We are working with the Canadian Society of International Health within the ENRICH (Enhancing Nutrition Services to Improve Maternal and Child Health) program on a project titled ‘Health Systems Strengthening - Linking Continuous Quality Improvement and Supportive Supervision and On-Job Training’. The training links leadership, change management and quality improvement, and supportive supervision.  We have adapted the GROW coaching method (Goal, Reality, Options and Way Forward) to the Tanzanian health sector and strengthen skills of District and Regional Health Managers in supportive supervision and leadership through on-job-training.