Optimizing Performance and Quality (OPQ) is a stakeholder-driven, cyclical process for analyzing human and organizational performance and setting up interventions to improve performance and quality or build on strengths and successes. It has been used by country leaders in over 15 countries to strengthen health-sector governance through greater accountability and transparency, broadened partnerships, and measurable results in improved service quality. The OPQ process builds capacity within an organization to recognize and address problems or performance gaps on an ongoing basis. Each of the seven stages provides evidence-based guidance and steps to follow, with a suite of tools to help users through the process.