The project is to provide support to the Ministry of Public Health of the Republic of Ecuador in the improvement and strengthening of the management of eleven hospitals. It affects those factors of the organization and functioning hospital that impact on the quality of patient care and perceived by this, in the satisfaction of the expectations of users, in the motivation of the professionals and on the image of the health services to the public opinion. Re-define the processes clinico-hospital administrative related to patient care and management on health-care resources (waiting lists, allocation of beds, use operating theaters and clinics, etc). It also provides support in the implementation of actions to improve short-term, giving priorities to those high-impact, low-cost, that contribute most to increase the positive perception that citizens have health services. The project will train in a practical way to the heads of the hospitals and their teams, as well as for the managers of the Ministry of Public Health, transferring skills and abilities, in the use of tools and instruments for management with special emphasis on the component of the perceived quality and the perception that the public has toward services provided by the Institution. A plan of internal and external communication facilitate the dissemination and mainstreaming of the measures taken, as well as the monitoring and evaluation of the achievements made with them.