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. 



Ministerio de Salud de Paraguay Realiza Taller de Sostenibilidad y Transicion

Con la participación del Director del Proyecto ASSIST DE USAID, Dr. Rashad Massoud, el Director Regional del proyecto, Doctor Jorge Hermida y el equipo del proyecto ASSIST de Paraguay, el Ministerio de Salud se reunió para desarrollar un...

The Involvement of Routine Dental Care in Prenatal Care as a Tool for Quality Counseling in the context of Zika in El Salvador

Dr. Lorena Arevalo, dentist UCSFI San Isidro, Cabanas sharing Zika prevention methods with patients during dental treatments UCSFI San Isidro is one of the Health Centers in the north of El Salvador that USAID's Project Applying Science to...

Screening for Microcephaly in Newborns in the Dominican Republic

Screening for Microcephaly in Newborns in the Dominican Republic "We had to reeducate ourselves mentally. Even if people say: ‘there is no Zika’ since in the country the Aedes Aegypti mosquito is endemic, we must continue with prevention...

Improving Care for Children Under Five and Pregnant Women Presenting with Fever in Malawi: Guide to Coaching Quality Improvement Teams

Quality improvement (QI) coaching is an important method to provide ongoing support to help teams of health care workers apply QI approaches in their setting. The purpose of this coaching guide is to support district malaria and/or...

Improving Care for Children Under Five and Pregnant Women Presenting with Fever in Malawi: Reference Sheet for Improvement Indicators

Since March 2018, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project has collaborated with the USAID Organized Network of Services for Everyone (ONSE) Project and ONSE’s supported health facilities to help them...

Improving Quality of Care for Children Under Five and Pregnant Women Presenting with Fever in Malawi Facilitator Guide

The purpose of this guide is to help improvement advisors conduct trainings for district level malaria and/or quality improvement coordinators, health care providers and managers to improve quality of care for children under five years of...