) principles. The twinned districts were categorized under relatively high and low performance statuses and established local partnerships using win-win principles. Through the process of implementation, the Activity aims to enhance the culture of CLA in order to achieve the stringent national criteria for ‘model’ districts. The Activity provides technical assistance including orientations on the process, support on collecting information, and engaging stakeholders, and also extends financial and resource support to the partner districts during the development of a full year twinning partnership project. Districts also receive continuous support to implement, monitor, and apply collaboration, learning, and adaptation cycles. The implementation of CLA approaches help to accelerate the performance of the district heath system in creating model villages, high performing primary health care units, and high performing district management systems.