In 2003–2004, the USAID-funded Quality Assurance Project began supporting health ministries in Nicaragua, Niger, and Tanzania to improve the quality of care for hospitalized children through national Pediatric Hospital Care Improvement (PHI) Collaboratives. The PHI Collaboratives’ purpose was to adapt WHO guidelines for the management of childhood illness to local health care settings and conditions, support the application of the adapted guidelines, and then scale up the lessons learned and improvements.