Perform 2 scale · Project

Proven District-Level Health Management Training Ready to Scale Across Developing Countries

healthPilotedTRL 7Thin data (2/5)

Imagine you're running a chain of clinics across a large rural area, but your local managers have never been trained to actually manage people and solve problems on the ground. This project built a hands-on training program for district health managers in Ghana, Malawi, and Uganda — teaching them to identify workforce problems and fix them locally instead of waiting for orders from the capital. They tested it across 3 countries over 3 years and proved it actually improves how health services are delivered. Think of it as an MBA crash course designed specifically for frontline health managers in Africa.

By the numbers

African countries where the intervention was scaled up (Ghana, Malawi, Uganda)

consortium partners across 7 countries

3 years

duration of the scale-up implementation

2030

target year for Universal Health Coverage achievement

total project deliverables produced

The business problem

What needed solving

Health systems in developing countries lose effectiveness not because of missing doctors or nurses, but because district-level managers lack the skills to organize, motivate, and problem-solve with the workforce they already have. This management gap between national policy and frontline delivery is a major barrier to achieving Universal Health Coverage by 2030. Training programs designed for Western corporate settings do not translate to the realities of under-resourced African health districts.

The solution

What was built

The project produced a validated management strengthening intervention (MSI) for district health teams, a scale-up strategy tested across 3 African countries over 3 years, and process and outcome evaluations documenting what works and what doesn't. A project website was delivered along with 12 total deliverables including the validated scale-up methodology.

Audience

Who needs this

Health consulting firms bidding on USAID, WHO, or World Bank health system strengthening contracts in AfricaInternational NGOs (e.g., MSF, Partners in Health) managing district-level health programsMinistries of Health in sub-Saharan African countries seeking proven management trainingEdTech companies building digital health workforce training platformsBilateral development agencies (DFID, GIZ, NORAD) funding health system programs

Business applications

Who can put this to work

Health consulting and workforce development

mid-size

Target: Consulting firms specializing in health system strengthening in low- and middle-income countries

If you are a health consulting firm bidding on contracts to improve health service delivery in Africa — this project developed a management strengthening intervention tested across 3 countries over 3 years with validated scale-up strategies. Instead of designing training programs from scratch, you can license or adapt a proven approach that already demonstrated effectiveness in Ghana, Malawi, and Uganda.

International development and NGOs

enterprise

Target: Development organizations managing health programs in sub-Saharan Africa

If you are an NGO running health programs and struggling with weak district-level management that undermines your field operations — this project produced a validated scale-up strategy and process evaluation covering 3 African countries. The intervention specifically targets the management gap between national policy and frontline delivery, giving your country teams a ready-made toolkit.

Health technology and e-learning

SME

Target: EdTech companies building training platforms for healthcare workers

If you are a health education technology company looking for evidence-based content to digitize — this project generated a management strengthening curriculum validated with district teams across 3 countries with 8 consortium partners. The structured intervention and evaluation data could form the backbone of a scalable digital training product for health managers.

Frequently asked

Quick answers

What would it cost to implement this management training in our organization?

The project data does not include specific per-unit costs or pricing for the management strengthening intervention. Implementation costs would depend on country context, number of districts, and adaptation needs. Contact the consortium through SciTransfer for a tailored cost discussion.

Can this be scaled beyond the 3 pilot countries?

Yes — that was the explicit purpose of PERFORM2scale. The project developed and validated a scale-up strategy designed for use in the 3 study countries (Ghana, Malawi, Uganda) and explicitly for adaptation elsewhere. The 3-year scale-up process was evaluated for both opportunities and barriers.

Who owns the intellectual property and can we license the methodology?

The consortium of 8 partners across 7 countries developed the intervention, led by Liverpool School of Tropical Medicine. Based on available project data, this is a Research and Innovation Action (RIA) funded under Horizon 2020, so IP arrangements would follow the consortium agreement. Contact the coordinator for licensing details.

Is there evidence this actually improves health service delivery?

The original PERFORM project demonstrated effectiveness in enabling district management teams to solve workforce performance problems locally and improve service delivery. PERFORM2scale then scaled this up across 3 countries over 3 years with both process evaluation and outcome evaluation to validate results.

How long does it take to implement in a new country?

Based on the project design, the scale-up was carried out over 3 years in each country, including capacity development and embedding the process at district level. A new implementation would likely require adaptation to local context before the 3-year rollout.

Does this work with existing government health systems?

The intervention was specifically designed to work with government agencies. In all 3 countries, the scale-up strategy was developed together with government agencies and aimed to embed the process within existing district-level structures rather than creating parallel systems.

Consortium

Who built it

The consortium of 8 partners across 7 countries is entirely academic and research-based, with 5 universities and 3 research organizations — zero industry partners and zero SMEs. This is typical for global health development research but means there is no built-in commercial pathway. Partners span the UK (coordinator: Liverpool School of Tropical Medicine), Netherlands, Switzerland, Ireland, and the 3 target countries (Ghana, Malawi, Uganda). The geographic spread ensures local knowledge in each pilot country, but a business partner looking to commercialize this would need to bring their own distribution and implementation capacity.

LIVERPOOL SCHOOL OF TROPICAL MEDICINECoordinator · UK
HET KONINKLIJK INSTITUUT VOOR DE TROPENparticipant · NL
UNIVERSITY OF GHANAparticipant · GH
THE PROVOST, FELLOWS, FOUNDATION SCHOLARS & THE OTHER MEMBERS OF BOARD, OF THE COLLEGE OF THE HOLY & UNDIVIDED TRINITY OF QUEEN ELIZABETH NEAR DUBLINparticipant · IE
NATIONAL UNIVERSITY OF IRELAND MAYNOOTHparticipant · IE
MAKERERE UNIVERSITYparticipant · UG
SCHWEIZERISCHES TROPEN UND PUBLIC HEALTH INSTITUTparticipant · CH

How to reach the team

Liverpool School of Tropical Medicine, UK — contact through SciTransfer for a warm introduction to the project team

Order a report on this consortium See LIVERPOOL SCHOOL OF TROPICAL MEDICINE profile →

Next steps

Talk to the team behind this work.

Want to implement this proven health management training in your country or organization? SciTransfer can connect you directly with the PERFORM2scale team and help structure a collaboration.

Order a report on this topic More in Health & Biomedical