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Table 2 Examples of WHO work to modify contextual health factors to improve guideline implementation

From: Health promoter, advocate, legitimiser — the many roles of WHO guidelines: a qualitative study

Contextual issueSituationWHO work as described by participants
Increasing medication accessA country wanted to implement a new pharmaceutical intervention according to WHO guidelines and “These medicines are not only expensive for health systems but also for individuals” (Greg, Regional Office staff)Regional and country offices “work with medicines departments, we assist the Ministry of Health, we’ve been undertaking an investment case for [disease 1]”) to increase access and decrease costs of the new medications to both health systems and to individuals (Greg, Regional Office staff)
Raising awareness/decreasing stigmaReducing stigma surrounding a poorly understood conditionRegional and country officers would encourage programmes “raising awareness of all parties and healthcare providers, general population, politicians, everybody” for the condition and treatment of the condition, and “speaking up, talking about it — that’s the first step towards reducing stigma” (Fiona, HQ staff)
Collectivising key populationsReaching marginalised patient populationsRegional and Country Officers advocated for local key populations to collectivise and form networks to help each other. Sometimes, they even have key population help run clinics as “they would rather go to these clinics, because they are more friendly” (Helen, HQ staff)