Community engagement in health guidelines and other normative products: a methodological review

OBJECTIVE: To explore and map how community engagement is conducted in the development or adaptation of health guidelines, norms and standards.

METHODS: We conducted a methodological review by searching MEDLINE, Scopus and CINAHL databases for articles published from January 2007 to May 2025, excluding publications reporting the engagement of only one or two community members on the guideline development panel. We extracted and categorized data on guideline characteristics (type of guideline, issuing entity, health-care topic), community engagement methods, the stages of guideline development for which community members were engaged and any evidence of evaluation. We compared the study characteristics using descriptive statistics.

FINDINGS: We reviewed 267 publications representing 258 unique studies, predominantly based in high-income countries. We observed that people affected by the health condition were most commonly engaged, and typically through surveys, workshops or as panel members. We noted that community engagement was most commonly used to identify community priorities and values, but less frequently for defining guideline scope or implementation. Although some studies described innovative approaches (for example, including lived-experience panels), these are rarely implemented globally. Only a small proportion of our reviewed studies included any evaluation of guideline development practices.

CONCLUSION: Our review highlights the importance and challenges of implementing community engagement in global health guideline development, which may involve adapting existing engagement methods to a global context, leveraging technology while encouraging diversity, and carefully balancing the costs and benefits of extensive engagement. Striving for inclusive guideline development processes can lead to effective and equitable health recommendations worldwide.