The reporting of guideline dissemination and implementation in WHO guidelines

Article type
Authors
Zhou Q1, Wang Z2, Liu L2, Xiao Y2, Tong Y3, He J2, Yang K4, Cheng Y4
1The First Hospital of Lanzhou University, Lanzhou
2The Second Hospital of Lanzhou University, Lanzhou
3School of Public Health, Lanzhou University, Lanzhou
4Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou
Abstract
Background:
The World Health Organization (WHO) produces guidelines to inform various stakeholders in the 194 member states of the United Nations. However, there has been no research on guideline dissemination and implementation.

Objectives:
To systematically analyse the reporting of dissemination and implementation in WHO guidelines.

Methods:
We examined Guidelines Review Committee (GRC)-approved WHO guidelines published in English from January 2013 to November 2017. We obtained a list of all such guidelines from the GRC Secretariat. Two researchers independently extracted the characteristics of the guidelines, including reports of implementation and dissemination.

Results:
A total of 101 WHO guidelines were included, of which 84 (83.2%) were updated versions. Thirty-one (30.7%) had full-text translations: guidelines were translated into French (21, 20.8%), Spanish (13, 12.9%), Russian (9, 8.9%), Chinese (5, 5.0%), Portuguese (4, 4.0%), Persian (3, 3.0%) and other languages (9, 8.9%).

Of the guidelines reporting dissemination, 77 (76.2%) had a dissemination section and 20 (19.8%) reported the framework or plan for dissemination. Sixty-seven guidelines (66.3%) reported the authority for the dissemination of the guidelines (WHO regional and country office (49, 48.5%), WHO collaborating centre (41, 40.6%), agency of the United Nations (29, 28.7%), ministry of health (36, 35.6%), professional association (42, 41.6%) and university (16, 15.8%)). Fifty-one guidelines (50.5%) were disseminated through the WHO website and 26 (25.7%) were disseminated through meetings or conferences.

Of the guidelines reporting implementation, 77 (76.2%) had an implementation section, 24 (23.8%) reported the implementation framework (plan) and 55 (54.5%) reported the promotion factors for guideline implementation. Thirty-two guidelines (31.7%) reported the barriers to guideline implementation and 25 (24.8%) reported the monitoring of guideline implementation.

Conclusions:
The translation rate for WHO guidelines is very low and the reporting of guideline dissemination and implementation is insufficient.

Patient or healthcare consumer involvement:
In systematically analysing the reporting of implementation and dissemination of WHO guidelines, we aimed to help guideline users, health policy-makers, to disseminate and implement WHO guidelines better, in order to improve public health.