gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Guideline Adaptation in Kazakhstan

Meeting Abstract

  • S. Muratov - Canadian Society for International Health, Toronto, Canada
  • E. Lang - University of Cagary, Calgary, Canada
  • J. McGowan - University of Ottawa, Ottawa, Canada
  • V. Foerster - Ottawa, Canada
  • D. Montoya - University of Ottawa, Ottawa, Canada
  • K. Rustemova - Center for Standardization, Republican Center for Health Development, Astana, Kazakhstan

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP131

doi: 10.3205/12gin243, urn:nbn:de:0183-12gin2432

Published: July 10, 2012

© 2012 Muratov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: In 2010, the Government of Kazakhstan and the World Bank initiated a multi-year, multi-component health system reform project to introduce institutional transformation and improve health outcomes. Evidence-based clinical practice guidelines (CPGs) are seen as instrumental.

Context: The Canadian Society for International Health (CSIH) has partnered with Kazakhstan’s Ministry of Health to build capacity to adapt and implement high quality international CPGs. Working Groups (WGs) comprised of clinical experts and health policy-makers are now established in four major medical specialties. CSIH has been supporting this process through a twinning program that has focused on mentorship and training workshops.

Best practice description: The adaptation process is based on CAN-IMPLEMENT. Key CPG topics are being identified, primarily by the Kazakhstani partners, using priority setting principles. The quality of candidate CPGs is then assessed by two CSIH experts using AGREE II. The WGs review the selected CPGs on a recommendation-by-recommendation basis and adopt, reject or modify each recommendation. Implementation barriers and facilitators are also identified. Background sections of a CPG template for Kazakhstan are then completed based on the chosen CPG.

Lessons Learned to Date: the desire of local officials to adapt too many CPGs within a short timeline is counterproductive; most relevant literature is only published in English and insufficient English language skills are a major barrier for local partners; copyright issues have added complexity and limited progress; a short version of AGREEII (emphasis on scope, bias and usability) may be ideal in this setting.