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

The USAID ASSIST Project provided long- and short-term technical assistance in 46 countries


URC was the lead implementer for the USAID Applying Science to Strengthen and Improve Systems (ASSIST) cooperative agreement of the Office of Health Systems in USAID’s Global Health Bureau.

ASSIST’s mission was to improve healthcare, strengthen health systems, and advance the frontier of improvement science in USAID-assisted countries. URC and its partners achieved these aims by:

  • 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 provided
  • Generating new knowledge to increase the effectiveness and efficiency of applying improvement methods in low- and middle-income countries
  • Strengthening maternal, newborn, and child health (MNCH) and family planning/reproductive health services in Zika-affected countries in Latin America and the Caribbean

USAID ASSIST built on the work of the USAID Health Care Improvement Project. From 2013 to 2020, ASSIST operated in over 40 countries, supporting quality improvement efforts for HIV and AIDS, MNCH, malaria, tuberculosis, Zika, orphans and vulnerable children, and non-communicable disease services at both facility and community levels.

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 achieve better health outcomes, we must change the underlying processes that lead to those outcomes.

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.


Final Report

Country Summaries

25 Essential Resources for Health Care Quality Improvement


2012 to 2020
US Agency for International Development (USAID)
American Academy of Pediatrics (AAP)
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)