Assessing the quality of world health organisation guidelines during health emergencies : a domain-based analysis

Abstract

Background: Effective response during global health emergencies hinges on the quality of guidelines provided by authoritative organisations like the World Health Organisation (WHO). This study assessed the quality of WHO emergency guidelines disseminated through the Disease Outbreak News (DONs) platform between 2023 and 2024 to identify strengths and weaknesses across established quality domains. Methods: A total of 115 WHO guidelines issued within DONs were analysed using the AGREE II framework, which evaluates six domains: Scope and Purpose; Stakeholder Involvement; Rigour of Development; Clarity of Presentation; Applicability, and Editorial Independence. Descriptive statistics and one-way repeated measures ANOVA were conducted to determine significant differences among domain scores. Results: The analysis revealed statistically significant differences across domains, F(2.40, 552.34) = 739.09, p < .001, ηp² = 0.866. The highest mean scores were recorded for Scope and Purpose (M = 6.46) and Clarity of Presentation (M = 6.27), indicating strengths in goal articulation and user accessibility. Conversely, Editorial Independence (M = 2.74) and Rigour of Development (M = 3.26) scored the lowest, pointing to persistent gaps in transparency and methodological robustness. Conclusions: While WHO guidelines during emergencies perform well in clarity and scope, critical weaknesses remain in transparency, stakeholder engagement, and methodological rigour. These findings indicate the need for more balanced and inclusive guideline development processes to enhance trust and utility during public health emergencies.