ArticleHealth research policy and systems2026
Developing a strategy for identifying recommendations prioritized for implementation in the Colombian health system.
Article in Health research policy and systems, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth systems guidelines (HSGs) developed by the WHO and clinical practice guidelines (CPGs) developed by the Colombian Ministry of Health can potentially support national and subnational policy-development processes. Barriers to implementation encountered when making necessary changes to the Colombian health system led to our research question: What prioritized recommendations are pending implementation in Colombia, and which require changes in health system arrangements?
methodsA document analysis of all 58 Colombian CPGs and all 14 WHO HSG documents was performed in April 2020. We extracted information about recommendations prioritized on the CPGs/HSGs, updated status (documents were outdated if 5 years had elapsed since publication, and close to outdated if they were in the fifth year since publication), and the strength and direction of the recommendation as graded by the guideline development group. Recommendations were evaluated by two researchers to determine whether their implementation required making changes to the health system. Those changes were classified into three dimensions: governance, financial and delivery arrangements.
resultsIn the 71 guidelines, 958 recommendations were identified. A total of 393 (41.0%) were updated, 425 (44.4%) were outdated and 140 (14.6%) were close to outdated. Regarding the strength and direction of the recommendations, 540 were strong (56.4%), 189 were weak (19.7%) and 173 were suggested or recommended in a specific context (18.1%). Most of the recommendations were in favour of the intervention (n = 861, 89.9%), and only 97 were against the intervention (10.1%). Among the 363 recommendations from the WHO HSGs, 244 (67.2%) had not been implemented in Colombia. Of 958 recommendations, 518 (54.1%) needed a health system arrangement for their implementation: 259 in governance, 102 in financial and 503 in delivery.
conclusionsWe identified 518 recommendations that require change in Colombian health system arrangements. The most common change was related to availability of care, given that many of the recommendations refer to technologies/services approved and publicly funded but not widely available or accessible to different population groups. Further research may evaluate whether this strategy helps to define priorities for implementation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.