Primary Health Care Performance Management Activity
Primary Health Care Performance Management Activity
Empowering district health leaders to drive measurable, lasting improvements in primary health care
Overview
Strong primary health care (PHC) is the foundation of resilient, equitable health systems. Realizing this vision depends on effective local leadership, particularly at the district level, where policies become services and systems meet communities. District Health Management Teams (DHMTs) are central to this effort. Yet, they often operate with limited access to real-time data, constrained resources, and limited authority to drive sustained performance improvement.
The PHC-PM Activity, funded by the Gates Foundation, works in Ghana and Rwanda to address this gap. The activity supports four DHMTs to lead, measure, and sustain improvements in PHC performance, strengthening systems from the ground up.
Now in its final year, PHC-PM has supported DHMTs in North Tongu and Akuapim South districts in Ghana and Bugesera and Gicumbi districts in Rwanda through multiple implementation cycles, contributing to measurable improvements in key PHC indicators while building lasting leadership and management capacity.
A defining feature of the activity is structured cross-country learning. Ghana and Rwanda exchange strategies and lessons across cycles, accelerating progress in both countries and contributing to a growing evidence base for district-led performance management.
Where we work
PHC-PM Activity operates in:
- Ghana: North Tongu and Akuapim South districts
- Rwanda: Bugesera and Gicumbi districts
Across these settings, district teams are leading their own improvement agendas—demonstrating what locally driven performance management can achieve.
Impact at a Glance
Action plans implemented across four PHC-LDP cycles, each anchored to a locally prioritized Desired Measurable Result spanning skilled delivery, immunization, maternal and child health, service readiness, and health information systems.
Catalytic grant funding provided to districts—modest, flexible resources that enabled DHMTs to translate local priorities and data insights into action, addressing PHC gaps not covered by routine budgets.
Strongly validated positive outcomes identified across Ghana and Rwanda — including improved leadership skills, DHMT efficiency, health worker transportation, and equipment availability at all levels of care.
All four districts improved routine data quality scores — building the evidence base DHMTs need to identify gaps, set priorities, and track progress across PHC improvement cycles.
Our Approach
PHC-PM supports district teams through four integrated components — each reinforcing a continuous cycle of data use, local action, and shared learning.
FROM DATA TO DECISIONS
Data dashboards
Timely, accessible data is essential for managing performance. PHC-PM works with national partners to co-design data dashboards that translate routine health data into actionable insights. These tools enable district leaders to monitor progress, identify gaps, and act between reporting cycles, not after them.
- Ghana: DHIMS2-based dashboards with HISP Ghana
- Rwanda: RHAP-based dashboards with Zenysis
BUILDING THE CAPACITY TO LEAD
PHC Leadership Development Program (PHC-LDP)
Through a structured, experiential process, DHMTs learn to translate data into action and sustain improvement over time. Using the Challenge Model , teams identify a PHC priority challenge, design a locally driven action plan, and implement and monitor progress over a six-month cycle. Ongoing coaching and behavioral self-assessments help teams strengthen leadership practices, collaboration, and accountability.
RESOURCES THAT FOLLOW LOCAL PRIORITIES
Catalytic grant funding
Flexible grant funding enables DHMTs to implement their action plans on their own terms. By placing decision-making authority at the district level, we build both financial management capacity and local ownership, ensuring changes are practical, relevant, and sustainable.
NO DISTRICT IMPROVES ALONE
Continuous learning & MEL
Learning is built into every phase of implementation. Within countries, districts share progress and adapt through regular learning cycles. Across countries, Ghana and Rwanda exchange insights through joint learning events.
These exchanges feed into national workshops and a growing global evidence base on district-led PHC performance improvement.
Project Factsheet
A concise summary of the PHC-PM Activity — what it does, where it works, who it partners with, and what it has achieved.
Leading Voices: MSH’s Colin Gilmartin on Helping Countries Improve Their Primary Health Care Systems
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MEL Lead, PHC Performance Management Activity
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