5
of the sessions. Participants who had recent or current research funding or personal payments from commercial entities on topics related to the meeting were excluded
from voting on inal ratiication the recommendations. he following declarations of interest by members were assessed and found to be
insuicient to exclude from full participation:
n
Fizan Abdullah declared research grants from NIH for necrotizing enterocolitis;
n
Shinjini Bhatnagar declared research funding for projects related to the topic of the meeting;
n
Harry Campbell declared making public statements for international action against pneumonia;
n
Trevor Duke declared completing systematic reviews related to the subject of the meeting;
n
Michael English declared research grants from the Wellcome Trust, the Gates Foundation, the Royal College for Paediatrics and Child Health RCPCH, and
the Hillman Medical Education Fund HMEF on topics related to this meeting;
n
Andrew Gray declared receiving honorarium and travel support from Aspen pharmaceuticals and Fresenius Kabi South Africa as a guest speaker, in 2009;
n
Stuart Macleod declared being a director, which ceased in 2010, of an institution that received research grants with no direct involvement from several commercial
and non-commercial entities. he following members were excluded from inal ratiication of the recommendations:
n
Haroon Saloojee received personal payments from the National Institute of Health US 3000, was an advisory board member on rotavirus project of GlaxoSmith-
Kline in 2008, as well as personal payment by Nestle Nutrition US 2500;
n
Leonila Dans declared a current research grant not related to the topic of the meeting from Pizer with personal payments of about US 2000year in 2010.
1.5 Guiding principles
he principles guiding the development of these recommendations were based on providing optimal public health guidance using the best available evidence in the
management of common childhood conditions in settings with limited resources. he guiding principles are as follows:
n
Prioritize and optimize the best options for treatment of common childhood illnesses to improve quality of care in hospitals in low-resource settings.
n
Promote best practices based on a high quality level of evidence supporting strong recommendations in order to deliver the highest standards of care despite limited
resources.
n
Analyse and balance the beneits, risks, and feasibility of implementation of the recommendations in hospitals with limited resources.
n
Build consensus among experts on recommendations in situations where there is very low quality or no supporting evidence.
6
2. Methodology and process
2.1 Defining the scope
he scope was deined by reviewing the 2005 edition of the Pocket Book of Hospital Care for Children and identifying the relevant recommendations that required
updating. he department initiated a consultative process in 2009 to map out the status of WHO guidelines and recommendations that contributed to the development
of the Pocket Book. In 2010, a Guidelines Steering Committee was set up consisting of members from key departments within WHO, including the Department of
Maternal, Newborn, Child and Adolescent Health, Global Malaria Program GMP, Essential Health Technologies EHT, Mental Health and Substance Abuse MSD,
Essential Medicines and Pharmaceutical Policies EMP, Stop TB STB, and Nutrition for Health and Development NHD. Consultations were undertaken
with external experts implementing the Pocket Book or and with those who were previously involved in writing andor editing the irst edition in an efort to identify
gaps, emerging evidence, or changes to clinical practice. Furthermore, feedback from the two ield surveys conducted in 2008 and 2009 on the implementation and use of
the Pocket Book were drawn upon to identify additional priority areas to be updated.
he process identiied two categories of updates for the Pocket Book:
n
Revisions to align the Pocket Book recommendations with recently published Guideline Review Committee GRC-approved WHO guidelines.
n
Revisions of priority areas that required collation, analysis, and synthesis of the evidence to make recommendations in line with the current level of evidence.
In the irst category, recommendations from existing GRC-approved WHO guide- lines were identiied for direct incorporation into the Pocket Book. he second
category required systematic reviews to provide evidence to update or make new recommendations. he second category is the basis of this document wherein the
group identiied speciic priority chapters, sections, and subsections of the Pocket Book requiring updates. As a result, a total of 34 PICO
1
questions were formulated for evidence collation and synthesis
Annex 2 .
1
PICO: PopulationPatient Group, Intervention, Comparator, and Outcome. A PICO question is one that is formulated using the PICO framework, wherein the health-care provider asks and answers a
series of questions meant to elicit information about their patient and their condition, interventions that have been undertaken or should be taken, any comparisons between the current treatment and
possible alternatives, and outcomes to be desired or achieved.
