Aboard the USS Bowfin (Pearl Harbor, Hawaii, United States of America). Personal collection.

Implementation of guidelines, officially

Global health

This is everything that the World Health Organization’s Handbook for Guideline Development says about implementation.  Implementation of a guideline should be taken into account right from the beginning of the guideline development. Implementation is generally the responsibility of national or subnational groups, which explains why their participation in guideline development is critical. WHO headquarters and regional and country offices can support implementation activities by promoting new guidelines at international conferences and providing guideline dissemination workshops, tools, resources and overall coordination [emphasis mine]. Implementation strategies are context-specific. The basic steps for implementing a guideline are: convene a multidisciplinary working group to analyse local needs and priorities (looking for additional data on actual practice); identify potential barriers and facilitating factors; determine available resources and the political support required to implement recommendations; inform relevant implementing partners at all levels; and design an implementation strategy (considering how to encourage theadoption of the recommendations and how …

Keys abord the USS Bowfin

I want them to read it

Thinking aloud

“So… can you tell me how you would like people to use the guidelines?” “Well… it is difficult to say… I am not sure.” “What is the change that you are hoping to produce?” “Well… I don’t know. It was so much work putting these together already! Now they are available and people in countries just need to start using them.” “So… what do you mean by ‘using them’? Can you tell me what that looks like…?” “I want them to read it.” That is our point of departure. Image: Aboard the USS Bowfin in Pearl Harbor, Hawaii, United States of America. Personal collection.  

USS Bowfin diving plane control levers

From guidelines to impact

Global health, Thinking aloud

Most global public health organizations issue guidelines that are of a high methodological quality and are developed through a transparent, evidence-based decision-making process. However, they often lack an effective, scalable mechanism to support governments and health workers at country and sub-country level in turning these into action that leads to impact. Existing activities intended to help countries build public health capacity carry potential risk for these organizations, as they rely on high-cost, low-volume workshops and trainings that may be characterized by startling disparities in quality, scalability, replicability, and sustainability, often making it difficult or impossible to determine their impact. In some thematic areas, stakeholders have recognized the problem and are developing their own frameworks to improve quality of training and improve capacity-building. A few stakeholders are experimenting with new capacity-building approaches to empower local actors and strengthen the resilience of communities. The global community allocates considerable human and financial resources …