Article type
Year
Abstract
Background:
Equity, rights, gender and societal (ERGS) considerations are central to achieving global health and well being as well as more equitable distribution of good health. The World Health Organization (WHO) is mandated to ensure incorporation of ERGS into its guidelines. However, practical and effective implementation when developing global guidelines that cover a vast array of topics is challenging.
In this collaborative project, we sought to evaluate how ERGS standards and principles have been used in WHO guideline development and what progress has been made since the adoption of formal guidance in the WHO Guideline Development Handbook (Chapter 5). We developed a protocol to guide this review that can be used to both evaluate guidelines, and as a prompt for guideline developers.
The key innovation in our work is a protocol-driven set of ERGS expectations that can be tailored to different topics to drive guideline development.
Objectives
1) To assess adherence to ERGS principles in 12 recent WHO guidelines, in terms of process and in the final product (content), and identify change over time.
2) To develop a protocol to effectively incorporate ERGS in: a) planning a guideline; b) conducting a guideline meeting; and c) evaluating guidelines.
Methods
Methods sought to address both procedural and content aspects of the guideline.
Process evaluation:
WHO has identified a set of process-based benchmarks to assess adherence to its guidance on human rights in the guideline development. These benchmarks will be used to evaluate the guideline development process including the developers composition.
Content evaluation:
We applied a modified version of domain 1 of the AGREE II tool combined with a set of prompts (Table 2) related to human rights.
Results
Results will be presented across the 12 guidelines evaluated detailing the full methods of the ERGS process evaluation and the content evaluation. We will discuss strengths and limitations of the method and suggest implications for a) planning a guideline; b) conducting a guideline meeting; and c) evaluating guidelines, and specifically how it can be used to inform recommendations.
Conclusions:
Guideline adherence to ERGS principles varies greatly. We apply a novel evaluation methodology to illustrate how WHO incorporates these principles in guideline development, and propose new methods for meaningful inclusion in future guidelines.
Final statement on patient or healthcare consumer involvement:
The proposed approach draws on professionals from within countries who experience health care as providers and as consumers. We intend to pilot consumer refereeing of the protocols in the development process.
Equity, rights, gender and societal (ERGS) considerations are central to achieving global health and well being as well as more equitable distribution of good health. The World Health Organization (WHO) is mandated to ensure incorporation of ERGS into its guidelines. However, practical and effective implementation when developing global guidelines that cover a vast array of topics is challenging.
In this collaborative project, we sought to evaluate how ERGS standards and principles have been used in WHO guideline development and what progress has been made since the adoption of formal guidance in the WHO Guideline Development Handbook (Chapter 5). We developed a protocol to guide this review that can be used to both evaluate guidelines, and as a prompt for guideline developers.
The key innovation in our work is a protocol-driven set of ERGS expectations that can be tailored to different topics to drive guideline development.
Objectives
1) To assess adherence to ERGS principles in 12 recent WHO guidelines, in terms of process and in the final product (content), and identify change over time.
2) To develop a protocol to effectively incorporate ERGS in: a) planning a guideline; b) conducting a guideline meeting; and c) evaluating guidelines.
Methods
Methods sought to address both procedural and content aspects of the guideline.
Process evaluation:
WHO has identified a set of process-based benchmarks to assess adherence to its guidance on human rights in the guideline development. These benchmarks will be used to evaluate the guideline development process including the developers composition.
Content evaluation:
We applied a modified version of domain 1 of the AGREE II tool combined with a set of prompts (Table 2) related to human rights.
Results
Results will be presented across the 12 guidelines evaluated detailing the full methods of the ERGS process evaluation and the content evaluation. We will discuss strengths and limitations of the method and suggest implications for a) planning a guideline; b) conducting a guideline meeting; and c) evaluating guidelines, and specifically how it can be used to inform recommendations.
Conclusions:
Guideline adherence to ERGS principles varies greatly. We apply a novel evaluation methodology to illustrate how WHO incorporates these principles in guideline development, and propose new methods for meaningful inclusion in future guidelines.
Final statement on patient or healthcare consumer involvement:
The proposed approach draws on professionals from within countries who experience health care as providers and as consumers. We intend to pilot consumer refereeing of the protocols in the development process.