Scope and purpose
The World Health Organization (WHO) is committed to driving public health impact in every country ensuring healthy lives and promoting well-being for all at all ages. Through its unique normative function in health, WHO aims to provide global, evidence-informed recommendations on the use of haemoglobin concentrations to assess and manage anaemia in individuals and populations. WHO’s normative, data, and research and innovation activities drive the creation of global public goods. This work has been included as one of the WHO Global Public Health Goods for country impact and aims to support regional and country offices work and to help WHO Member States and their partners to make evidence-informed decisions on the appropriate actions in their efforts to improve access to quality essential health services, support countries to be prepared for health emergencies, and address the determinants of health. It will also help in increasing capacity in the countries to respond to their needs on assessing anaemia prevalence and control, and to prioritize essential actions in national health policies, strategies and plans.
This normative work is aligned with the World Health Organization 13th General Programme of Work approved by the Seventy-first World Health Assembly in resolution WHA71.1 on 25 May 2018, and based on the SDGs and is relevant to all countries – low, middle and high income. Its strategic priorities and goals include specifically enabling countries to provide high-quality, people-centred health services, based on primary health care strategies and comprehensive essential service packages through collaboration and coordination from diverse sectors in their efforts to improve human capital across the life course. This and other WHO’s normative guidance is informed by developments at the frontier of new scientific disciplines, all of which pose transformational opportunities but also risks to global health.
Accurate characterisation of anaemia is critical to understand the burden and epidemiology of this problem, for planning public health interventions, and for clinical care of people across the life course. A prioritization exercise on anaemia was led by WHO in 2016, via a two-stage international consultation. The process considered the feedback from 123 respondents in 48 countries across all six WHO regions. Six subtopics were established, including physiology of anaemia, haemoglobin thresholds for different population groups, definition of anaemia across clinical and environmental contexts, approach to development of anaemia thresholds, laboratory, equipment, regulatory and diagnostic considerations, and implementation of WHO’s haemoglobin threshold guidelines.
Based on the normative needs identified at various technical meetings organized by WHO, the available evidence will be summarised and presented to a WHO guideline development group after input from the steering committee, to obtain the priority questions and develop the global recommendations on haemoglobin thresholds to diagnose and manage anaemia in both clinical and public health practice. For this purpose, WHO is establishing a WHO guideline development group – anaemia to advise and support this normative work. The guideline development group is a multidisciplinary group of experts encompassing a range of technical and programmatic skills as well as diverse perspectives, aiming at having geographical representation and gender balance.
The WHO guideline development group – anaemia will support WHO’s 13th programme of work on various areas and will advise WHO on the following:
- Providing input into the scope of the guidelines and assisting the steering group in developing the key questions in PICO format;
- Choosing and ranking priority outcomes that will guide the evidence reviews and focus the recommendations;
- Examining the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence profiles or other assessments of the quality of the evidence used to inform the recommendations and provide input;
- Interpreting the evidence, with explicit consideration of the overall balance of benefits and harms;
- Formulating recommendations and determining their strength taking into account benefits, harms, values and preferences, feasibility, equity, ethics, acceptability, resource requirements and other factors, as appropriate;
- Defining implications for further research and gaps;
- Discussing implementation and evaluation considerations of the guideline.
WHO is convening the first meeting of the WHO guideline development group – anaemia in Barcelona, Spain on 6-8 November 2019. The main objectives of this meeting are to:
- Formally launch the WHO guideline development group – anaemia;
- Introduce members of the guideline development group to the WHO guideline development process, including Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology;
- Agree on the consensus decision-making process and decision rules;
- Develop and prioritise PICO questions;
- Identify topics for further discussions, technical meetings or research.
This WHO normative meeting is by invitation only.