WHO Principles and Tools to Improve Use and Impact of WHO Guidelines

The WHO Principles and Tools emerged from a rigorous global co-design process involving extensive stakeholder collaboration with 15 diverse countries across five of the six WHO regions. Participants included healthcare leaders, ministries of health and transport, WHO regional offices, and community representatives, ensuring comprehensive understanding of real-world needs. The Principles support the WHO to embed end-user needs in guideline development, while the Tools provide tangible design methods for empathising with users, designing for accessibility, clarity, translation, and a global movement to ‘living’ content powered by AI.

Over 2.5 years, MADA facilitated four iterative co-design consultations. Initially, 33 participants from eight countries explored barriers to guideline accessibility and implementation, informing the creation of seven prototype Principles. A subsequent consultation with 22 participants across five countries refined these principles, emphasizing clarity, accessibility, translation, and practicality.

The third and fourth consultations shifted focus to developing tangible, practical tools that support guideline mapping, clear writing, visual clarity, translation readiness, and adaptive digital formats. Participants included technical experts in translation, accessibility specialists, and WHO guideline developers, ensuring tools were practical, inclusive, and effective. This innovative process resulted in a robust, tested suite of Principles and Tools.

The resource was launched in December 2024 and is available to guideline developers in all WHO Member States (194 countries in six regions) via the WHO SharePoint system, ensuring it is embedded into workflows and processes. A public-facing version of the resource is also available on the WHO website, supporting the work of guideline developers globally.

The project’s methods and findings have been documented in two WHO reports and an academic publication (others in review), guiding broader organisational adoption and underscoring the value of design methods in global health contexts.

The WHO Principles and Tools exemplify design excellence in process and execution, setting a new benchmark in global public health and social impact. The initiative followed a deeply human-centred design approach that balanced systems-level consultation with ground-level insights.

Over 2.5 years, MADA engaged stakeholders across 15 countries — including government officials, healthcare workers, WHO technical teams, and people with lived experience — to co-design, test, refine, and evaluate the principles and tools. Through iterative feedback, live testing, and evaluation, the project tackled real-world barriers such as clarity, accessibility, translation, and understanding end-user needs.

Designed for seamless integration across the entire guideline lifecycle — from planning through layout and dissemination — the Principles guide WHO teams to prioritise end-user understanding, clarity, and accessibility. The complementary Tools facilitate guideline mapping and stakeholder engagement, clear and concise writing, and accessible layout for low-bandwidth environments or low-vision readers. Intuitive and downloadable for offline or digital use, the resource requires no training, making it ideal for resource-limited settings.

The initiative supports WHO’s core normative function and is designed for scale across all six regions and 194 Member States. Already implemented in critical WHO programmes — such as global hand hygiene initiatives and reproductive health guidelines — the resource streamlines organisational workflows, reduces production inefficiencies, and contributes to significant enhancement of global uptake and impact.

MADA’s ongoing collaboration with WHO ensures sustained alignment with broader organisational goals and evolving global health challenges. By embedding design thinking early and systematically, the WHO Principles and Tools fundamentally transform how WHO health guidelines are created, presented, and implemented. They not only enhance immediate usability and effectiveness but also foster sustained improvements in disseminating health advice that impacts billions globally — demonstrating the transformative potential of design thinking at scale.

The WHO Design Principles and Tools represent a pioneering leap in applying design thinking systematically in global multilateral contexts. The resource innovatively redefines traditional guideline development — shifting from a static, expert-driven approach to a dynamic, user-centred model responsive to real-world contexts, capabilities, and motivations, while remaining evidence-based. This person-centred model is not only transformative in global guideline design but also scalable across geographies and health domains.

This is the first time design thinking has been systematically scaled across the WHO, focusing on the WHO guideline development process and systematically engaging diverse stakeholders from across 15 countries, ensuring comprehensive representation of diverse health contexts. This process created Principles and practical Tools explicitly designed to address significant implementation barriers — lengthy documents, inaccessible formats, and inadequate contextual relevance.

The design process itself is also innovative, requiring global co-design methods to engage input from 15 countries over 2.5 years. These design processes and the artefacts developed enabled the global stakeholder community to understand the motivations of guideline developers and guideline users, which is critical for the successful implementation of a guideline.

By leveraging systems thinking, the WHO Principles and Tools foster collaboration across sectors and break down silos within and between WHO departments (those leading the development) and external collaborating organisations (those contributing to development). They encourage multidisciplinary input — from clinical experts to behavioural scientists and health economists — to ensure guidelines are co-created with the communities they serve.

The project also sets the stage for future innovations, including leveraging AI-driven digital platforms to facilitate rapid guideline updating, adaptation, and localisation — advancing the concept of “living” guidelines adaptable to shifting global health contexts. Ultimately, the WHO Principles and Tools demonstrate the transformative potential of institutionalising design thinking within complex multilateral settings, creating scalable methods to deliver globally relevant, highly adaptable, and deeply impactful public health guidance.

The WHO Principles and Tools resource is creating global design impact by enhancing how WHO guidelines are accessed, understood, and implemented — strengthening WHO’s influence on public health. Developed over 2.5 years through global co-design processes, the initiative marks a cultural shift across WHO and its 194 Member States, prioritising user needs and real-world context in health guideline design. It equips technical teams with practical, evidence-informed tools to create more effective and efficient guidelines.

This initiative addresses key barriers — complexity, inaccessibility, and limited input from users — that often hinder implementation of recommended interventions. By overcoming these, the resource boosts the likelihood that recommendations are acted upon. Since its December 2024 launch, the resource has supported development of a global hand hygiene implementation framework, informed adaptation of abortion care guidelines for Mauritius, and contributed to the co-design of a living evidence technology platform with the Asia Pacific.

The impact of the WHO Principles and Tools is both measurable and scalable. WHO tracks implementation impact through web analytics, SharePoint usage data, and formal consultation requests, providing quantitative evidence of widespread, meaningful adoption. WHO departments now routinely report their use of the resource in global consultations. Ongoing Monash University research evaluates effectiveness and usage patterns, ensuring continuous refinement and evidence-based enhancements.

Ultimately, the initiative improves guideline implementation, supporting SDG 3, WHO’s 14th General Programme of Work, and the goal of achieving “the highest attainable standard of health” for all. It stands as a global model of design for social impact, with potential for wide-reaching application across regions, disciplines, and health priorities. The resource is available to guideline developers in all WHO Member States (194 countries in six regions), supporting evidence-based care of billions of people worldwide, particularly in low-resource settings.