This document summarizes the implementation of the Standards Based Management and Recognition (SBM-R) approach to improve quality of child health services in Guinea and Zimbabwe. Key findings include: 1) SBM-R improved health workers' clinical skills and adherence to performance standards, but longer-term impacts on health outcomes were not measured. 2) Implementation lacked consistency with the SBM-R manual and did not sufficiently address health systems support. 3) Recommendations are to better link implementation strength and duration to results, include outcome measures, and adapt SBM-R for low-volume facilities and client perspectives.