Strengthening Human And Institutional Capacity: A Program Assessment

Date of Award



© 2017 Emma Kofa Mtiro

Document Type


Degree Name

Doctor of Education (EdD)



First Advisor

Brianna Parsons

Second Advisor

Michael Patrick

Third Advisor

Angela Makota


Shortages of health care workers compromises the ability for health workers to provide care. Rwanda’s priority to increase the production and quality of the health care workforce through multilateral partnerships demonstrates their commitment to achieve positive health outcomes, promote sustainability, and self-sufficiency over time. This descriptive case study documented the impact of institutional capacity developed in Rwanda’s health and education system through the twinning model from 2011 to 2016.

This case study was a desk review of historical data on the twinning initiative between US faculty and their Rwandan counterparts. The coding technique was used to analyze text from historical data - repetition, key words in context, compare and contrast, and connectors to identify codes. The codes were further analyzed through a reiterative process to identify focused codes, subthemes, and overarching themes.

From 33 historical documents, five overarching themes were used to describe the impact of institutional capacity – development, education, systems development positive health outcomes, and barriers to sustainability. The findings revealed that 1.) The twinning model was influential in expanding the health professional programs offered at the College of Medicine and Health Sciences; 2.) The twinning approach improved teaching practices from the College of Medicine and Health Sciences faculty; 3.) The twinning initiative had some positive effect on service delivery practices, which led to improvements in heath policy in select disease focus areas; 4.) The findings revealed mix results in the perception of the impact the twinning initiative had on faculty development at the University of Rwanda College of Medicine and Health Sciences; and 5.) It is too early to determine the impact of the program on the number of highly skilled professionals practicing Rwanda’s health workforce.

The findings from the document review showed that the partnership between US and Rwandan faculty led to increasing the number of health education programs offered at the University’s College of Medicine and Health Sciences. This study illuminated an example of how mutual learning exchanges can influence comprehensive, system-level changes to improve national education policy and build the infrastructure necessary to sustain that practice. This results of this study could be used to strengthen the current SRHC program and to provide a model practice for similar countries looking to increase efficiency of foreign aid and build a sustainable future in health care.


Ed.D. Dissertation

This document is currently not available here.