title: Guidelines in lower-middle income countries.
abstract: Guidelines include recommendations intended to optimize patient care; used appropriately, they make healthcare consistent and efficient. In most lower-middle income countries (LMICs), there is a paucity of well-designed guidelines; as a result, healthcare workers depend on guidelines developed in Higher Income Countries (HICs). However, local guidelines are more likely to be implemented because they are applicable to the specific environment; and consider factors such as availability of resources, specialized skills and local culture. If guidelines developed in HICs are to be implemented in LMICs, developers need to incorporate local experts in their development. Involvement of local stakeholders may improve the rates of implementation by identifying and removing barriers to implementation in LMICs. Another option is to encourage local experts to adapt them for use in LMICs; these guidelines may recommend strategies different from those used in HICs, but will be aimed at achieving the best practicable standard of care. Infrastructural deficits in LMICs could be improved by learning from and building on the successful response to the human immunodeficiency virus/acquired immunodeficiency syndrome pandemic through interactions between HICs and LMICs. Similarly, collaborations between postgraduate medical colleges in both HICs and LMICs may help specialist doctors training in LMICs develop skills required for guideline development and implementation.
authors.affiliation: Department of Haematology, College of Health Sciences, University of Ghana, Accra, Ghana.|Ghana Institute of Clinical Genetics, Korle Bu, Accra, Ghana.
authors.forename: Edeghonghon
authors.identifier: 0000-0002-1646-4470
authors.initials: E
authors.lastname: Olayemi
authors.affiliation: Ghana Institute of Clinical Genetics, Korle Bu, Accra, Ghana.
authors.forename: Eugenia V
authors.initials: EV
authors.lastname: Asare
authors.affiliation: Department of Haematology, College of Health Sciences, University of Ghana, Accra, Ghana.
authors.forename: Amma A
authors.initials: AA
authors.lastname: Benneh-Akwasi Kuma
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D003906:Developing Countries; D019983:Guideline Adherence; D006405:Hematology / Q000592:standards; D006801:Humans; D017410:Practice Guidelines as Topic
keywords: adaptation; challenges; collaboration; guidelines; implementation