Stories

Tag: WHO

  • Implementation of guidelines, officially

    Implementation of guidelines, officially

    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 to make the overall context favourable to the proposed changes). Implementation or operational research can help inform field testing and rollout strategies to promote the uptake of recommendations.

    There is a range of derivative documents or tools that can be developed to facilitate implementation. These can be distributed with the guideline, or local guideline implementers can develop them. Such documents or tools may include a slide set re ecting the guideline content; a “how to” manual or handbook; a flowchart, decision aide or algorithm; fact sheets; quality indicators; checklists; computerized applications; templates, etc.

    Source: World Health Organization. WHO Handbook for Guideline Development, 2014.

    Image: Aboard the USS Bowfin in Pearl Harbor, Hawaii, United States of America. Personal collection.

  • Lessons learned from Ebola

    Lessons learned from Ebola

    This is the first in a series of five blog posts reflecting on what is at stake in how we learn lessons from the Ebola crisis that erupted in 2014 and continued in 2015. A new blog post will be published each morning this week (subscribe here).

    The unprecedented complexity and scale of the current Ebola outbreak demonstrated that existing capacities of organizations with technical, normative culture, methods and approaches are not necessarily scalable or adaptable to novel or larger challenges. Large and complex public health emergencies are different each time. Each new event poses specific problems. Hence, traditional approaches to standardize “best practice” are unlikely to succeed. What are the appropriate mechanisms for learning from each of them? More broadly, how do we change the capacity of individuals and systems to learn?

    “Huge praise is due to those who have responded to the Ebola outbreak in West Africa. At the same time, the retrospective analysis that is just beginning has already revealed several glaring lessons to be heeded next time” (Petherick 2015:591).

    I believe that we can and should mobilize education and the affordances of technology that support it to tackle three questions:

    1. How do we ensure that lessons learned include the experience and expertise of communities on the frontline of the crisis?
    2. How can we ensure that lessons learned are retained, adapted and used by individuals, teams, and organizations?
    3. How close to the village can an online, distance learning initiative reach?

    If we improve access, inclusion and retention of lessons learned, we can then help address the following questions:

    1. What humanitarian health standards and normative guidelines are needed and how can they be developed to stay relevant in the face of increasingly complex crises, when every outbreak is different?
    2. How do we foster an organizational culture of improved coordination, leadership, and preparedness in and between organizations, governments, and local communities?
    3. How do we develop a global workforce with the surge capacity to respond to crises?

    These questions have an educational dimension that is not being addressed by current efforts. This is compounded by the fact that current humanitarian health education is mired by transmissive approaches that cannot allow for learners as knowledge producers – and that lessons must first be generated before they can be learned. This is why we urgently need a new education paradigm, supported by affordable, practical learning technologies and pedagogies, to strengthen humanitarian health response and preparedness.

    Tuesday, I’ll explore why learning is the hidden key to the strategic shift – called for by the World Health Organization – in how the world manages health crises.

    Reference: Petherick, Anna. “Ebola in West Africa: Learning the Lessons.” The Lancet 385, no. 9968 (February 2015): 591–92. doi:10.1016/S0140-6736(15)60075-7.