From 1990–2008, URC and its non-profit affiliate, the Center for Human Services, provided technical assistance and conducted operations research on health care quality improvement to the USAID-funded Quality Assurance Project (QAP). The project, which operated globally, worked to help raise awareness in countries an internationally that quality improvement (QI) is an essential component of health system strengthening and that quality standards and QI capacity development are vital to the development of health care systems in even the most resource-constrained countries. The initiative demonstrated that in developing country settings the improvement collaborative approach could achieve significant results and public health impact in a short period. Through dozens of operations research studies, QAP documented numerous quality problems and approaches to their solutions.