Adapting and implementing health systems guidelines: learning lessons from countries

Adapting and implementing evidence-based health system guidelines presents numerous challenges, particularly when they are introduced in settings that differ from those in which they were originally developed [ 1 ]. Effective implementation requires careful consideration of local context and the development of processes that enable these guidelines to be adapted to the specific settings and populations [ 2 ] Health guidelines traditionally have focused on clinical practice and healthcare service delivery, but there is a growing global recognition of the importance of developing guidelines that address structural and policy-level challenges to strengthen the broader health system [ 3 ]. Their integration into policy and practice has been associated with significant improvements in health outcomes for the target populations [ 4 ]. Furthermore, effective implementation is critical for strengthening health systems and advancing progress toward the Sustainable Development Goals (SDGs). Despite this, empirical knowledge about the diverse factors influencing the adaptation and implementation of health system recommendations remains limited, particularly in low- and middle-income countries (LMICs) [ 5 ].