After the successful implementation of a master plan for diagnostic services involving 100 hospitals in Tanzania five years earlier, AMPC was asked by the Tanzanian Ministry of Health and Social Welfare (MOHSW) to develop a master plan for the referral system in the country. This assignment started in 2007 and covered 37 hospitals: 7 district hospitals, 23 regional hospitals and 3 national referral hospitals. Firstly, AMPC conducted an in-depth analysis of the health needs, demands and supply in Tanzania generally and carried out on-site assessments of the selected 37 hospitals to map the availability and status of infrastructure and equipment. Thereafter, a vision for the for the future operations of the referral system was designed, followed by the definition of the scope of services, including related infrastructural, equipment and HR and training needs, to be provided per hospital depending on its role in the referral system. The content of the Master Plan was then translated into an upgrading plan for each individual hospital, describing the required infrastructural works, the types and quantities of equipment to be procured and the training to be provided to clinical and technical hospital staff. Furthermore, a financial scheme and forecast were developed for the master plan.