The challenges Although there have been improvements in health outcomes globally, 5 million people die each year in low- and middle-income countries (LMIC) due to poor quality health care. These deaths could be avoided in a well-functioning health system that provides safe, effective and quality health care, delivered by a well-trained, skilled and motivated health workforce. Investing in the health workforce is critical to the attainment of the health Sustainable Development Goals (SDGs). Around 80% of the investment required to achieve universal health coverage (UHC) by 2030 is for the education and employment of health personnel. However, the World Health Organisation (WHO) projects a shortfall of 18 million health workers to accelerate UHC by 2030, particularly in low and middle-income countries. This shortfall is further worsened by lack of adequate training and support available to health workers, often leading to the incorrect diagnosis and management of serious conditions. Wider challenges also impact on the quality of healthcare. Inadequate systems and processes for the management of health services, and a lack of investment in leadership and management skills can undermine the quality of care. Our approach A strong health workforce and access to quality care are two vital building blocks required for a strong health system. Our staff and volunteers work alongside African partners to: 1) Strengthen higher education and training for health professionals, by: Strengthening teaching, learning and assessment within Health Education institutes Developing the skills of higher education personnel and the management of institutions Strengthening the governance and management of higher education for health 2) Improve the quality of health services, by: Ensuring that health professionals have the clinical skills and motivation to provide high quality care in a supportive environment. Building the evidence-base and increasing our understanding of the barriers to high quality care and the effectiveness of clinical interventions Improving care pathways across the health system, ensuring that patients are able to navigate and access services, and have their voices heard Developing leadership skills and promoting a culture of transparency and accountability in the management of health services. Our partnerships are jointly led, recognising that our African partners have deep understanding of the context in which they operate. They also have different ways of solving complex health problems in low-resource settings, as well as low-cost solutions from which the UK can learn.