Starting in 2010, JSI began exploring applying quality improvement practices and tools to the Reaching Every District strategy, an approach for immunization programs that had been used for years. This report summarized the lessons learned from implenting and scaling-up this novel approach, Reaching Every District using Quality Improvement (RED-QI), in Ethiopia and Uganda. Based on a desk review of program documents and key informant interviews, it documents the processes and steps of how RED-QI was scaled, identifies success factors, and provides lessons that inform how the approach can be tailored in other contexts.