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The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs.A supportive context is considered a key element for successful implementation of evidence-based practices (EBP).Also, similarly to the ACT, we aimed to develop a tool that focused on modifiable aspects of context, i.e. This project was developed within an informal network, which had a focus on implementation research and the ‘know-do-gap’ in relation to the millennium development goals 4–6 .In a network meeting in 2010, a member of the network identified the need for a tool to assess local organizational context in LMICs as context was seen as an important variable influencing the implementation of health interventions.The tool was validated for use amongst physicians, nurse/midwives and community health workers.The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties.The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool.Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries.
The ACT contains eight dimensions measuring (1) leadership, (2) culture, (3) feedback, (4) connection amongst people, (5) formal interactions, (6) informal interactions, (7) structural and electronic resources and (8) organizational slack (sub-divided into staffing, space and time) .
There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs).