Staged Development Tool (SDT)

Participants using the SDT at the 2016 IANPHI Annual meeting in Shanghai, China.

Participants using the SDT at the 2016 IANPHI Annual meeting in Shanghai, China.

Helping National Public Health Institutes improve effectiveness and efficiency.

“We spent three days in an intense and passionate process that made us think and thoroughly explore our capacity. The SDT tool was of great use to us and we were delighted to have participated.”

– Togo INH Deputy Director Dr. Kossi Badziklou

National Public Health Institutes (NPHIs) sometimes struggle to define the most critical next steps that will improve capacity for core public health functions and effective and efficient internal operations. To fill this gap, the U.S. Centers for Disease Control and Prevention (CDC) and the International Association of National Public Health Institutes (IANPHI), with the assistance from a consultative group of NPHI leaders from around the world, developed a Staged Development Tool (SDT). The tool helps NPHIs assess their current capacity and develop a roadmap for achieving a higher level of functioning.

What is the Staged Development Tool?

The SDT is a process and toolkit to help NPHIs function at a higher level.

The process involves three steps:

  1. Assess gaps
  2. Prioritize
  3. Plan

30 Discussion Guides have been developed to help NPHIs determine their maturity in priority areas and identify areas for improvement. The Discussion Guides are based on a maturity model, or the idea that for a given topic, NPHIs exhibit different levels of maturity or development. By providing examples of what these maturity stages look like, Discussion Guides facilitate conversations that help participants clarify their NPHI’s current state, desired state, and major gaps that need to be addressed to move to their ideal state. NPHIs can reapply the SDT assessment at different time intervals to determine if the steps taken to address gaps led to significant improvements in capacity.

SDT Background and Description is a presentation about the SDT, which describes its structure, components, and usage. PowerPoint and PDF files in English, French, Portuguese, and Spanish can be found on the IANPHI SDT page.

Who can use the SDT?

  • The SDT can be used by established NPHIs or during establishment of an NPHI, if it is clear what groups and people will comprise the NPHI
  • Groups that are using the SDT need to have identified priority areas for improvement. These can relate to public health functions or to internal issues, such as leadership and management.

Who can assist with using the SDT?

  • The SDT process is designed to be facilitated, either by an internal or external facilitator
  • An external facilitator trained on how to use the tool is recommended, especially if the NPHI is using the SDT for the first time. An external facilitator offers the following advantages:
    • Knowledge of maturity models
    • Familiarity with Discussion Guides, terms used, and NPHI functions
    • Ability to offer fresh perspectives and relevant experiences
    • Ability to remain neutral, if difficult issues arise (e.g., in discussion of leadership and management)
    • Ability to step back and make sure the big picture guides all activities

SDT Resources

SDT files are available in English, French, Portuguese, and Spanish. All files reside on the IANPHI website, and are accessible through the buttons in each section below.


The SDT Background and Description presentation describes the tool’s structure, components, and usage.


The SDT Assessment Form is used to capture the key points from the assessment. It allows the facilitator to record current and desired scores, plus the justifications and examples that informed decisions about the current scores. The SDT Next Steps Form is used to develop plans to address gaps identified by the assessment. This form is for recording activities, milestones, responsible staff, and projected timeline. Other work-planning templates could also be used to capture the elements referenced in the Next Steps Form.

Discussion Guides

The Discussion Guide Definition and Notes document provides an overview of the 30 Discussion Guides, which describe stages of development for a range of topics. Topics are both internal-facing (e.g., related to management and leadership) and external-facing (e.g., related to core public health functions like surveillance and research). Each Discussion Guide is a one-page description of NPHI capacities in Basic, Developing, Advanced, and Leading Edge stages.