Twinning Partnerships for Improvement

WHO Twinning Partnerships for Improvement (TPI) is an innovative approach utilized for improving different aspects of health service delivery. When people work together, they have more opportunities to learn from each other, this is why TPI values the institution-to-institution partnerships to support long-term efforts on quality of care. This is important in achieving Universal Health Coverage (UHC) and resilient health systems.

TPI is based on a “doing while learning” model in which the collaboration, co-development, and sharing of knowledge are key elements. WHO supports institutions in establishing strong relationships, implement effective improvements and spread the learning across local, regional and national health systems. 

The TPI model is built on a 6-step cycle which begins when two partners agree on the establishment of the partnership. TPI then guides the partners through a systematic process to set the areas for improvement, develop an action plan and then evaluate the activities conducted.

The Twinning partnerships for improvement has three objectives:

The partners are guided through a 6 step cycle:

Step 1-Partnership development begins the formal establishment of a fully functioning, communicative twinning relation between two health institutions. Both arms of the partnership agree to work together to improve the quality of healthcare.

Step 2-Needs assessment allows for baseline needs of the health facility to be identified and understood. This forms the basis for the gap analysis and ultimately, guides all future improvement activities of the partnership.

Step 3-Gap analysis is a review of the needs assessment and identifies key priority areas for action. From the gap analysis, the foundation for action planning is established in a systematic approach in order to help facilitate partners to implement a more focused improvement effort.

Step 4-Action planning brings partners to a jointly agreed written plan of action. This action plan is grounded in the gap analysis and sets clear short-term and long-term targets for the twinning partnership. In this step, it is important to also focus upon communication, spread, and budget.

Step 5-Action is the start of implementing the agreed improvement activities set forth by the action plan. At this time, partners have established and strategized methods of action and have secured communication channels for ongoing partnership action.

Step 6-Evaluation and review enables twinning partnerships to assess the impact of both their technical improvement work and the strength and functioning of their twinning relations. This reflects on the strengths and gaps of the partnerships so that refinements can be made.