Two researchers with the Centre for Evidence-based Health Care (CEBHC) are involved in an important World Health Organisation (WHO) project to update and develop a global guideline on the prevention and treatment of child wasting.
Prof Celeste Naude and Dr Michael McCaul from the CEBHC are supporting the development of this guideline as methodologists, complementing the technical expertise of the subject-matter experts.
The United Nations (UN) Agencies working on the prevention of child wasting recently developed the Framework for the Global Action Plan (GAP) on Child Wasting. One essential component of the GAP for wasting is to update and develop wasting guidelines and tools to support governments with the prevention and treatment of child wasting in all contexts.
The World Health Organisation (WHO) is currently working with other UN agencies and key stakeholders to update and develop a global guideline on the prevention and treatment of child wasting, with the potential to impact actions aimed at reducing wasting in the more than 45 million children under five years of age worldwide (6.7% of all children) who suffer from wasting.
The WHO guideline development process uses the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to assess the certainty of a body of evidence, and to develop and formulate recommendations.
Naude and McCaul’s involvement in the project started in December 2020 and they are gaining valuable hands-on experience in being methodologists.
“In this role we are advising the WHO guideline steering committee, supporting the technical and systematic review teams, and facilitating the review of the evidence by the guideline development group to make recommendations via the GRADE Evidence to Decision (EtD) Framework,” explains McCaul.
This particular WHO guideline has a comprehensive scope covering more than 16 recommendations, including intervention, prevention, diagnostic and prognostic questions related to moderate and severe wasting in infants and children older than six months of age, as well as growth faltering in infants younger than six months. Naude adds that “this scope and diversity has demanded our active involvement, substantial methodological inputs and a significant time-commitment from us throughout the process, including navigating various challenges and novel territory, such as the application of methods to include prognostic evidence in recommendations about interventions”.
Naude and McCaul have described their experience thus far as an opportunity for rich and real-time experiential learning, which is “intensely rewarding but can simultaneously be very challenging at times”. Positive aspects of this role include learning to work well together, and building on each other’s strengths, understanding and perspectives to problem-solve, in order to fulfil their responsibilities in the guideline development process. Some challenges have been specific methodological synthesis challenges, as well as the need to balance other deliverables and projects.
The guideline development group meetings, essential for producing transparent recommendations, have continued throughout 2022, with Naude and McCaul serving as Methods Chairs for these meetings. The meetings have predominantly been three-hour online sessions and the methodologists will also attend the only face-to-face meeting for this guideline in September at the WHO headquarters in Geneva.
Photo Caption: Dr Michael McCaul and Prof Celeste Naude.