ZHI uses a quality improvement (QI) approach and adopted the FHI-360 Total Quality Leadership and Accountability (TQLA) model as its data-driven models for adaptive management and stakeholder engagement. The “Situation Room” concept, which is a key TQLA feature, ensures daily and weekly meetings with implementation staff and local stakeholders to review localized data, identify gaps and/or bottlenecks, brainstorm on solutions, identify areas for collaboration or redoubled focus, and maximize program results. This data-driven adaptive management model promotes achievement of sustainable results. In order to incentivize supported districts to assume greater responsibility and systematically transfer knowledge and capacities for sustainability, a TQLA graduation approach is developed with local stakeholders that 1) establishes milestones for key technical, financial, and institutional capacities; 2) creates local agreements on how to build capacity through TQLA; 3) routinely monitors and scores implementation; 4) graduates districts that consistently meet score thresholds for a minimum of six months; and 5) supports districts as they assume primary responsibility to maintain reach, quality, efficiency, and effectiveness of program services.