To improve access to care and outcomes, the USAID-funded Quality Assurance Project (QAP) and Health Care Improvement Project (HCI) have worked since 2004 in a pilot district (Krasnogvardeisky) of St. Petersburg to develop and then scale up a model for the decentralized delivery of treatment, care and support services to PLWH using the improvement collaborative approach. QAP staff and participating providers first analyzed the system of care for PLWH. The analysis included collection of baseline data and diagramming patient flow through the care process The results were presented to experts and key stakeholders at a planning meeting in 2005.