Performance levels from the baseline audit to the 12- to 15-month audit among 968 testing sites in five African countries (Cameroon, Uganda, Malawi, Tanzania, and Zambia) and one Caribbean country (Jamaica). Shown are SPI-RT scores at level 0 (<40%), level 1 (40 to 59%), level 2 (60 to 79%), level 3 (80 to 89%), and level 4 (>90%). The numbers on the top of each bar represent the percentages of the total sites.