Table 2 EDL (2013) AGREE domains support quotations

1. Scope and purpose

Quote 2a: “In the EDL objectives are not clearly explained, for example, it is not stated how much percentage this intervention [guideline] is expected to reduce mortality from malnutrition” (Informant 4, Paediatric Ward Doctor)

2. Stakeholder involvement

Quote 2b: “The national essential drug list committee appointed by the Minister of Health [national official] includes health professionals, officials from the ministry of health and heads of pharmaceutical services from the provinces” (Informant 2, Government Official) Quote 2c: “They should involve clinical associates when developing these guidelines; we are in the field, we are likely to say what is needed” (Informant 6, Clinical Associate)

3. Rigour of development

Quote 2d: “Honestly, there is not always evidence thus sometimes only expert opinions are used. Particularly when new medicine has to be added then there has to be a systematic review of evidence and cost effectiveness of introducing a new medicine” (Informant 2, Government Official) Quote 2e: “In those forums the loudest voice wins, I wrote them to revise treatment per the new WHO recommendations, guess what, they overlooked my suggestion” (Informant 3, Academic)

4. Clarity of presentation

Quote 2f: “The EDL is very good for individuals experienced in SAM care, if not, some treatments are skipped since one has to go back and forth the pages. It could be best if the treatments were outlined in specific steps of execution for beginners or clinicians with general training” (Informant 4, Paediatric doctor)

5. Applicability

Quote 2 g: “affordability is taken into account at national level thus once something is in the EDL the affordable drugs team makes sure supplies are procured and made available. That’s the theory to say once something is in the EDL it should be available in the whole country” (Informant 2, Government Official)

6. Editorial independence

Quote 2 h: “The EDL is funded by national department of health and there is a process for managing conflict of interest. So no funding will ever be accepted from any supplier that has interest” (Informant 2, Government Official)