Sustainability and normalization of an intervention to improve evidence-based myocardial infarction care in Tanzania

This study is among the first to apply the CSAT and NoMAD tools to evaluate a quality improvement intervention in sub-Saharan Africa. Findings indicate high capacity to sustain MIMIC and strong normalization at KCMC, as reflected by consistently high mean domain scores across both instruments, although formal thresholds for these measures have not yet been established. Strengthening organizational capacity and long-term support, particularly financing and team coordination, may further enhance capacity for ongoing implementation.