Learning across methods, contexts, and practice: insights from the global evidence–local adaptation project on developing clinical practice guidelines for newborn and child health
1
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
2
Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
3
Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1863
ABSTRACT
INTRODUCTION:
Clinical practice guidelines (CPGs) that are both evidence-based and responsive to local circumstances serve as essential instruments for translating research evidence into public health practice. In low-resource settings, CPG development and implementation is hindered by limited methodological capacity, insufficient contextual adaptation, and fragmented health system governance. In response, the Global Evidence, Local Adaptation (GELA) project aimed to strengthen context-specific, evidence-informed CPGs for newborn and child health in Malawi, Nigeria and South Africa.
METHODS:
This paper aimed to identify key insights and lessons from the GELA project, with a particular focus on implications for methodology, content expertise, contextual influences and future projects. We synthesised annual project reports, applied thematic analysis and narratively presented the lessons that emerged.
RESULTS:
Involving multiple stakeholders in CPG development led to more contextually informed guidelines that can improve the relevance, acceptability and implementation of interventions. Multi-stakeholder relationships were facilitated and sustained through Integrated Knowledge Translation (IKT) approaches that were structured (yet flexible), well-resourced and contextually appropriate. Fostering knowledge, skills and expertise within the CPG landscape was possible through formal training and experiential learning such as mentoring. Moreover, engagement throughout the project enhanced content expertise amongst stakeholders.
CONCLUSIONS:
Contextualising guideline development through inclusive, multi-stakeholder processes can enhance relevance, acceptability, and the implementation of CPGs within local health systems. In addition, local voices should be prioritised in CPG development which can foster enhanced understandings of the needs, meanings and realities of particular situated contexts. Training and mentorship should be valued to build knowledge of evidence-informed policy and practice and deepen content expertise in African health research. Notably, multi-stakeholder partnerships might benefit from IKT if this is conscientiously applied and tailored to local contexts and available resources.
Clinical practice guidelines (CPGs) that are both evidence-based and responsive to local circumstances serve as essential instruments for translating research evidence into public health practice. In low-resource settings, CPG development and implementation is hindered by limited methodological capacity, insufficient contextual adaptation, and fragmented health system governance. In response, the Global Evidence, Local Adaptation (GELA) project aimed to strengthen context-specific, evidence-informed CPGs for newborn and child health in Malawi, Nigeria and South Africa.
METHODS:
This paper aimed to identify key insights and lessons from the GELA project, with a particular focus on implications for methodology, content expertise, contextual influences and future projects. We synthesised annual project reports, applied thematic analysis and narratively presented the lessons that emerged.
RESULTS:
Involving multiple stakeholders in CPG development led to more contextually informed guidelines that can improve the relevance, acceptability and implementation of interventions. Multi-stakeholder relationships were facilitated and sustained through Integrated Knowledge Translation (IKT) approaches that were structured (yet flexible), well-resourced and contextually appropriate. Fostering knowledge, skills and expertise within the CPG landscape was possible through formal training and experiential learning such as mentoring. Moreover, engagement throughout the project enhanced content expertise amongst stakeholders.
CONCLUSIONS:
Contextualising guideline development through inclusive, multi-stakeholder processes can enhance relevance, acceptability, and the implementation of CPGs within local health systems. In addition, local voices should be prioritised in CPG development which can foster enhanced understandings of the needs, meanings and realities of particular situated contexts. Training and mentorship should be valued to build knowledge of evidence-informed policy and practice and deepen content expertise in African health research. Notably, multi-stakeholder partnerships might benefit from IKT if this is conscientiously applied and tailored to local contexts and available resources.
| eISSN: | 2654-1459 |
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