Building capacity for clinical practice guideline development: Experiences from Malawi, Nigeria and South Africa

Background: Within the Global Evidence, Local Adaptation (GELA) project, we offered training to guideline development group (GDG) and steering group (SG) members in Malawi, Nigeria and South Africa, to build capacity in clinical practice guideline (CPG) development. Aim: This study aimed to evaluate the capacity development of GDG and SG committee members within GELA. Setting: Guideline development group members were mainly based at health or academic institutions, while SG members were mostly linked to the health ministries in Malawi, Nigeria and South Africa. Methods: We used mixed-methods for our summative evaluation, comprising a document analysis, online surveys, semi-structured, in-depth interviews and a structured reflection. For the survey, respondents rated their confidence in knowledge, skills and behaviour before and after GELA. Data were analysed with R studio. We interviewed selected participants from all countries and analysed qualitative data through framework analysis. The author team met in-person to reflect on activities, survey findings and interview data. Results: Confidence in CPG development skills and related behaviour increased during GELA. Qualitative themes showed an enhanced understanding and valuing of a rigorous guideline development process that should be sustained and institutionalised. The intensive nature of training, limited internet connectivity, time constraints and unmet expectations, were some reported challenges. Participants appreciated increased collaboration and opportunities for future networking. Reflections highlighted the importance of learning by doing. Conclusion: Global Evidence, Local Adaptation built capacity of GDG and SG members to participate in rigorous CPG development through a multifaceted approach. Continued networking and collaboration of various stakeholders is key to sustain learning. Contribution: Capacity for rigorous CPG development can be built through a strategic multifaceted capacity development programme and learning by doing.