Tools and Resources:

When dealing with issues related to healthcare delivery, policy, or education, health organizations oftentimes look to the experience of other organizations who have dealt with similar problems. In some cases, health organizations find it useful to work together to pool their experiences and collectively figure out ways to address common problems. When two or more organizations begin formally working together in this way, a "healthcare twinning partnership" is formed.

What Is Twinning?

Twinning provides a flexible framework that helps organizations collaborate to meet common goals and objectives. For example, two organizations can form a twinning partnership in order to:

  • develop or organize a community outreach program or other types of health services
  • design training programs to improve the skills of nurses, social workers, and other care providers
  • share educational and training resources

To meet these objectives, twinning partnerships may involve a number of different types of activities, including:

  • professional travel exchanges of organizational staff
  • delivery of training workshops (on-site or virtual)
  • online collaboration
  • resource sharing

Purpose and Structure of this Toolkit

This toolkit is designed to help organizations establish and manage twinning relationships and to provide a set of tools that can help twinning partners to achieve the best results. Many of the materials included in this toolkit were created by the American International Health Alliance (AIHA). AIHA has over a decade of experience in establishing and managing twinning partnerships through the USAID-funded NIS and CEE Healthcare Partnerships Program and through the HRSA-funded HIV/AIDS Twinning Center, which supports twinning in the area of HIV/AIDS. While these twinning relationships have been supported with funding from the US government, it should be noted that twinning relationships can be established and sustained without donor funding. Even with donor support, most of AIHA's twinning partnerships have involved a significant volunteer-driven component, where each side of the twinning partnership is contributing staff and other resources to support and sustain the relationship.

Based on AIHA's partnership model, the toolkit is organized into six sections, each of which contains forms, templates, and other tools that can be adapted for use by other programs.


In this current, preliminary version of the toolkit, the resources almost exclusively represent AIHA's model of twinning. However, AIHA is planning to enhance this toolkit with additional resources and input from other organizations that support twinning efforts around the world. If you would like to contribute resources or general feedback regarding the future development of this toolkit, please send an e-mail to or send correspondence to:

American International Health Alliance
Twinning Toolkit
1250 Eye St., NW, Suite 350
Washington, DC 20005
Fax: +1 (202) 789-1277

Twinning Partnership Phases:

© 2006 American International Health Alliance