Standards and Guidelines Development

A core component in health systems strengthening is developing, adapting and disseminating up-to-date, evidence-based health standards and guidelines for comprehensive health services—including family planning, essential maternal and newborn health care, HIV/AIDS, and infection prevention and control. Standards and guidelines are also critical in health education and training, serving as the foundation for curriculum development in both pre-service education and training of practicing professionals. In many low-resource settings, however, standards and guidelines are outdated or nonexistent; or they may not address the health problems that most affect the population they are meant to serve. Implemented effectively, appropriate standards and guidelines can lead to improved quality of service delivery and ultimately the reduction of long-term disability and death in the most vulnerable populations.

In the context of health care, two types of guidelines exist at the national level: policy guidelines and service delivery guidelines.

  • Policy guidelines are a government’s official statement about the country’s standards and should reflect the health care situation in the country. They describe which services are offered, who delivers and receives the services, how and where they will be delivered, and what the minimal acceptable level of performance is for each service offered.
  • Service delivery guidelines provide the detailed, technical information needed to implement the national policy guidelines. Health care providers use service delivery guidelines in their work as a source of specific, up-to-date information about the health services offered in a country, as well as a source of general information to provide high-quality care.

Standards describe exactly what actions should be taken in order to provide services that adhere to the guidelines; they also serve as criteria against which to judge performance and as benchmarks against which to evaluate progress.

In developing and implementing standards and guidelines, a participatory approach that fosters in-country involvement and “ownership” has been shown effective in the overall process of health systems strengthening. Such an approach engages a country’s key stakeholders, decision-makers and other leaders to ensure responsiveness to the country’s needs and to foster the broad acceptance necessary for implementation by health care providers.