Quality is a direct outcome of the primary health care principles of equity accessibility cost-effectiveness sustainability and partnership with the community. Therefore quality assurance and improvement in primary health care continues to top the agenda for most countries of the world including those in the WHO Eastern Mediterranean Region. This manual describes the concept and applications of quality in primary health care settings in a simple and user-friendly format. In addition to explaining various quality management models and techniques the manual presents case studies that address the problems regularly faced by health care providers. The manual will assist in identifying and selecting opportunities for improvement and in acting on them to achieve better health outcomes.