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

URC is 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.

In September 2017, URC was awarded a two-year extension to the USAID ASSIST Project. Under the terms of the extension, the USAID ASSIST Project will operate until September 29, 2019, complete all previously core- and Mission-funded activities, and focus on strengthening maternal, newborn, and child health (MNCH) and family planning/reproductive health services in Zika-affected countries in Latin America and the Caribbean.

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 provided
  • Generating new knowledge to increase the effectiveness and efficiency of applying improvement methods in low- and middle-income countries

During the extension period, ASSIST is applying quality improvement methods to health systems strengthening efforts in Zika-affected countries, including Antigua and Barbuda, Dominica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Jamaica, Nicaragua, Paraguay, Peru, Saint Kitts and Nevis, and Saint Vincent and the Grenadines. Additionally in 2018, ASSIST wrapped up country-level assistance in Cambodia, Indonesia, Kenya, Lesotho, Tanzania, and Uganda.



URC is supporting the institutionalization of improvement methods and pre-service training in HIV and maternal and child services in the medical and nursing schools of six public and private universities. We are assisting in developing the skills of nursing and medical faculty to apply a teaching package for quality care. Finally, we are providing technical assistance to NGOs to improve client-centered care for transgender populations.


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.


Key Activities

USAID ASSIST builds on the work of the USAID Health Care Improvement Project. From 2013 to 2017, ASSIST operated in 38 countries, supporting quality improvement efforts for HIV and AIDS, MNCH, malaria, tuberculosis, orphans and vulnerable children, and non-communicable disease services at both facility and community levels.  During the extension period, ASSIST will continue to carry out functions related to research and evaluation, knowledge management, and global technical leadership not only as related to previous ASSIST work, but also for new Zika activities, to institutionalize the use of improvement methods for stronger health systems.

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


A family from the municipality of Palín in Escuintla, Guatemala whose daughter Dulce was born with congenital Zika syndrome with microcephaly. Credit: Amalia Lima, Director of Health Center in Palín.
A family from the municipality of Palín in Escuintla, Guatemala whose daughter Dulce was born with congenital Zika syndrome with microcephaly. Credit: Amalia Lima, Director of Health Center in Palín.
2012 to 2019
US Agency for International Development (USAID)
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)