WHO-INTEGRATE evidence to decision framework version 1.0
The WHO-INTEGRATE framework helps health decision-makers consider all important factors when making health recommendations. It focuses on WHO's core values and takes into account complex real-world conditions. The framework includes six main areas to assess—like health effects, fairness, human rights, costs, and feasibility—and also considers how strong the evidence is. It guides users through structured questions and methods to support better decisions at global and national levels.
At a glance
Use when
Developing health guidelines or making policy decisions at global or national levels, especially when equity, human rights, and complex system effects are important.
Avoid when
Rapid decisions with limited data availability across social, ethical, or equity domains, or when a purely clinical or cost-effectiveness focus is sufficient.
Inputs
Evidence on health outcomes, equity impacts, human rights considerations, economic data, feasibility factors, and quality of evidence across domains.
Outputs
Structured assessment to inform health guidelines or policy decisions, including rationale for recommendations based on multiple criteria and context-specific factors.
How it works
The WHO-INTEGRATE EtD framework version 1.0 is a principles-based, iterative framework developed from WHO norms and values and informed by an overview of systematic reviews on health decision criteria. It comprises six substantive criteria: balance of health benefits and harms, human rights and sociocultural acceptability, health equity, equality and non-discrimination, societal implications, financial and economic considerations, and feasibility and health system considerations, along with the meta-criterion of quality of evidence. Each criterion includes definitions, subcriteria, example questions, and suggested methods for evidence collection and synthesis. The framework is designed to support context-specific and problem-specific decision-making in guideline development and broader health policy, with explicit attention to complexity and equity. Further validation and refinement are planned through field testing and multidisciplinary input.
- HTA domains
- Clinical Effectiveness, Costs & Economic Evaluation, Patient and Social Aspects
- Assumptions
- Decision-making should be guided by WHO norms and values; health interventions operate within complex systems; equitable and rights-based considerations are essential in health decisions.
- Strengths
- Rooted in WHO norms and values,Explicit focus on equity, human rights, and complexity,Applicable across diverse interventions and contexts,Provides structured guidance with example questions and methods
- Limitations
- May require adaptation for local contexts,Framework is labeled version 1.0, indicating it is subject to change,Relies on availability of data across multiple domains, which may be limited
- Also known as
- WHO-INTEGRATE EtD framework, INTEGRATe Evidence framework
Questions this answers
- › What are the health benefits and harms of the intervention?
- › How does the intervention affect human rights and sociocultural values?
- › Does the intervention promote health equity and avoid discrimination?
- › What are the broader societal implications of implementing the intervention?
- › What are the economic costs and financial impacts of the intervention?
- › Is the intervention feasible to implement within the health system and context?
References & sources
Related methods
Similar by meaning
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