Table 2 Examples of guideline adaptation situations in the Copy or Customise model
Situation | Example | Quote |
|---|---|---|
Whole recommendations are adopted | Direct usage of WHO guidelines | “Often countries that don’t have the resources, don’t have the human or financial resources will just copy and paste our guidelines.” (Garry, Regional Office Staff) |
Parts of recommendations are adopted | Customised to adopt only parts of recommendations AND/OR some recommendations due to medication availability | “We kind of updated this pocketbook which would be very useful … but we needed the country adaptation meaning the translation and also some of the parts had to be [adjusted], again, because some of the drugs that this group was talking about were missing in the country pharmacy so we had to make an adjustment for that.” (Judy, Country Office Staff) |
Recommendations are customised | Change recommendations due to resource limitations in the context | “When WHO made the recommendation of … treat all, irrespective of the [Diagnostic Measure 1], that people should be put on treatment … because one is the recommendation to ‘treat all’ but the other is that, okay, if you have limited resources you also need to do prioritisation... so [MOH] didn’t want to move straight to treat all … it was that for all key populations you can start irrespective of [Diagnostic Measure 1].” (Nicole, Regional Office Staff) |