Improvement Science

The power of existing interventions is not matched by the power of health systems to deliver them to those in greatest need, in a comprehensive way, and on an adequate scale.

                                                                                                                                                             -- Margaret Chan, Director General, WHO

Despite an abundance of evidence-based guidelines and consensus on what should be done, many simple, high-impact interventions capable of saving lives and alleviating suffering are not reaching the people who most need them.
Model for Improvement

Adapted from Associates in Process Improvement, 1996

Much of this implementation gap is related to weak health systems and processes of care delivery. The USAID ASSIST Project is designed to address this challenge, achieving better health outcomes and strengthening health systems in USAID-assisted countries, through improvement science

Improvement science is the application of scientific methods to make processes and systems work better.  The fundamental concept of improvement science is that improvement requires change. If a system is not changed, it can only be expected to continue to achieve the same results. In order to achieve a different level of performance, changes must be made to that system in ways that permit it to produce better results.

An equally important concept is that while improvement requires change, not every change is an improvement. Because not every change makes care better, changes must be tested and studied to determine whether the change improves care quality.

This section of the ASSIST Knowledge Portal provides information on improvement methods and tools and resources for building capacity for improvement to help you make changes to improve your own system of care.

We also invite you to browse our database of improvement stories or submit your own story of how you have improved care. 



Reflections from Over a Decade of Managing Large, Global, USAID-Funded Quality Improvement Projects

This paper describes the insights and reflections of Dr. M. Rashad Massoud in directing the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project and the USAID Health Care Improvement (HCI) Project. These reflections...

The Next Frontier of Healthcare Quality Improvement: Remaining Gaps and Priorities

This paper is a synthesis of the views of leaders from the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project on where the field of improving healthcare is heading in the coming years. This paper outlines the journey...

USAID ASSIST Project FY20 Annual Performance Monitoring Report

University Research Co., LLC (URC) and its partners have completed almost eight years of implementation of the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project. This report is the 16 th and final Semi-Annual...

Case Book Launch: Improving Health Care in Low-and Middle-Income Countries


Launch of the Open Access Improving Health Care in Low- and Middle-Income Countries: A Case Book

The Critical Role of Quality Improvement in the Era of the SDGs, UHC, and Countries’ Journey to Self-Reliance: Achievements and Learning from the USAID ASSIST Project


This capstone webinar highlighted through presentations, commentary, and facilitated virtual discussions, the key lessons learned and achievements of the USAID ASSIST Project from 2012-2020 (FY13-FY20).

ISQua's Learning about Improvement Community of Practice Webinar (in partnership with University Research Co.)


ISQua's Learning about Improvement Community of Practice (in partnership with University Research Co.) is delighted to host Helen Crisp for her virtual session on 'Learning from Measurements in Improvement'


Effective Leadership for Quality Improvement in Health Care: A Practical Guide

One of the greatest opportunities to improve the quality of health services in low and middle-income countries (LMICs) – and meet global health goals, such as the Sustainable Development Goals (SDGs) and the UNAIDS 95-95-95 goals– is...

Leadership efficace pour l’amélioration de la qualité des soins de santé: Guide pratique

L’une des meilleures opportunités d’améliorer la qualité des services de santé dans les pays à revenu faible etintermédiaire et d’atteindre les objectifs mondiaux en matière de santé, tels que les objectifs de développement durable (ODD)...

Zika webinar series - Why It’s Critical to Strengthen a Public Health Emergency Response with Quality Improvement (QI): What We Learned Implementing QI in the Zika Response


On September 25th, the USAID Zika team in collaboration with GHPoD hosted the first in a webinar series to highlight accomplishments and lessons learned from partners across the response.  There were presentations by Dr. M. Rashad Massoud, Senior Vice President, and Dr. Jorge Hermida, Regional Director for Programs in Latin America and the Caribbean, from the USAID ASSIST project titled Why It’s Critical to Strengthen a Public Health Emergency Response with Quality Improvement (QI): What We Learned Implementing QI in the Zika Response. Dr. Massoud and Dr.

Shushufindi General Hospital at the Forefront of Quality Zika Care in Sucumbios, Ecuador

Team members of the three collaboratives executed with the assistance of the ASSIST- Zika Project working on the continuous improvement of quality Zika health care at Shushufindi General Hospital. “ASSIST’s technical assistance has enabled...