National guideline development and adaptation, Egypt

Problem: In 2018, the Egyptian government enacted a universal health coverage law mandating provision of high-quality, effective and equitable health care. Achieving this mandate would require expanding availability and use of evidence-based national clinical practice and public health guidelines. Approach: In 2022, Egypt's Ministry of Health and Population requested support from the World Health Organization (WHO) to establish a national guideline development and adaptation programme. To inform the process, WHO conducted a situation analysis. The findings led to a collaboration between WHO and national stakeholders including the newly established Egyptian Health Council. In partnership they delivered capacity-building, developed a roadmap and implemented the programme. Local setting: Egypt is a lower-middle income country of 117 million people. Health services are provided by agencies in public (governmental and semi-governmental) and private sectors (providers and professional syndicates). No national guideline programme existed before 2022. Relevant changes: In total, 225 individuals attended the capacity-building workshops. After the council ratified the roadmap, the ministry, WHO and the council formally launched the national guideline programme in July 2024. Implementation of the programme led to clearer delineation of responsibilities, eliminated role overlaps and harmonized processes across different professional societies, teaching hospitals, nurses and allied health professionals. Lessons learnt: Consistent, informed political support and stakeholder commitment contributed to successful implementation. WHO's approach to contextualizing global guidelines added value. Challenges included reliance on international experts, constrained resources and insufficient institutional capacity. Moving forward, sustained institutional development, coaching, monitoring and evaluation, funding and stakeholder engagement are needed.