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This document provides an analysis of the application of the Water and Sanitation for Health Facility Improvement tool (WASH FIT), along with case studies from a select number of countries which illustrate different approaches for implementing and scaling up the tool. Recommendations for improving WASHFIT, its implementation and integration with health, energy and climate efforts are also included. As of 2024, over 70 countries from every region of the world are known to be using the tool and this number is growing year on year.