Tamara Kredo, Solange Durão, Emmanuel Effa, Celeste Naude, Michael McCaul, Amanda Brand, Simon Lewin, Claire Glenton, Susan Munabi-Babigumira, Elodie Besnier, Trudy D Leong, Bey-Marie Schmidt, Nyanyiwe Mbeye, Ameer Hohlfeld, Anke Rohwer, Tandekile Lubelwana Hafver, Nicolas Delvaux, Lungiswa Nkonki, Funeka Bango, Emma Thompson, Sara Cooper
{"title":"在马拉维、尼日利亚和南非建设采用、调整或制定儿童健康准则的可持续能力。","authors":"Tamara Kredo, Solange Durão, Emmanuel Effa, Celeste Naude, Michael McCaul, Amanda Brand, Simon Lewin, Claire Glenton, Susan Munabi-Babigumira, Elodie Besnier, Trudy D Leong, Bey-Marie Schmidt, Nyanyiwe Mbeye, Ameer Hohlfeld, Anke Rohwer, Tandekile Lubelwana Hafver, Nicolas Delvaux, Lungiswa Nkonki, Funeka Bango, Emma Thompson, Sara Cooper","doi":"10.2471/BLT.24.291564","DOIUrl":null,"url":null,"abstract":"<p><strong>Problem: </strong>Many national child health guidelines in Malawi, Nigeria and South Africa are outdated and score poorly on rigorous methods and stakeholder participation.</p><p><strong>Approach: </strong>In line with the World Health Organization's (WHO) emphasis on local guideline contextualization, the Global Evidence-Local Adaptation (GELA) project supported multistakeholder processes to adapt evidence-informed recommendations for child health in Malawi, Nigeria and South Africa. The GELA project team convened national steering groups, which conducted structured, iterative priority-setting exercises to identify priority topics. We identified appropriate source guidelines by systematically searching and screening available guidelines. We then matched recommendations in potential source guidelines to the relevant questions, and assessed the guidelines for timeliness and quality. Drawing on WHO's guideline process, we applied the GRADE-ADOLOPMENT process to develop contextualized recommendations from existing guidelines. If no source guideline or reviews were identified, we conducted new evidence syntheses.</p><p><strong>Local setting: </strong>Malawi, Nigeria and South Africa are countries with varying health priorities and systems, all transitioning to universal health coverage. Guideline structures differ between countries, with processes largely led from national health ministries.</p><p><strong>Relevant changes: </strong>National guideline groups, supported by GELA researchers and government-academic partners, developed five contextually-tailored child health recommendations. For most of these recommendations, additional evidence was required to inform contextually appropriate national decision-making. Formal capacity-building and on-the-job learning enhanced the competencies of national contributors and researchers in evidence-informed decision-making.</p><p><strong>Lessons learnt: </strong>Developing context-relevant recommendations requires considerable resources and time. Further investment in strengthening local capacity is needed for sustainable national guideline development.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":null,"pages":null},"PeriodicalIF":8.4000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418851/pdf/","citationCount":"0","resultStr":"{\"title\":\"Building sustainable capacity to adopt, adapt or develop child health guidelines, Malawi, Nigeria and South Africa.\",\"authors\":\"Tamara Kredo, Solange Durão, Emmanuel Effa, Celeste Naude, Michael McCaul, Amanda Brand, Simon Lewin, Claire Glenton, Susan Munabi-Babigumira, Elodie Besnier, Trudy D Leong, Bey-Marie Schmidt, Nyanyiwe Mbeye, Ameer Hohlfeld, Anke Rohwer, Tandekile Lubelwana Hafver, Nicolas Delvaux, Lungiswa Nkonki, Funeka Bango, Emma Thompson, Sara Cooper\",\"doi\":\"10.2471/BLT.24.291564\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Problem: </strong>Many national child health guidelines in Malawi, Nigeria and South Africa are outdated and score poorly on rigorous methods and stakeholder participation.</p><p><strong>Approach: </strong>In line with the World Health Organization's (WHO) emphasis on local guideline contextualization, the Global Evidence-Local Adaptation (GELA) project supported multistakeholder processes to adapt evidence-informed recommendations for child health in Malawi, Nigeria and South Africa. The GELA project team convened national steering groups, which conducted structured, iterative priority-setting exercises to identify priority topics. We identified appropriate source guidelines by systematically searching and screening available guidelines. We then matched recommendations in potential source guidelines to the relevant questions, and assessed the guidelines for timeliness and quality. Drawing on WHO's guideline process, we applied the GRADE-ADOLOPMENT process to develop contextualized recommendations from existing guidelines. If no source guideline or reviews were identified, we conducted new evidence syntheses.</p><p><strong>Local setting: </strong>Malawi, Nigeria and South Africa are countries with varying health priorities and systems, all transitioning to universal health coverage. Guideline structures differ between countries, with processes largely led from national health ministries.</p><p><strong>Relevant changes: </strong>National guideline groups, supported by GELA researchers and government-academic partners, developed five contextually-tailored child health recommendations. For most of these recommendations, additional evidence was required to inform contextually appropriate national decision-making. Formal capacity-building and on-the-job learning enhanced the competencies of national contributors and researchers in evidence-informed decision-making.</p><p><strong>Lessons learnt: </strong>Developing context-relevant recommendations requires considerable resources and time. Further investment in strengthening local capacity is needed for sustainable national guideline development.</p>\",\"PeriodicalId\":9465,\"journal\":{\"name\":\"Bulletin of the World Health Organization\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":8.4000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418851/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bulletin of the World Health Organization\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2471/BLT.24.291564\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bulletin of the World Health Organization","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2471/BLT.24.291564","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
问题:马拉维、尼日利亚和南非的许多国家儿童健康指南已经过时,在严格的方法和利益相关者参与方面得分很低:根据世界卫生组织(WHO)对地方指南背景化的强调,全球证据-地方适应(GELA)项目为马拉维、尼日利亚和南非的多方利益相关者进程提供支持,以调整以证据为依据的儿童健康建议。GELA 项目团队召集了国家指导小组,这些小组开展了结构化、反复的优先事项设定工作,以确定优先主题。我们通过系统搜索和筛选现有指南,确定了合适的来源指南。然后,我们将潜在来源指南中的建议与相关问题进行匹配,并对指南的时效性和质量进行评估。借鉴世界卫生组织的指南流程,我们采用 GRADE-ADOLOPMENT 流程,从现有指南中提出符合实际情况的建议。如果没有找到来源指南或综述,我们就进行新的证据综合:马拉维、尼日利亚和南非三国的卫生优先事项和体系各不相同,都在向全民医保过渡。各国的指南结构各不相同,主要由国家卫生部主导制定过程:在 GELA 研究人员和政府-学术界合作伙伴的支持下,国家指南小组制定了五项符合国情的儿童健康建议。对于其中的大多数建议,需要更多的证据,以便根据具体情况为国家决策提供信息。正式的能力建设和在职学习提高了国家撰稿人和研究人员在以证据为依据的决策方面的能力:制定符合国情的建议需要大量的资源和时间。为了可持续地制定国家指南,需要进一步投资加强地方能力。
Building sustainable capacity to adopt, adapt or develop child health guidelines, Malawi, Nigeria and South Africa.
Problem: Many national child health guidelines in Malawi, Nigeria and South Africa are outdated and score poorly on rigorous methods and stakeholder participation.
Approach: In line with the World Health Organization's (WHO) emphasis on local guideline contextualization, the Global Evidence-Local Adaptation (GELA) project supported multistakeholder processes to adapt evidence-informed recommendations for child health in Malawi, Nigeria and South Africa. The GELA project team convened national steering groups, which conducted structured, iterative priority-setting exercises to identify priority topics. We identified appropriate source guidelines by systematically searching and screening available guidelines. We then matched recommendations in potential source guidelines to the relevant questions, and assessed the guidelines for timeliness and quality. Drawing on WHO's guideline process, we applied the GRADE-ADOLOPMENT process to develop contextualized recommendations from existing guidelines. If no source guideline or reviews were identified, we conducted new evidence syntheses.
Local setting: Malawi, Nigeria and South Africa are countries with varying health priorities and systems, all transitioning to universal health coverage. Guideline structures differ between countries, with processes largely led from national health ministries.
Relevant changes: National guideline groups, supported by GELA researchers and government-academic partners, developed five contextually-tailored child health recommendations. For most of these recommendations, additional evidence was required to inform contextually appropriate national decision-making. Formal capacity-building and on-the-job learning enhanced the competencies of national contributors and researchers in evidence-informed decision-making.
Lessons learnt: Developing context-relevant recommendations requires considerable resources and time. Further investment in strengthening local capacity is needed for sustainable national guideline development.
期刊介绍:
The Bulletin of the World Health Organization
Journal Overview:
Leading public health journal
Peer-reviewed monthly journal
Special focus on developing countries
Global scope and authority
Top public and environmental health journal
Impact factor of 6.818 (2018), according to Web of Science ranking
Audience:
Essential reading for public health decision-makers and researchers
Provides blend of research, well-informed opinion, and news