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Publication Years
704
2959
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Category
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Toolboxes
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1
Third edition.
The main changes within the third edition of the JEE tool include the split of the technical area National legislation, policy, and financing into two technical areas (Legal instruments and Financing); the drop of the technical area previously titled Reporting and the move of indicat
...
ors to the technical area IHR coordination, National IHR Focal Point and advocacy; and the merging of two previous technical areas (Emergency preparedness and Emergency operations centre) into a single one named Health emergency management.
more
The Capacity Project worked to strengthen HRIS in several low-resource countries to assist decision-makers and human resources managers in identifying and responding to critical gaps in HRH. The findings and recommendations in this report cover the Capacity Project’s implementation of HRIS in Swaz
...
iland, Rwanda and Uganda.
more
Child friendly spaces (CFS) are safe spaces where
communities create nurturing environments in which
children can access free and structured play and
learning activities. CFS, also commonly referred to
as Child Centred Spaces or Safe Spaces for Children,
may provide educational and psychosocial
...
support
and other activities that restore a sense of normality
and continuity for children whose lives have been
disrupted by war, natural disaster or other emergency
situations.
more
Kenya Signature Programme Endline Evaluation Report: Bungoma, Busia and WajirCounties.
Obare F., Abuya T., Mukisa S., Odwe G., Kanyuuru L., Cassar C., Mohamed H.
Population Council and Save the Children
(2018)
CC
CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent complications, caring for newborns and their mothers at
...
home immediately after discharge from health care centers. CHW upskilling training on maternal-newborn services should be prioritized in the most affected areas.
more
This project aimed to reduce the risk of vector-borne infection with Chagas disease by
controlling triatomine bugs, the vectors transmitting the parasite of Chagas disease, and
establishing an epidemiological surveillance system with community participation.
Assessing changes in HIV-related legal and policy environments: Lessons learned from a multi-country evaluation
L. Ferguson; A. Nicholson; I. Henry; et al.
PLOS One; US National Library of Medicine National Institutes of Health (PMC); NCBI
(2018)
CC
PLOS ONE | https://doi.org/10.1371/journal.pone.0192765 February 23, 2018
The Middle East Program for Youth in Crisis at the Harvard Humanitarian Initiative
Brett D. Nelson, Maya Fehling, Margaret E. Tierna, Zina Maan Jarrah
Harvard Humanitarian Initiative
(2015)
Examining the needs of at‐risk youth in the Middle East and North Africa: A multi‐method landscape analysis and systematic literature review
The Good Enough Guide
recommended
A set of basic guidelines on how to be accountable to local people and measure program impact in emergency situations. The "good enough" approach emphasizes simple and practical solutions and encourages the user to choose tools that are safe, quick,
...
and easy to implement
more
Early-warning indicators to prevent stock-outs and overstocking of antiretroviral, antituberculosis and antimalaria medicines.
The NACS User’s Guide is a series of modules that provide program managers and implementers with a package of essential information and resources. These modules are living documents and will be updated as appropriate when new evidence, guidelines,
...
or field experience emerges. Additional modules are slated to be released on such topics as nutrition support, monitoring and reporting, tools, and service implementation. Readers are invited to submit comments and suggestions for improving or updating the guidance.
more
International Journal of Mental Health Systems2011,5:17http://www.ijmhs.com/content/5/1/17
Philippines: National tuberculosis control program laboratory network strategic plan 2013-2016
Noel G. Macalalad, Ma. Cecilia G. Ama, Arthur B. Lagos et al.
Research Institute for Tropical Medicine National Tuberculosis Reference Laboratory
(2013)
C1
The SPPCHS project worked with the Ministry of Home Affairs to design a peer education program for prisons to provide knowledge, skills, and tools to prevent and respond to tuberculosis (TB) and HIV in prisons. AIDSFree held two training of trainers
...
(TOT) in Dodoma to train 55 prison officers from 26 prison facilities to train prison staff and inmates on the new peer education program.
more
Accessed November 2017.
This external performance evaluation of the Malawi Girls’ Empowerment through Education and Health Activity (ASPIRE), conducted 2.5 years after ASPIRE began, establishes the activity’s progress against its objectives, proposes adaptations for th
...
e final year, and captures lessons for application in future girls’ empowerment, health, and education programming in Malawi.
more
National Tuberculosis Control Program; Mycobacterial Disease Control National AIDS/STD Program
Antimicrobial resistance (AMR) is a major public health challenge, which is recognized as high priority area by the Government of India. The increasing consumption of antibiotics is one of the key drivers of antimicrobial resistance seen in bugs of public health importance. Irrational prescription o
...
f broad-spectrum antibiotics, poor regulations around sale of antibiotics, self-medication, lack of education and awareness regarding responsible use of antibiotics have been identified as some of the key factors driving antimicrobial resistance in our country. The ‘National Health Policy’ (2017), addresses antimicrobial resistance as one of the key issues and prioritises development of guidelines regarding antibiotic use, limiting the over-the-counter use of antibiotics, restricting the use of antibiotics as growth promoters in livestock, and pharmaco-vigilance including prescription audit inclusive of antibiotic usage in the hospital and community.
more
Healthy Activity Program
A. Anand; N. Chowdhary, S.Dimidji and V. Patel
Sangath; London School of Hygiene & Tropical Medicine
(2013)
CC
The Healthy Activity Program manual aims at providing counsellors like you with information about counselling patients with moderate to severe Depression in primary care settings.
PEPFAR Asia Regional Program
The United States President's Emergency Plan For Aids Relief
(2016)
C2
Regional Operational Plan 2016 FY17 Strategic Direction Summary
2 May 2016
Ukraine HIV Program Efficiency Study: Can Ukraine improve value for money in HIV service delivery?
International Bank for Reconstruction and Development The World Bank
(2019)
C2
Accessed: 04.10.2019
The data collection process was organized by UCDC Director, Natalia Nizova, and M&E Department Head, Igor Kuzin, and implemented by M&E specialists from oblast AIDS Centers: Zhanna Antonenko, Oksana Gorbachuk, Volodymyr Zahorovskyi (Kiev City); Anna Lopatenko, Irina Kozina, I
...
ryna Chukhalova, (Dnipropetrovsk); Galina Vysotskaja, Iryna Petrovska, Oleksandr Guzieiev (Mykolayiv). Qualitative data collection as well as a desk review was done by the WB’s local consultants Anna Shapoval, Olesia Trofymenko, Anna Pisotska and Elena Dzyuba.
The report was prepared by a World Bank Task Team led by Iris Semini (seconded to the World Bank until July 2013, and now back with UNAIDS), and concluded by Emiko Masaki and Marelize Görgens (World Bank), with support and guidance provided by Daniel Dulitzky, Paolo Belli, Alejandro Cedeno, Alona Goroshko and Lombe Kasonde. Administrative support was provided by Anna Goodman, Mario Mendez and Uma Balasubramanian. When draft results were ready, an in-country workshop was held where stakeholders provided their inputs. Once a draft report was produced, written comments were received from World Bank colleagues, Son Nam Nguyen, Rosemary Sunkutu and Alona Goroshko.
more
Toolkit for monitoring and evaluation of interventions for sex workers
World Health Organization (South East Asia Region; Western Pacific Region)
(2009)
C_WHO
HIV testing in Europe - Evaluation of the impact of the ECDC guidance on HIV testing: increasing uptake and effectiveness in the European Union
European Centre for Disease Prevention and Control (ECDC)
European Centre for Disease Prevention and Control (ECDC)
(2016)
C2
Technical Report
Naicker et al. BMC Palliative Care (2016) 15:41 DOI 10.1186/s12904-016-0114-7
Closing the immunisation gap in Ethiopia: a formative evaluation of ‘The Fifth Child Project’
Shiferaw Dechasa Demissie, et al.
International Rescue Committee, London School of Hygiene & Tropical Medicine, Assosa Referral Hospital
(2019)
C1
This toolkit was developed by the Centers for Disease Control and Prevention (CDC) Division for Heart Disease and Stroke Prevention (DHDSP) to provide healthcare organizations, including those in resource-constrained settings, with the information and resources to implement the HMP and improve hyper
...
tension control among their patients. CDC DHDSP developed an online toolkit that consists of interactive e-learning modules that are designed to guide learners through the key features of the ten HMP components and prepare them for implementation at their health system. The online e-learning modules are accompanied by a PDF toolkit document that can be used as an additional resource for users.
The purposes of this toolkit and the associated online e-learning modules are to provide healthcare organizations:
An overview of the HMP, its ten core components, and suggestions for implementing the HMP in clinical settings.
Guidance to staff, administrators, and other healthcare professionals on how to implement and adapt the HMP for their unique clinical setting.
The online e-learning modules you can find here:
https://www.cdc.gov/dhdsp/pubs/toolkits/hmp-toolkit/index.htm
accessed 29.07.2021
more
The Community Health Systems (CHS) Catalog is a resource that provides information on community health program workers, and interventions for the 25 countries deemed priority by USAID’s Of of Population and Reproductive Health. It comprises a com
...
pilation of 25 country profiles developed from a desk review of community health policies, strategies, a related documentation.
This document summarizes country trends drawn from the CHS Catalog and highlights interesting and relevant findings
about the global community health policy landscape.
more
Biosafety involves the implementation of containment principles, technologies and practices to prevent unintentional exposure to biological agents. Biosecurity involves the protection, control and accountability of biological materials and information related to these materials and dualuse research,
...
to prevent their unauthorized access, loss, theft, misuse, diversion or intentional release.
more
At the global, national, and regional levels, there are several guidelines and guides regarding the preparedness, prevention, surveillance, and control of diseases caused by respiratory viruses; most initiatives focus on specific virus events or cases. During the coronavirus disease 2019 (COVID-19)
...
pandemic, it has been found that even when there are strategies designed and planned for pandemics, it is necessary to strengthen and improve them. Planning for imminent threats, including those posed by respiratory viruses, contributes to strengthening the core capacities of the International Health Regulations (IHR [2005])
more
Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study
Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al.
BMC Health Services Research, part of Springer Nature
(2023)
CC2
Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th
...
e implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
more
The Boston Medical Center Patient Navigation Toolkit
The Boston Medical Center AVON Foundation for Women
The Boston Medical Center AVON Foundation for Women
(2020)
C1
This toolkit is designed to help you plan and implement a Patient Navigation program with the best chance of reducing health disparities and improving health outcomes for your patients. It contains evidence-based and experience-based examples, case
...
studies, practical tools, and resources to help you:
1. Establish an evidence-based patient navigation program tailored to reduce barriers for your patients
2. Incorporate best practices to enhance current patient navigation programs or services
3. Implement a patient navigation model to address any targeted medical condition
where disparities exist
4. Hire, prepare, supervise, support and retain effective Patient Navigators
5. Navigate patients who experience health disparities
6. Evaluate patient navigation programs with the aim of continuous quality
improvement
more
Using Theory of Change in the development, implementation and evaluation of complex health interventions. A practical guide
Mary De Silva, Lucy Lee& Grace Ryan
The Centre for Global Mental Health &the Mental Health Innovation Network
(2015)
C1
This guide provides a practical overview of the process of developing a Theory of Change, focusing on using a stakeholder-driven, workshop approach to achieve this.
PLoSONE 12(9):e0184986.https://doi.org/10.1371/journal.pone.0184986
Effectiveness of Education and an Antibiotic-Control Program in a Tertiary Care Hospital in Thailand
Overuse of antimicrobial agents occurs globally in both community and hospital settings. Misuse of antibiotics can lead to a variety of adverse outcomes, including the development of antimicrobial resistanceand increased cost of hospitalization. This issuehas been particularly problematic in de
...
veloping countries, where antibiotic-management programs rarely exist and where antibiotics can be purchased without aprescription. In Thailand, the rate of antibiotic resistance among gram-positive and gram-negative or-ganisms has increased significantly over the past decade. These findings provide compelling evidence ofthe need for more-rational use of antimicrobial agents in Thailand.
Clinical Infectious Diseases2006; 42:768–752006 by the Infectious Diseases Society of America.
more
Action Plan for Implementation of Recommendations from the Evaluation of PAHO's Response to COVID-19
An external team evaluated PAHO’s response to COVID-19 to provide an independent assessment of the Pan American Sanitary Bureau’s (PASB) performance regarding preparedness for and response to the COVID-19 pandemic. The evaluations’ final report culminates with eight recommendations for actions
...
to future response to health emergencies. The final report of EPRC culminates with eight evidence-based recommendations of actions to strengthen future pandemic responses, while building a resilient recovery in the Region. The recommendations by the external team focus on PAHO’s governance and management, on specialized regional mechanisms, diversified funding models, and use of new technologies, among others.
more
The Haiti Earthquake and Cholera Emergency appeal (MDRHT018) was implemented by the International Federation of Red Cross and Red Crescent Societies (IFRC) in collaboration with the Haitian Red Cross Society (HRCS) following the devastating earthquake on 14 August 2021, and the cholera outbreak on 2
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October 2022.
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Capacity Needs Assessment for Pharmaceutical Services for the ART Program in Lesotho
Wang, S., N. Hoohlo, I. Tshabalala, K. Ntoi, and T. Sepetla
Arlington, VA: Management Sciences for Health
(2013)
C2
Submitted to the US Agency for International Development by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program.
LESOTHO COPDAM BASELINE STUDY 2013
The five hepatitis viruses have different epidemiological profiles, and their impact, duration, and transmission route also vary. The most common transmission routes contributing to the spread of hepatitis are exposure to infected blood via blood transfusion or unsafe injection practices, consumptio
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n of contaminated food and drinking water, and transmission from mother to child during pregnancy and delivery. Also, unsafe injection practices, including the use of unsterile needles and syringes, serve as a major pathway for the spread of hepatitis B and C, and reducing transmission of both diseases requires addressing these practices.
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The COVID-19 Strategic Preparedness and Response Plan (SPRP) 2021 Monitoring and Evaluation Framework tracks global progress against the COVID-19 SPRP 2021 for the ten pillars of the public health response. The operational intelligence complements t
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he epidemiologic information used to drive a global dynamic system of support and response. Monitoring SPRP 2021 implementation will support countries, partners and WHO in strategic thinking, operational tracking and course correction based on evidence and transparency to strengthen the response to COVID-19.
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As the global community aims to fulfill its commitments to the UN Sustainable Development Goals, and the achievement of universal health coverage, dozens of countries have committed to the expansion of community health workers (CHWs) as the front line of their healthcare systems [1, 2]. Robust resea
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rch demonstrates CHWs improve access to care, reduce maternal, newborn, and child mortality, improve clinical outcomes for chronic diseases, and prevent disease outbreaks [3].
To support the operationalization of quality CHW program design and implementation, USAID, UNICEF, the Community Health Impact Coalition, and Initiatives Inc. have updated and adapted the Community Health Worker Assessment and Improvement Matrix (CHW AIM) Program Functionality Matrix [12]. This tool can be used to identify design and implementation gaps in both small- and national-scale CHW programs, and close gaps in policy and practice.
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Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is
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intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
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3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe asthma phenotypes in relation to genetics, natural history, pathobiology and physiology, as well as sections on
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evaluation and treatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice.
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The Government of Malawi’s Health Sector Strategic Plan II highlights the importance of service integration; however, in practice, this has not been fully realized. We conducted a mixed methods evaluation of efforts to systematically implement int
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egrated family planning and immunization services in all health facilities and associated community sites in Ntchisi and Dowa districts during June 2016–September 2017. Methods included secondary analysis of service statistics (pre- and postintervention), focus group discussions with mothers and fathers of children under age one, and in-depth interviews with service providers, supervisors, and managers. Results indicate statistically significant increases in family planning users and shifts in use of family planning services from health facilities to community sites. The intervention had no effect on immunization doses administered or dropout rates. According to mothers and fathers, benefits of service integration included time savings, convenience, and improved understanding of services. Provision and use of integrated services were affected by availability of human resources and commodities, community linkages, data collection procedures and availability, sociocultural barriers, organization of services, and supervision and commitment of health surveillance assistants. The integration approach was perceived to be feasible and beneficial by clients and providers.
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Essential for Excellence. Research, Monitoring and Evaluation Strategic Communication for Behaviour and Social Change
UNICEF
(2008)
with special reference to prevention and control of avian influenza
The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda’s 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In p
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roject districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates.
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This report investigates the impact of potential misclassification of samples on HIV prevalence estimates for 23 surveys conducted from 2010-2014. In addition to visual inspection of laboratory results, we examined how accounting for potential misclassification of HIV status through Bayesian latent
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class models affected the prevalence estimates. Two types of Bayesian models were specified: a model that only uses the individual dichotomous test results and a continuous model that uses the quantitative information of the EIA (i.e., the signal-to-cutoff values). Overall, we found that adjusted prevalence estimates matched the surveys’ original results, with overlapping uncertainty intervals. This suggested that misclassification of HIV status should not affect the prevalence estimates in most surveys. However, our analyses suggested that two surveys may be problematic. The prevalence could have been overestimated in the Uganda AIDS Indicator Survey 2011 and the Zambia Demographic and Health Survey 2013-14, although the magnitude of overestimation remains difficult to ascertain. Interpreting results from the Uganda survey is difficult because of the lack of internal quality control and potential violation of the multivariate normality assumption of the continuous Bayesian latent class model. In conclusion, despite the limitations of our latent class models, our analyses suggest that prevalence estimates from most of the surveys reviewed are not affected by sample misclassification.
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Dziva Chikwari et al. Implementation Science (2018) 13:70 https://doi.org/10.1186/s13012-018-0762-5
The Federal Ministry of Health (FMOH) has been coordinating sector wide reforms that aim to improve equity and quality of maternal and child health services. As part of these efforts, the ministry is also exerting concerted efforts to improve availability and use of quality
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RMNCH pharmaceuticals. Management of RMNCH pharmaceuticals has had significant challenges such as poor availability of essential pharmaceuticals and wastages of valuable resources as pharmacy professionals were not demonstrating the required knowledge, skill and attitude towards availing the pharmaceuticals and ensuring their rational medicine use.
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The evaluation covers the period January 2020 to August 2023. The geographical scope of the evaluation has involved the three levels of WHO (global, regional and country levels) and external key par
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tners. The programmatic evaluation scope was concerned with assessing the SP-PHC in the following areas/evaluation criteria: relevance, coherence, effectiveness, efficiency, added value, sustainability and equity, gender and human rights considerations. The evaluation did not assess the Universal Health Coverage Partnership (UHC-P) as it has its own separate governing body and reviews/evaluations, but instead considered how the SP-PHC had enhanced the value of the UHC-P and vice versa. The resilience and essential public health functions (REPHF) team and Systems’ Governance and Stewardship (SGS) were also not within the scope of this evaluation. However, these workstreams were considered in the wider conclusions and recommendations for the SP-PHC, as appropriate. Finally, the evaluation was focused on the SP-PHC; its scope did not include assessing the configuration and capacity of WHO’s departments and functions as they relate to UHC and health systems.
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Training materials for healthcare workers
Relevance and effectiveness of World Bank support for public sector capacity building in Sub-Saharan Africa from 1995 to 2004. Benin is part of a six country case study.
MEASURE Evaluation PRH Working Paper Series
Document on key points needed to design, manage, deliver and evaluate training
You can also find a spanish and french version here: http://reprolineplus.org/resources/training-works-what-you-need-know-about-managing-designing-delivering-and-evaluating-group
Guidelines on Community DOTS Implementation
recommended
Financing Global Health 2018: Countries and Programs in Transition
Institute for Health Metrics and Evaluation (IHME)
Institute for Health Metrics and Evaluation (IHME)
(2019)
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This 10th edition of the Institute for Health Metrics and Evaluation’s annual Financing Global Health report provides the most up-to-date estimates of development assistance for health, domestic spending on health, health spending on two key infec
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tious diseases – malaria and HIV/AIDS – and future scenarios of health spending. Several transitions in global health financing inform this report: the influence of economic development on the composition of health spending; the emergence of other sources of development assistance funds and initiatives; and the increased availability of disease-specific funding data for the global health community. For funders and policymakers with sights on achieving 2030 global health goals, these estimates are of critical importance. They can be used for identifying funding gaps, evaluating the allocation of scarce resources, and comparing funding across time and countries.
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This guide assumes the reader already has a general understanding of the Care Group methodology. It is highly recommended that all Care Group implementers familiarize themselves with the contents of theCare Groups: A Training Manual for Program Desi
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gn and Implementation,and, ideally,to participate in an in-person training on Care Groups, before commencing Care Group activities. This guide is meant to serve as a companion to the Care Group Training Manual; and additional details on all topics covered in this guide are provided in the Training Manual. This guide may also be used by program evaluators, as a means to assess the extent to which Care Groups were implemented in accordance with theevidence-based model and their potential contribution to program outcomes.
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This analysis focused on the chronic form of HAT caused by T. b. gambiense, as it contributes to the majority of disease burden. Information from the literature review,
product development landscape, and stakeholder interviews was compiled to:
- Identify use cases and understand current diagnosti
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c practices and tools associated with each use case.
- Analyze progress toward robust diagnostics for HAT across different biomarkers.
- Develop recommendations for steps to improve the availability, access, and adoption of HAT diagnostic tools.
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