Translating research into action: WHO evidence-informed guidelines for safe and effective micronutrient interventions

Abstract

In 2009 WHO adopted a new process by which recommendations for safe and effective micronutrient interventions are developed, ensuring the use of best practices and available evidence. This process includes nine steps ranging from establishing steering and guideline groups and prioritizing needs to planning the implementation and updating the guidelines. Systematic reviews of evidence are used to address critical outcomes for decision making, considering the balance among risks and benefits, values, preferences, and costs. Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology is used to assess the overall evidence quality and establish the strength of the recommendations. Guideline development is underway for interventions covering iron and vitamin A supplementation, home fortification with multiple micronutrient powders, and fortification of staple foods. Global guidelines are disseminated through the WHO electronic Library of Evidence for Nutrition Actions, a resource of the evidence and tools for scaling-up micronutrient interventions. The WHO Department of Nutrition for Health and Development and the Evidence-Informed Policy Network will support countries to scale-up the delivery of micronutrient interventions by adapting these evidence-informed guidelines and policies to make them context specific. This will be accomplished by providing summaries of the best available evidence on micronutrient interventions, evidence on health systems, and effective delivery systems along with capturing the tacit knowledge of the countries' realities. With a systematic approach that uses the WHO strategy on research for health as the connecting thread, the challenges to successfully implement safe and effective micronutrient programs can be addressed.