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In 2011-15, staff from the Department of Health Policy Planning and Management took part in a pilot programme – PERFORM – which aimed to test a problem-based management strengthening intervention (MSI) to improve health systems’ performance. The programme was a success. We found that it strengthened the capacity of district health managers, enabled management teams to solve workforce performance and other problems locally, improved service delivery and helped them become better managers.

PERFORM2Scale expands on that approach, taking the highly effective, management strengthening intervention and up-scaling it for use in other health systems.

Makerere University & London School of Hygiene and Tropical Medicine team

Background to PERFORM2Scale

The current challenge in global health is to achieve Universal Health Coverage by 2030. Having an adequate health workforce is critical to enabling states to achieve that goal, and while efforts are in place to increase the numbers of health workers, improving health workforce performance has been somewhat neglected despite being equally important. It is also very challenging to address. PERFORM2Scale seeks to meet that challenge.

How PERFORM2Scale works

The Makerere team is now one of three from African institutions working in a consortium with European partners to deliver PERFORM2Scale (School of Public Health at the University of Ghana and REACH Trust, Malawi are the other two). We are developing and evaluating a sustainable approach to scaling up the MSI in different and changing contexts. The plan is to increase the number of MSI cycles for each district to deepen their learning and increase the number of participating district teams (so far, Luwero, Nakaseke, Wakiso, Ntoroko, Kabarole and Bunyangabu districts are involved). The scale-up strategy includes working with governments, non-government employers and other stakeholders to develop plans and networks to sustain the implementation and expansion of the MSI at district level. The validated framework and strategy will enable other countries to sustainably improve workforce performance and service delivery at district level.

Fieldwork in Bunyangabo District, Western Uganda

More information

Read our latest briefing paper on our progress as at October 2019.

For up to date information on the progress of PERFORM2Scale in Uganda and across the consortium:

Contact: Adelaine Aryaija-Karemani, Department of Health Policy Planning and Management –

Visit: the PERFORM2Scale website [] and follow the project on twitter [] and Facebook []

Subscribe: to the project newsletter []

PERFORM2Scale has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 733360

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