This brief outlines a set of critical shifts for a reimagined approach to technical assistance (TA) that enable strengthened capacity of country institutions to lead their health agenda and deliver better health outcomes. A JSI-led and Bill & Melinda Gates Foundation (BMGF)-funded, two-phase project inspired the need to reimagine models for delivering TA. During phase 1 (2018–2020), JSI and Sonder Design, a human-centered design (HCD) firm, in partnership with the ministries of health in the DRC and Nigeria facilitated TA actors to co-create the critical shifts. In phase 2 (2020-2021) the Inter-agency Working group (IAWG) for capacity strengthening, comprising BMGF, USAID, and the World Bank, with facilitation from JSI and Global Changelabs, further refined and validated the critical shifts. In this phase, the critical shifts were updated to elevate the focus on capacity strengthening and add key shifts related to power and gender, through a co-creation process with the IAWG and representatives across 13 countries.