Dissemination, adaptation and implementation

Publication Details


The current guideline will be disseminated through electronic media such as slide presentations, CD-ROMs and the World Wide Web, either through the World Health Organization (WHO) Micronutrients and United Nations Standing Committee on Nutrition (SCN) mailing lists or the WHO nutrition web site. The Department of Nutrition for Health and Development is developing the WHO e-Library of Evidence for Nutrition Actions (eLENA). This library aims to compile and display WHO guidelines related to nutrition, along with complementary documents such as systematic reviews and other evidence that informed the guidelines, biological and behavioural rationales, and additional resources produced by Member States and global partners. This guideline will also be disseminated through a broad network of international partners, including WHO country and regional offices, ministries of health, WHO collaborating centres, universities, other United Nations agencies and nongovernmental organizations. It will also be published in the WHO Reproductive Health Library.

Adaptation and implementation

As this is a global guideline, it should be adapted to the context of each Member State. Prior to implementation, an intermittent iron and folic acid supplementation programme should have well-defined objectives that take into account available resources, existing policies, suitable delivery platforms and suppliers, communication channels and potential stakeholders. Supplementation programmes should start with a pilot and scaled up as experience and evidence grow and resources allow. Ideally, intermittent iron and folic acid supplementation should be part of a national strategy to control nutritional deficiencies and should be integrated into national programmes focused on adolescent and reproductive health.

To ensure that WHO global guidelines and other evidence-informed recommendations for micronutrient interventions are better implemented in low- and middle-income countries, the Department of Nutrition for Health and Development works with the WHO Evidence-Informed Policy Network (EVIPNet) programme. EVIPNet promotes partnerships at country level between policy-makers, researchers and civil society to facilitate policy development and implementation through use of the best available evidence.

Monitoring and evaluation of guideline implementation

A plan for monitoring and evaluation with appropriate indicators is encouraged at all stages. The impact of this guideline can be evaluated within countries (i.e. monitoring and evaluation of the programmes implemented at national or regional scale) and across countries (i.e. the adoption and adaptation of the guideline globally). The WHO Department of Nutrition for Health and Development, Micronutrients Unit, jointly with the US Centers for Disease Control and Prevention (CDC) International Micronutrient Malnutrition Prevention and Control (IMMPaCt) programme, and with input from international partners, has developed a generic logic model for micronutrient interventions in public health to depict the plausible relationships between inputs and expected MDGs by applying the micronutrient programme evaluation theory. Member States can adjust the model and use it in combination with appropriate indicators, for designing, implementing, monitoring and evaluating the successful scaling-up of nutrition actions (27).

For evaluation at the global level, the WHO Department of Nutrition for Health and Development is developing a centralized platform for sharing information on nutrition actions in public health practice implemented around the world. By sharing programmatic details, specific country adaptations and lessons learnt, this platform will provide examples of how guidelines are being translated into nutrition actions.

Examples of programmes implemented in two WHO regions have been recently published (16, 28).