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ArticleHealth research policy and systems2025

The Guideline Uptake in Digital Ecosystems (GUIDE) study: protocol for implementation research on the impact of WHO SMART guidelines digital adaptation kits to improve quality of care.

Tigest Tamrat, Rosemary K Muliokela, Abdulaziz Mohammed Hussen, Ernest Tei Maya, Berhanu Fikadie Endehabtu, Samuel Dery, Hanna Abayneh Telake, Jessica Asante, Adane Nigusie, Soe Soe Thwin and 18 more

Abstract read
In one paragraph

Article in Health research policy and systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Tigest TamratDepartment of Sexual and Reproductive Health and Research, which includes UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1202, Geneva, Switzerland. tamratt@who.int.
Rosemary K MuliokelaDepartment of Sexual and Reproductive Health and Research, which includes UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1202, Geneva, Switzerland.
Abdulaziz Mohammed HussenCenter for Digital Health and Implementation Science, University of Gondar, Gondar, Ethiopia.
Ernest Tei MayaSchool of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Berhanu Fikadie EndehabtuCenter for Digital Health and Implementation Science, University of Gondar, Gondar, Ethiopia.
Samuel DerySchool of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Hanna Abayneh TelakeCenter for Digital Health and Implementation Science, University of Gondar, Gondar, Ethiopia.
Jessica AsanteSchool of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Adane NigusieCenter for Digital Health and Implementation Science, University of Gondar, Gondar, Ethiopia.
Soe Soe ThwinDepartment of Sexual and Reproductive Health and Research, which includes UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1202, Geneva, Switzerland.
Will ProbertDepartment of Global HIV, Hepatitis, and STIs Programmes, World Health Organization, Geneva, Switzerland.
Maria BarreixDepartment of Sexual and Reproductive Health and Research, which includes UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1202, Geneva, Switzerland.
Frances Baaba da-Costa VroomSchool of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Seth AfagbedziSchool of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Angela AbrosoSchool of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Haimanot Ambelu WorkinehGhana Country Office, World Health Organization, Accra, Ghana.
Dominic Kwabena AtweamEthiopia Country Office, World Health Organization Addis, Ababa, Ethiopia.
Kafui SenyaEthiopia Country Office, World Health Organization Addis, Ababa, Ethiopia.
Kassu Ketema GurmuGhana Country Office, World Health Organization, Accra, Ghana.
Gabriela Garcia-CamachoDepartment of Sexual and Reproductive Health and Research, which includes UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1202, Geneva, Switzerland.
Natschja RatanaprayulDepartment of Digital Health and Innovation, World Health Organization, Geneva, Switzerland.
Shona DalalDepartment of Global HIV, Hepatitis, and STIs Programmes, World Health Organization, Geneva, Switzerland.
Ӧzge TunçalpDepartment of Sexual and Reproductive Health and Research, which includes UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1202, Geneva, Switzerland.
Sarai MalumoEthiopia Country Office, World Health Organization Addis, Ababa, Ethiopia.
Nancy KidulaDepartment of Sexual and Reproductive Health and Research, which includes UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1202, Geneva, Switzerland.
Lale SayDepartment of Sexual and Reproductive Health and Research, which includes UNDP/UNFPA/UNICEF/World Bank Special Program of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 Avenue Appia, 1202, Geneva, Switzerland.
Binyam TilahunCenter for Digital Health and Implementation Science, University of Gondar, Gondar, Ethiopia.
Chris GuureSchool of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundDespite the potential for digital tools to facilitate guideline uptake, translating paper-based narrative guidelines into digital formats is resource-intensive and may compromise the fidelity to the recommended content. The World Health Organization (WHO) launched the SMART Guidelines initiative, in which digital adaptation kits (DAKs) are a foundational component. DAKs comprise software requirements documentation, including detailed data dictionary  and algorithms--derived from WHO guidelines =for encoding within digital systems.

methodsThis implementation research consists of a formative assessment and impact evaluation on integrating DAKs within national digital systems to improve service delivery outcomes for antenatal care (ANC), family planning, and HIV in two countries (Ethiopia and Ghana). The formative phase will assess the requirements to customize the DAKs to align with the national protocols and subsequently incorporate the localized DAKs' content into the respective nationally endorsed digital systems: Bahmni in Ethiopia and DHIS2 tracker in Ghana. The impact evaluation will assess the effect of using the DAK-upgraded digital systems using pre-post designs in Ethiopia and Ghana. Primary outcomes of adherence to guideline recommendations will be assessed when digital systems incorporate country-adapted DAK content in comparison with the existing practice. Guideline knowledge questionnaires and in-depth interviews with software developers, health workers and facility managers will supplement the impact evaluation. DISCUSSION: This research represents one of the first impact evaluations focused on integrating DAKs into existing national digital systems and the effect on service delivery outcomes. The mixed-methods study design will provide learnings for future scale-up and replication across other countries. We expect final results to be available in 2026, and preliminary findings will be shared at relevant fora. Trial registration https://www.isrctn.com/ISRCTN18394724 . Registration date: 21 December 2022.

Indexed as

Guideline AdherencePractice Guidelines as TopicQuality ImprovementQuality of Health CareEthiopiaFemaleGhanaHIV InfectionsHumansPregnancyPrenatal CareResearch DesignSoftwareWorld Health OrganizationAntenatal careClinical decision support systemsDigitalElectronic medical recordsFamily planningGuidelinesHealth management information systemsHIV/AIDS

Identifiers

PMID41068964
PMCPMC12512293

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.