Key domains that require consideration when formulating WHO recommendations
| Factor | How the factor influences the direction and strength of a recommendation |
| Quality of the evidence | The quality of the evidence across outcomes critical to decision making will inform the strength of the recommendation. The higher the quality of the evidence, the greater the likelihood of a strong recommendation. |
| Values and preferences | This describes the relative importance assigned to health outcomes by those affected by them; how such importance varies within and across populations; and whether this importance or variability is surrounded by uncertainty. The less uncertainty or variability there is about the values and preferences of people experiencing the critical or important outcomes, the greater the likelihood of a strong recommendation. |
| Balance of benefits versus harms | This requires an evaluation of the absolute effects of both benefits and harms (or downsides) of the intervention and their importance. The greater the net benefit or net harm associated with an intervention or exposure, the greater the likelihood of a strong recommendation in favour or against the intervention. |
| Resource implications | This pertains to how resource intense an intervention is, whether it is cost–effective and whether it offers any incremental benefit. The more advantageous or clearly disadvantageous the resource implications are, the greater the likelihood of a strong recommendation either for or against the intervention. |
| Priority | The problem’s priority is determined by its importance and frequency (ie, burden of disease, disease prevalence or baseline risk). The greater the importance of the problem, the greater the likelihood of a strong recommendation. |
| Equity and human rights | The greater the likelihood that the intervention will reduce inequities, improve equity or contribute to the realisation of one or several human rights as defined under the international legal framework, the greater the likelihood of a strong recommendation. |
| Acceptability | The greater the acceptability of an option to all or most stakeholders, the greater the likelihood of a strong recommendation. |
| Feasibility | The greater the feasibility of an option from the standpoint of all or most stakeholders, the greater the likelihood of a strong recommendation. Feasibility overlaps with values and preferences, resource considerations, existing infrastructures, equity, cultural norms, legal frameworks and many other considerations. |
Reproduced from the WHO 2014.1