Distinct dimensions of quality vary in importance depending on the context in which quality assurance effort takes place. Working through the process of quality assurance and continuous quality improvement may create an environment for transforming the health services and achieving positive health outcome goals. Substantial improvements have been observed in the coverage and access to health service delivery in Ethiopia. However, the quality of care has been lagging behind. The purpose of this study was to develop guidelines for care to enhance quality health services at Gindabarat District, Oromia Regional State, Ethiopia. The study followed a mixed method approach. The participants were purposively included in the study based on their availability, from a total of 7 government health facilities from the Gindabarat District. Self-administered questionnaires and interviews were used to collect data from samples of 127 health care workers and 29 health facilities managers, respectively. Collected data were analysed using SPSS Version 24 and ATLAS TI 8 respectively. The results revealed barriers towards quality health services delivery which were lack of equipment and supplies (inadequacy of blocks, materials, medical equipment; lack of sustainable supplies of drugs); inadequate human resources (low retention of skilled staff; absence of focal person assigned for quality improvement; shortages of health workers); absence of standard operating procedures (protocols, guidelines and manuals); and dissatisfaction of health care providers with services provided at the District. Based on the results, guidelines were developed to enhance quality health care delivery. The reccommendations were aimed at improvement approaches at all levels of health service delivery. / Health Studies / D.Litt. et Phil. (Health Studies)