USAID/Uganda’s Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN) activity supports Uganda’s Ministry of Health (MOH) to strengthen quality and comprehensive HIV/AIDS care, prevention, laboratory and tuberculosis (TB) services at selected regional referral and district health care facilities in Uganda, as well as build the capacity of the public health system to sustain these services. SUSTAIN is a six­-year USAID­-funded activity launched in 2010 and implemented by University Research Co., LLC (URC). SUSTAIN is one of many PEPFAR-­funded activities to address the HIV/AIDS epidemic in Uganda. The main objective of the SUSTAIN program evaluation was to examine the activity’s methodology for achieving its objectives in order to inform future USAID design work. USAID noted that URC had performed well on SUSTAIN, as evidenced by its activity reports, but wanted an evaluation of the approach used by SUSTAIN to inform future program designs. SUSTAIN implementation adapted to contextual changes in the Government of Uganda's (GoU) HIV/AIDS strategy responding to a spike in new infections and people living with HIV, and major shifts in PEPFAR policy.