Use of qualitative research in World Health Organisation guidelines: a document analysis

Area of Science:

• Health Services Research
• Evidence Synthesis
• Qualitative Research Methods

Background:

• Guidelines rely on effect estimates from randomized controlled trials.
• Qualitative research can enhance guideline decisions, but its integration methods are unclear.
• This study examines qualitative evidence use in World Health Organization (WHO) guidance since 2020.

Purpose of the Study:

• To describe and appraise the utilization of qualitative research in WHO guidelines.
• To identify how qualitative evidence informs different stages of guideline development.
• To assess the transparency and quality of qualitative evidence integration.

Main Methods:

• Document analysis of WHO guidelines published between 2020 and 2022.
• Purposive sampling of guidelines on maternal and newborn health (MANH) and infectious diseases.
• Deductive frameworks used to describe and appraise the use of qualitative evidence.

Main Results:

• Over half of the 29 analyzed guidelines (18/29) incorporated qualitative research.
• Qualitative evidence informed guideline scope (8/18), recommendations (all 18), and implementation (1/18).
• Reporting lacked transparency in evidence interpretation and weighing; contextualization of recommendations was limited.

Conclusions:

• Qualitative research is frequently used in WHO guidelines, particularly for MANH.
• The integration process often lacks transparency and methodological rigor.
• Further development is needed to enhance the use of qualitative evidence for implementation considerations and recommendation contextualization.