Lean Healthcare: Barriers and Enablers in the Colombian Context

Lean philosophy has evolved over time and has been implemented both in manufacturing and services, more recently lean has been integrated in the companies of the health sector. Currently it is important to understand the successful way to implement this philosophy and try to identify barriers and enablers to the sustainability of lean healthcare. The main purpose of this research is to identify the barriers and enablers in the implementation of Lean Healthcare based on case studies of Colombian healthcare centers. In order to do so, we conducted semi-structured interviews based on a maturity model. The main results indicate that the success of Lean implementation depends on its adaptation to contextual factors. In addition, in the Colombian context were identified new factors such as organizational culture, management models, integration of the care and administrative departments and triple helix relationship.

The Management and Funding of Education in Nigeria

This paper looks at the management and funding of education in Nigeria. The concept of management and administration has been concisely defined. Also the historical background of educational management in Nigeria has been discussed alongside the management of primary education, secondary education and tertiary education in Nigeria. Furthermore, the funding of education has also been concisely discussed in this paper alongside the various sources of funds available to education in Nigeria. The sources include government grant, school fees, external aids, school revenue yielding businesses and so on. The budgetary allocation of Nigeria to education from 1999 to 2013 was also highlighted in this in paper and it was discovered that the lowest allocation was in 1999 with 4.46% while the highest allocation was in 2006 with 10.43%. It is also of note that, Nigeria is still yet to meet the recommendation of UNESCO of 26% budgetary allocation to education by developing countries. Recommendations have been drawn that the government should increase budgetary allocation to this sector in a consistent manner because of its importance to the national economy, hoping that with proper monitoring of fund, it would contribute more significantly to the development of the country. An effective utilization of such funds is also advocated for greater achievements. All organs of the government should exhibit good corporate governance and transparency and so on.

Measuring Enterprise Growth: Pitfalls and Implications

Enterprise growth is generally considered as a key driver of competitiveness, employment, economic development and social inclusion. As such, it is perceived to be a highly desirable outcome of entrepreneurship for scholars and decision makers. The huge academic debate resulted in the multitude of theoretical frameworks focused on explaining growth stages, determinants and future prospects. It has been widely accepted that enterprise growth is most likely nonlinear, temporal and related to the variety of factors which reflect the individual, firm, organizational, industry or environmental determinants of growth. However, factors that affect growth are not easily captured, instruments to measure those factors are often arbitrary, causality between variables and growth is elusive, indicating that growth is not easily modeled. Furthermore, in line with heterogeneous nature of the growth phenomenon, there is a vast number of measurement constructs assessing growth which are used interchangeably. Differences among various growth measures, at conceptual as well as at operationalization level, can hinder theory development which emphasizes the need for more empirically robust studies. In line with these highlights, the main purpose of this paper is twofold. Firstly, to compare structure and performance of three growth prediction models based on the main growth measures: Revenues, employment and assets growth. Secondly, to explore the prospects of financial indicators, set as exact, visible, standardized and accessible variables, to serve as determinants of enterprise growth. Finally, to contribute to the understanding of the implications on research results and recommendations for growth caused by different growth measures. The models include a range of financial indicators as lag determinants of the enterprises’ performances during the 2008-2013, extracted from the national register of the financial statements of SMEs in Croatia. The design and testing stage of the modeling used the logistic regression procedures. Findings confirm that growth prediction models based on different measures of growth have different set of predictors. Moreover, the relationship between particular predictors and growth measure is inconsistent, namely the same predictor positively related to one growth measure may exert negative effect on a different growth measure. Overall, financial indicators alone can serve as good proxy of growth and yield adequate predictive power of the models. The paper sheds light on both methodology and conceptual framework of enterprise growth by using a range of variables which serve as a proxy for the multitude of internal and external determinants, but are unlike them, accessible, available, exact and free of perceptual nuances in building up the model. Selection of the growth measure seems to have significant impact on the implications and recommendations related to growth. Furthermore, the paper points out to potential pitfalls of measuring and predicting growth. Overall, the results and the implications of the study are relevant for advancing academic debates on growth-related methodology, and can contribute to evidence-based decisions of policy makers.

The Impact of Regulatory Changes on the Development of Mobile Medical Apps

Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Measurement of Acoustic Loss in Nano-Layered Coating Developed for Thermal Noise Reduction

Structural relaxation processes in optical coatings represent a fundamental limit to the sensitivity of gravitational waves detectors, MEMS, optical metrology and entangled state experiments. To face this problem, many research lines are now active, in particular the characterization of new materials and novel solutions to be employed as coatings in future gravitational wave detectors. Nano-layered coating deposition is among the most promising techniques. We report on the measurement of acoustic loss of nm-layered composites (Ti2O/SiO2), performed with the GeNS nodal suspension, compared with sputtered λ/4 thin films nowadays employed.

Similitude for Thermal Scale-up of a Multiphase Thermolysis Reactor in the Cu-Cl Cycle of a Hydrogen Production

The thermochemical copper-chlorine (Cu-Cl) cycle is considered as a sustainable and efficient technology for a hydrogen production, when linked with clean-energy systems such as nuclear reactors or solar thermal plants. In the Cu-Cl cycle, water is decomposed thermally into hydrogen and oxygen through a series of intermediate reactions. This paper investigates the thermal scale up analysis of the three phase oxygen production reactor in the Cu-Cl cycle, where the reaction is endothermic and the temperature is about 530 oC. The paper focuses on examining the size and number of oxygen reactors required to provide enough heat input for different rates of hydrogen production. The type of the multiphase reactor used in this paper is the continuous stirred tank reactor (CSTR) that is heated by a half pipe jacket. The thermal resistance of each section in the jacketed reactor system is studied to examine its effect on the heat balance of the reactor. It is found that the dominant contribution to the system thermal resistance is from the reactor wall. In the analysis, the Cu-Cl cycle is assumed to be driven by a nuclear reactor where two types of nuclear reactors are examined as the heat source to the oxygen reactor. These types are the CANDU Super Critical Water Reactor (CANDU-SCWR) and High Temperature Gas Reactor (HTGR). It is concluded that a better heat transfer rate has to be provided for CANDU-SCWR by 3-4 times than HTGR. The effect of the reactor aspect ratio is also examined in this paper and is found that increasing the aspect ratio decreases the number of reactors and the rate of decrease in the number of reactors decreases by increasing the aspect ratio. Finally, a comparison between the results of heat balance and existing results of mass balance is performed and is found that the size of the oxygen reactor is dominated by the heat balance rather than the material balance.

Effect of Collector Aspect Ratio on the Thermal Performance of Wavy Finned Absorber Solar Air Heater

A theoretical investigation on the effect of collector aspect ratio on the thermal performance of wavy finned absorber solar air heaters has been performed. For the constant collector area, the various performance parameters have been calculated for plane and wavy finned solar air heaters. It has been found that the performance of wavy finned solar air heater improved with the increase in the collector aspect ratio. The performance of wavy finned solar air heater has been found 30 percent higher than those of plane solar air heater. The obtained results for wavy fin solar air heaters are compared with the available experimental data of most common type solar air heaters.

Feasibility Study of MongoDB and Radio Frequency Identification Technology in Asset Tracking System

Taking into consideration the real time situation specifically the higher academic institutions, small, medium to large companies, public to private sectors and the remaining sectors, do experience the inventory or asset shrinkages due to theft, loss or even inventory tracking errors. This happening is due to a zero or poor security systems and measures being taken and implemented in their organizations. Henceforth, implementing the Radio Frequency Identification (RFID) technology into any manual or existing web-based system or web application can simply deter and will eventually solve certain major issues to serve better data retrieval and data access. Having said, this manual or existing system can be enhanced into a mobile-based system or application. In addition to that, the availability of internet connections can aid better services of the system. Such involvement of various technologies resulting various privileges to individuals or organizations in terms of accessibility, availability, mobility, efficiency, effectiveness, real-time information and also security. This paper will look deeper into the integration of mobile devices with RFID technologies with the purpose of asset tracking and control. Next, it is to be followed by the development and utilization of MongoDB as the main database to store data and its association with RFID technology. Finally, the development of a web based system which can be viewed in a mobile based formation with the aid of Hypertext Preprocessor (PHP), MongoDB, Hyper-Text Markup Language 5 (HTML5), Android, JavaScript and AJAX programming language.

Identifying the Barriers behind the Lack of Six Sigma Use in Libyan Manufacturing Companies

This paper investigates the barriers behind the underutilisation of six sigma in Libyan manufacturing companies (LMCs). A mixed-method methodology is proposed, starting by conducting interviews to collect qualitative data followed by the development of a questionnaire to obtain quantitative data. The focus of this paper is on discussing the findings of the interview stage and how these can be used to further develop the questionnaire stage. The interview results showed that only four key barriers were highlighted as being encountered by LMCs. With a difference in terms of their significance, these factors were identified, and placed in descending order according to their importance, namely: “Lack of top management commitment”, “Lack of training”, “Lack of knowledge about six sigma”, and “Culture effect”. The findings also showed that some barriers which, were found in previous studies of six sigma implementation were not considered as barriers to LMCs but can, in fact, be considered as success factors or enablers for six sigma adoption. These factors were identified as: “sufficiency of time and financial resources”; “customers unsatisfied”; “good communication between all departments in the company”; “we are certain about its results and benefits to our company and unhappy with the current quality system”. These results suggest that LMCs face fewer barriers to adopting six sigma than many well-established global companies operating in other countries and could take advantage of these successful factors by developing and implementing a six sigma framework to improve their product quality and competitiveness.

Graphic Animation: Innovative Language Learning for Autistic Children

It is difficult for autistic children to mix with and be around with other people. Language difficulties are a problem that affects their social life. A lack of knowledge and ability in language are factors that greatly influence their behavior, and their ability to communicate and interact. Autistic children need to be assisted to improve their language abilities through the use of suitable learning resources. This study is conducted to identify weather graphic animation resources can help autistic children learn and use transitive verbs more effectively. The study was conducted in a rural secondary school in Penang, Malaysia. The research subject comprised of three autistic students ranging in age from 14 years to 16 years. The 14-year-old student is placed in A Class and two 16-year-old students placed in B Class. The class placement of the subjects is based on the diagnostic test results conducted by the teacher and not based on age. Data collection is done through observation and interviews for the duration of five weeks; with the researcher allocating 30 minutes for every learning activity carried out. The research finding shows that the subjects learn transitive verbs better using graphic animation compared to static pictures. It is hoped that this study will give a new perspective towards the learning processes of autistic children.

Analytical Study of Applying the Account Aggregation Approach in E-Banking Services

The advanced information technology is becoming an important factor in the development of financial services industry, especially the banking industry. It has introduced new ways of delivering banking to the customer, such as Internet Banking. Banks began to look at electronic banking (e-banking) as a means to replace some of their traditional branch functions using the Internet as a new distribution channel. Some consumers have at least more than one account, and across banks, and access these accounts using e-banking services. To look at the current net worth position, customers have to login to each of their accounts and get the details and work on consolidation. This not only takes ample time but it is a repetitive activity at a specified frequency. To address this point, an account aggregation concept is added as a solution. E-banking account aggregation, as one of the e-banking types, appeared to build a stronger relationship with customers. Account Aggregation Service generally refers to a service that allows customers to manage their bank accounts maintained in different institutions through a common Internet banking operating a platform, with a high concern to security and privacy. This paper presents an overview of an e-banking account aggregation approach as a new service in the e-banking field.

Speaker Identification by Atomic Decomposition of Learned Features Using Computational Auditory Scene Analysis Principals in Noisy Environments

Speaker recognition is performed in high Additive White Gaussian Noise (AWGN) environments using principals of Computational Auditory Scene Analysis (CASA). CASA methods often classify sounds from images in the time-frequency (T-F) plane using spectrograms or cochleargrams as the image. In this paper atomic decomposition implemented by matching pursuit performs a transform from time series speech signals to the T-F plane. The atomic decomposition creates a sparsely populated T-F vector in “weight space” where each populated T-F position contains an amplitude weight. The weight space vector along with the atomic dictionary represents a denoised, compressed version of the original signal. The arraignment or of the atomic indices in the T-F vector are used for classification. Unsupervised feature learning implemented by a sparse autoencoder learns a single dictionary of basis features from a collection of envelope samples from all speakers. The approach is demonstrated using pairs of speakers from the TIMIT data set. Pairs of speakers are selected randomly from a single district. Each speak has 10 sentences. Two are used for training and 8 for testing. Atomic index probabilities are created for each training sentence and also for each test sentence. Classification is performed by finding the lowest Euclidean distance between then probabilities from the training sentences and the test sentences. Training is done at a 30dB Signal-to-Noise Ratio (SNR). Testing is performed at SNR’s of 0 dB, 5 dB, 10 dB and 30dB. The algorithm has a baseline classification accuracy of ~93% averaged over 10 pairs of speakers from the TIMIT data set. The baseline accuracy is attributable to short sequences of training and test data as well as the overall simplicity of the classification algorithm. The accuracy is not affected by AWGN and produces ~93% accuracy at 0dB SNR.

Directivity and Gain Improvement for Microstrip Array Antenna with Directors

Methodology is suggested to design a linear rectangular microstrip array antenna based on Yagi antenna theory. The antenna with different directors' lengths as parasitic elements were designed, simulated, and analyzed using HFSS. The calculus and results illustrate the effectiveness of using specific parasitic elements to improve the directivity and gain for microstrip array antenna. The results have shown that the suggested methodology has the potential to be applied for improving the antenna performance. Maximum radiation intensity (Umax) of the order of 0.47w/st was recorded, directivity of 6.58dB, and gain better than 6.07dB are readily achievable for the antenna that working.

Exploration of Influential Factors on First Year Architecture Students’ Productivity

The design process in architecture education is based upon the Learning-by-Doing method, which leads students to understand how to design by practicing rather than studying. First-year design studios, as starting educational stage, provide integrated knowledge and skills of design for newly jointed architecture students. Within the basic design studio environment, students are guided to transfer their abstract thoughts into visual concrete decisions under the supervision of design educators for the first time. Therefore, introductory design studios have predominant impacts on students’ operational thinking and designing. Architectural design thinking is quite different from students’ educational backgrounds and learning habits. This educational challenge at basic design studios creates a severe need to study the reality of design education at foundation year and define appropriate educational methods with convenient project types with the intention of enhancing architecture education quality. Material for this study has been gathered through long-term direct observation at a first year second semester design studio at the faculty of architecture at EMU (known as FARC 102), fall and spring academic semester 2014-15. Distribution of a questionnaire among case study students and interviews with third and fourth design studio students who passed through the same methods of education in the past 2 years and conducting interviews with instructors are other methodologies used in this research. The results of this study reveal a risk of a mismatch between the implemented teaching method, project type and scale in this particular level and students’ learning styles. Although the existence of such risk due to varieties in students’ profiles could be expected to some extent, recommendations can support educators to reach maximum compatibility.

A Study on Holosen-Pleistosen Sedimentology of Morphotectonic Structure and Seismicity of Gökova Bay

In this research which has been prepared to show the relationship between Gökova Bay’s morphotectonic structure and seismicity, it is clear that there are many active faults in the region. The existence of a thick sedimentary accumulation since Late Quaternary times is obvious as a result of the geophysical workings in the region and the interpretation of seismic data which has been planning to be taken from the Bay. In the regions which have been tectonically active according to the interpretation of the taken data, the existence of the successive earthquakes in the last few years is remarkable. By analyzing large earthquakes affecting the areas remaining inside the sediments in West Anatolian Collapse System, this paper aims to reveal the fault systems constituting earthquakes with the information obtained from this study and to determine seismicity of the present residential areas right next to them. It is also aimed to anticipate the measures to be taken against possible earthquake hazards, to identify these areas posing a risk in terms of residential and urban planning and to determine at least partly the characteristics of the basin.

Effects of Urbanization on Land Use/Land Cover and Stream Flow of a Sub-Tropical River Basin of India

Rapid urbanization changes the land use/land cover pattern of a developing region. Due to these land surface changes, stream flow of the rivers also changes. It is important to investigate the factors affecting hydrological characteristics of the river basin for better river basin management planning. This study is aimed to understand the effect of Land Use/Land Cover (LU/LC) changes on stream flow of Upper Bhima River basin which is highly stressed in terms of water resources. In this study, Upper Bhima River basin is divided into two adjacent sub-watersheds: Mula-Mutha (urbanized) sub-watershed and Bhima (non-urbanized) sub-watershed. First of all, LU/LC changes were estimated over 1980, 2002, and 2009 for both Mula-Mutha and Bhima sub-watersheds. Further, stream flow simulations were done using Soil and Water Assessment Tool (SWAT) for the streams draining both watersheds. Results revealed that stream flow was relatively higher for urbanized sub-watershed. Through Sensitivity Analysis it was observed that out of all the parameters used, base flow was the most sensitive parameter towards LU/LC changes.

Identification of Lean Implementation Hurdles in Indian Industries

Due to increased pressure from global competitors, manufacturing organizations are switching over to lean philosophies from traditional mass production. Lean manufacturing is a manufacturing philosophy which focuses on elimination of various types of wastes and creates maximum value for the end customers. Lean thinking aims to produce high quality products and services at the lowest possible cost with maximum customer responsiveness. Indian Industry is facing lot of problems in this transformation from traditional mass production to lean production. Through this paper an attempt has been made to identify various lean implementation hurdles in Indian industries with the help of a structured survey. Identified hurdles are grouped with the help of factor analysis and rated by calculating descriptive statistics. To show the effect of lean implementation hurdles a hypothesis “Organizations having higher level of lean implementation hurdles will have poor (negative) performance” has been postulated and tested using correlation matrix between performance parameters of the organizations and identified hurdles. The findings of the paper will be helpful to prepare road map to identify and eradicate the lean implementation hurdles.

An Online Space for Practitioners in the Water, Sanitation and Hygiene Sector

The increasing availability and quality of internet access throughout the developing world provides an opportunity to utilize online spaces to disseminate water, sanitation and hygiene (WASH) knowledge to practitioners. Since 2001, CAWST has provided in-person education, training and consulting services to thousands of WASH practitioners all over the world, supporting them to start, troubleshoot, improve and expand their WASH projects. As CAWST continues to grow, the organization faces challenges in meeting demand from clients and in providing consistent, timely technical support. In 2012, CAWST began utilizing online spaces to expand its reach by developing a series of resources websites and webinars. CAWST has developed a WASH Education and Training resources website, a Biosand Filter (BSF) Knowledge Base, a Household Water Treatment and Safe Storage Knowledge Base, a mobile app for offline users, a live chat support tool, a WASH e-library, and a series of webinar-style online training sessions to complement its in-person capacity development services. In order to determine the preliminary outcomes of providing these online services, CAWST has monitored and analyzed registration to the online spaces, downloads of the educational materials, and webinar attendance; as well as conducted user surveys. The purpose of this analysis was to find out who was using the online spaces, where users came from, and how the resources were being used. CAWST’s WASH Resources website has served over 5,800 registered users from 3,000 organizations in 183 countries. Additionally, the BSF Knowledge Base has served over 1000 registered users from 68 countries, and over 540 people from 73 countries have attended CAWST’s online training sessions. This indicates that the online spaces are effectively reaching a large numbers of users, from a range of countries. A 2016 survey of the Biosand Filter Knowledge Base showed that approximately 61% of users are practitioners, and 39% are either researchers or students. Of the respondents, 46% reported using the BSF Knowledge Base to initiate a BSF project and 43% reported using the information to train BSF technicians. Finally, 61% indicated they would like even greater support from CAWST’s Technical Advisors going forward. The analysis has provided an encouraging indication that CAWST’s online spaces are contributing to its objective of engaging and supporting WASH practitioners to start, improve and expand their initiatives. CAWST has learned several lessons during the development of these online spaces, in particular related to the resources needed to create and maintain the spaces, and respond to the demand created. CAWST plans to continue expanding its online spaces, improving user experience of the sites, and involving new contributors and content types. Through the use of online spaces, CAWST has been able to increase its global reach and impact without significantly increasing its human resources by connecting WASH practitioners with the information they most need, in a practical and accessible manner. This paper presents on CAWST’s use of online spaces through the CAWST-developed platforms discussed above and the analysis of the use of these platforms.

Effect of Environmental Factors on Photoreactivation of Microorganisms under Indoor Conditions

Ultraviolet (UV) disinfection causes damage to the DNA or RNA of microorganisms, but many microorganisms can repair this damage after exposure to near-UV or visible wavelengths (310–480 nm) by a mechanism called photoreactivation. Photoreactivation is gaining more attention because it can reduce the efficiency of UV disinfection of wastewater several hours after treatment. The focus of many photoreactivation research activities on the single species has caused a considerable lack in knowledge about complex natural communities of microorganisms and their response to UV treatment. In this research, photoreactivation experiments were carried out on the influent of the UV disinfection unit at a municipal wastewater treatment plant (WWTP) in Edmonton, Alberta after exposure to a Medium-Pressure (MP) UV lamp system to evaluate the effect of environmental factors on photoreactivation of microorganisms in the actual municipal wastewater. The effect of reactivation fluence, temperature, and river water on photoreactivation of total coliforms was examined under indoor conditions. The results showed that higher effective reactivation fluence values (up to 20 J/cm2) and higher temperatures (up to 25 °C) increased the photoreactivation of total coliforms. However, increasing the percentage of river in the mixtures of the effluent and river water decreased the photoreactivation of the mixtures. The results of this research can help the municipal wastewater treatment industry to examine the environmental effects of discharging their effluents into receiving waters.

A Practical Methodology for Evaluating Water, Sanitation and Hygiene Education and Training Programs

Many organizations in the Water, Sanitation and Hygiene (WASH) sector provide education and training in order to increase the effectiveness of their WASH interventions. A key challenge for these organizations is measuring how well their education and training activities contribute to WASH improvements. It is crucial for implementers to understand the returns of their education and training activities so that they can improve and make better progress toward the desired outcomes. This paper presents information on CAWST’s development and piloting of the evaluation methodology. The Centre for Affordable Water and Sanitation Technology (CAWST) has developed a methodology for evaluating education and training activities, so that organizations can understand the effectiveness of their WASH activities and improve accordingly. CAWST developed this methodology through a series of research partnerships, followed by staged field pilots in Nepal, Peru, Ethiopia and Haiti. During the research partnerships, CAWST collaborated with universities in the UK and Canada to: review a range of available evaluation frameworks, investigate existing practices for evaluating education activities, and develop a draft methodology for evaluating education programs. The draft methodology was then piloted in three separate studies to evaluate CAWST’s, and CAWST’s partner’s, WASH education programs. Each of the pilot studies evaluated education programs in different locations, with different objectives, and at different times within the project cycles. The evaluations in Nepal and Peru were conducted in 2013 and investigated the outcomes and impacts of CAWST’s WASH education services in those countries over the past 5-10 years. In 2014, the methodology was applied to complete a rigorous evaluation of a 3-day WASH Awareness training program in Ethiopia, one year after the training had occurred. In 2015, the methodology was applied in Haiti to complete a rapid assessment of a Community Health Promotion program, which informed the development of an improved training program. After each pilot evaluation, the methodology was reviewed and improvements were made. A key concept within the methodology is that in order for training activities to lead to improved WASH practices at the community level, it is not enough for participants to acquire new knowledge and skills; they must also apply the new skills and influence the behavior of others following the training. The steps of the methodology include: development of a Theory of Change for the education program, application of the Kirkpatrick model to develop indicators, development of data collection tools, data collection, data analysis and interpretation, and use of the findings for improvement. The methodology was applied in different ways for each pilot and was found to be practical to apply and adapt to meet the needs of each case. It was useful in gathering specific information on the outcomes of the education and training activities, and in developing recommendations for program improvement. Based on the results of the pilot studies, CAWST is developing a set of support materials to enable other WASH implementers to apply the methodology. By using this methodology, more WASH organizations will be able to understand the outcomes and impacts of their training activities, leading to higher quality education programs and improved WASH outcomes.