USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project | Global

URC is the lead implementer for this five-year project of the Office of Health Systems in USAID’s Global Health Bureau. ASSIST’s mission is to improve healthcare, strengthen health systems, and advance the frontier of improvement science in USAID-assisted countries. To achieve these aims, URC and its partners are:

  • Fostering improvements in a range of healthcare processes through the application of modern improvement methods by host-country providers and managers
  • Building the capacity of host-country systems to improve the effectiveness, efficiency, client-centeredness, safety, accessibility, and equity of the healthcare services they provide
  • Generating new knowledge to increase the effectiveness and efficiency of applying improvement methods in low- and middle-income countries.

USAID ASSIST works in more than 20 countries across the globe.

About Improvement Science

The science underlying modern improvement is grounded in a “systems understanding,” drawing on psychology, organizational behavior, adult learning principles, and the statistical analysis of variation. The fundamental concept underlying all improvement is that “every system is perfectly designed to achieve exactly the results it achieves” (Paul Batalden, MD). To make any system perform better, we must change the system.

Improvement requires changes in the way we work, but not every change results in improvement. To ensure that changes improve the system’s performance, testing is required, as is measurement of results. 

Applying improvement science at country level

USAID ASSIST builds the capacity of host-country implementers to apply improvement science to healthcare and other services for vulnerable populations, applying the following core principles:

  • The work of delivering healthcare happens in processes and systems. Understanding them and changing them to produce better results is at the heart of improving healthcare.
  • Working in teams of different providers involved in delivering care is the key to making changes work and fostering ownership of those changes to enhance sustainability.
  • Testing changes to determine whether they yield the desired results is at the heart of improvement. Data are used to analyze processes, identify problems, and determine whether changes have resulted in improvement and how to react.
  • Improving care also means meeting the needs and expectations of patients, clients, and communities.
  • Shared learning—in which multiple teams work toward common aims and exchange information on what works, what does not, how it worked, and why—is an essential part of improvement, producing better and faster results.

Key Activities

USAID ASSIST builds on the work of the USAID Health Care Improvement Project, addressing the following services and service delivery issues:

  • Care and support for vulnerable children and families
  • Community-based care and linkages with facility services
  • Gender issues in health care delivery
  • Health workforce performance
  • HIV prevention, care, and treatment
  • Maternal, newborn, and child health
  • Care for noncommunicable diseases and chronic conditions
  • Nutrition assessment, counseling, and support
  • Reproductive health and family planning
  • Tuberculosis, malaria, and other infectious diseases

Learn more at the project website and follow @USAIDASSIST on Twitter.

Quality improvement team members from site in Uganda preparing their presentation at a learning session for safe male circumcision sites. Photograph by Angella Kigonya, URC (2013)
Quality improvement team members from site in Uganda preparing their presentation at a learning session for safe male circumcision sites. Photograph by Angella Kigonya, URC (2013)
2012 to present
US Agency for International Development (USAID), Bureau for Global Health, Office of Health Systems
EnCompass, LLC
FHI 360
Harvard T.F. Chan School of Public Health
HEALTHQUAL International
Initiatives, Inc.
Institute for Healthcare Improvement (IHI)
Johns Hopkins Center for Communication Programs
World Health Organization (WHO)
Regions/ Countries 
Geographic Scope