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Developing the 2023 WHO guideline on wasting and nutritional oedema in infants and children

Key reflections on processes and methods

Bibliographic Data

ID21881583
AuthorsCeleste Naude (0000-0002-9114-1452, Stellenbosch University), Michael McCaul (0000-0002-2730-6478, Stellenbosch University), Kirrily de Polnay (World Health Organization), Jaden Bendabenda (0000-0001-6231-1224, World Health Organization), Zita Weise Prinzo (World Health Organization), Allison I Daniel (0000-0002-1774-1214, World Health Organization)
Year2025
Volume10
IssueSuppl 5
Pagese017223
Publication date2025-08-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2024-017223
PMID40803703
OpenAlexW4413115311
LanguageEN
Citations received4
References cited19

The 2023 WHO guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition) in infants and children under 5 years has a broad scope aligned with WHO’s responsibility to develop a comprehensive guideline as part of the Global Action Plan on Child Wasting. A WHO technical team consisting of the WHO Steering Committee for this guideline, supported by a consultant and two independent methodologists, coordinated guideline development according to WHO’s standards and methods. The guideline contains 21 recommendations and 12 good practice statements on prevention and management across four focus areas. As can be expected from a broad guideline covering many new areas, we faced complexities. As a technical team involved throughout the 3-year process, we reflected on the challenges and our experiences in addressing these. In this paper, we summarise selected elements of processes and methods and our key reflections and learnings relevant to three challenging areas that may be useful to other guideline developers and groups addressing complex needs across contexts. Key reflections included (1) implementing comprehensive and systematic prioritisation was time well spent, allowing the most pressing guidance gaps to be addressed first, while also identifying possible future gaps; (2) evidence syntheses and evidence-to-decision approaches for broad and composite guideline questions required careful planning and coordination, which helped streamline Guideline Development Group discussions and consensus during decision-making and (3) putting steps in place aimed at ensuring consistency and rigour across multiple questions, reviews and meetings improved transparent and systematic guideline development processes

Guideline · Intensive care medicine · Pathology · Wasting · Clinical Nutrition and Gastroenterology · Computer Science · Diet and metabolism studies · Medicine · Obesity and Health Practices · Internal Medicine · Pediatrics

  • Strengthening the evidence base around prevention and management of wasting and nutritional oedema in infants and children

    Open Access•Allison I Daniel, Kirrily de Polnay et al.•BMJ Global Health•2025

  • Infants and children 6–59 months of age with moderate wasting

    Open Access•Indi Trehan, Robert H J Bandsma et al.•BMJ Global Health•2025

  • A WHO global research priority agenda for wasting and nutritional oedema in infants and children under 5 years

    Open Access•Allison I Daniel, Allison Daniel et al.•BMJ Global Health•2025

  • Development of core outcome sets for effectiveness trials focused on infants and children with wasting and nutritional oedema

    Open Access•Allison I Daniel, Kirrily de Polnay et al.•BMJ Global Health•2025

  • Grade

    Open Access•Gordon H Guyatt, Gordon Guaytt et al.•BMJ•2008

  • Framework for enhancing clinical practice guidelines through continuous patient engagement

    Open Access•Melissa J Armstrong, Juan‐David Rueda et al.•Health Expectations•2017

Citations per year4
Citation span2025 - 2025 (1)
Highly citedNo

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