Implementing validating environmental health monitoring system
The three available tools were developed for, and validated in, high-income settings [17–19, 25, 26].
There has been no tool readily available for use in low- and middle-income countries (LMICs), where contextual issues influencing efforts to implement EBPs might include other aspects than those in high-income settings [28, 29].
The tool was developed in Canada, has been psychometrically tested also in other countries and is presently used in several large studies in high-income settings [20, 25–27].
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) .
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).
evidence, facilitation and context, and the Context Assessment Index  has a stronger focus on the individual health worker.
Thus, the ACT, which has a stronger focus on assessing organizational aspects of context were perceived to be a suitable tool to depart from.
Understanding the socio-political nature of health systems, the organization’s readiness to change and the role of tailored implementation is regarded as a priority field in implementation science, including the need to systematically study the attributes of context influencing this process [9–16].The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge.