Developing and applying a ‘living guidelines’ approach to WHO recommendations on maternal and perinatal health

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How should the WHO most efficiently keep its global recommendations up to date? In this article we describe how WHO developed and applied a ‘living guidelines’ approach to its maternal and perinatal health (MPH) recommendations, based on a systematic and continuous process of prioritisation and updating. Using this approach, 25 new or updated WHO MPH recommendations have been published in 2017–2018. The new approach helps WHO ensure its guidance is responsive to emerging evidence and remains up to date for end users.


  • Over the past decade, WHO has issued over 400 maternal and perinatal health (MPH) recommendations for global use, and the size of this portfolio presents a major challenge to ensuring that all recommendations are up to date.
  • A dynamic ‘living guidelines’ approach has been developed and applied to respond more rapidly to new, important evidence that may affect specific WHO recommendations in MPH.
  • The new approach uses an evidence-informed, consultative prioritisation process, rapid updating of prioritised systematic reviews and electronic consultations with ‘living guidelines’ panels.
  • Using this approach enables WHO to efficiently use resources to execute its global mandate on normative guidance for MPH.
  • Other guideline development organisations can also adapt this approach to facilitate more rapid and efficient updating of recommendations.

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