Dear HIFA colleagues,
A new paper in WHO Bulletin: citation, extracts and a comment from me below.
CITATION: Bull World Health Organ. 2025 Feb 13;103(4):281–284. doi: 10.2471/BLT.24.291587
An international guideline training and certification programme
https://pmc.ncbi.nlm.nih.gov/articles/PMC11978408/
'Trustworthy clinical, public health and health policy guidelines are products that set norms and standards based on the best available evidence. A single guideline, such as on tuberculosis or the coronavirus disease 2019 (COVID-19), can affect millions of people worldwide. Health guidelines are produced by the World Health Organization (WHO) and many other entities including the European Commission, health ministries, national health programmes, government organizations, professional societies and commercial organizations. To improve health outcomes and populations’ well-being, guidelines should optimize health workers’ actions, inform the public, create a basis for health policy and quality improvement and reduce unnecessary variation in care. However, although many evidence-based guidelines have been developed over the past 50 years, important gaps in quality of care remain. In addition to insufficient guideline implementation, at least two important global challenges create quality gaps in guideline development: lack of standardized guideline-related education leading to certification, and insufficient guideline creation capacity...'
'Professionalizing guideline training and its certification is crucial for enhancing the trustworthiness, quality, effectiveness and global reach of health guidelines...'
'We call for guideline developers to support and adopt certification with a focus on quality to strengthen capacity...'
COMMENT (NPW): This paper in the current issue of the WHO Bulletin proposes a way to strengthen one part of the global evidence ecosystem, specifically that relating to guideline development, which involves the synthesis and packaging of evidence [ https://www.hifa.org/about-hifa/hifa-vision-mission-strategy ]. There are several guideline development professionals on HIFA (including some of those who authored this paper) and I invite you and others to comment.
There is a wider challenge here: not only to strengthen quality and capacity, but also to strengthen relevance to end-users. This in turn depends at least in part on global-local synthesis, a process that is seriously underresourced especially in LMICs. There is also of course the challenge of making such guidelines available in a form that best meets the needs of users; and to promote the application of guidelines through various means.
Coming back to the question of capacity, a further exercise that could be helpful would be to improve the effectiveness and reduce duplication among the different institutions that produce guidelines. The authors note that 'guidelines are produced by the World Health Organization (WHO) and many other entities including the European Commission, health ministries, national health programmes, government organizations, professional societies and commercial organizations'. How to promote more collaboration for increased impact and decreased costs?
There is also the question of how to raise awareness and understanding of the importance of rigorously developed guidelines among intended users, in a world where some of the most senior health professionals and policymakers prefer to ignore the evidence.
In general, when considering the development and application of guidelines we need to take into account multiple aspects.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org