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This book aims to evaluate the feasibility and effectiveness of a systems-based methodology for engaging frontline staff in safety and quality improvement within an austere medical environment. Study Design: Aligned the study with the Health Sector Quality Improvement Framework and Strategic Plan recommended improvement methodology-the three fundamental questions and the PDSA cycle. Population: targeted over 2,000 frontline providers, core members of both the district and site levels quality improvement teams (mixed naïve and experienced QI staff). Setting: Both public and private; urban and rural health facilities with quality improvement teams, preferably at facilities with high clientele load on average 2-3 sites per the old districts (2006-7). Interventions: Multilevel and innovative strategies and with slots of proved and re-tested best practices. Primary outcome measures and the method of analysis: Aligned with the UNAIDS' three nineties but in the context of the expected possible outcomes of the different technical areas. Applied the tools of quality improvement to explain the registered outcomes.