​South Africa and Stellenbosch University (SU) will be represented in the influential World Health Organisation's Guidelines Review Committee (GRC) for a second consecutive term.

Prof Ian Couper, Director of the Ukwanda Centre for Rural Health and professor of Rural Health at the Faculty of Medicine and Health Science's Centre for Health Professions Education, recently received official confirmation of the GRC's invitation to serve another term, expiring at the end of 2019.

The committee mainly consists of World Health Organisation (WHO) staff members, and he is one of only four external members. “I think the importance of the appointment is in terms of the particular role and perspective I bring to the committee. Most of the other members are epidemiologists, public health specialists, experts in evidence-based health care and biostatistics," Couper explains.

“Though I've been involved in research for many years as someone who has been engaged in rural health care for the last 25 years, I think I bring an outside perspective, a more practical and on-the-ground perspective, which allows me to share how I see the guidelines might be implemented and influence practice." Couper is the only South African serving on the GRC.

His original appointment in 2013 followed after his involvement in two sets of non-disease- related guidelines, the first to have gone through the committee. “I was involved in an expert panel that was developing global policy recommendations for the WHO on increasing access to health workers in remote and rural areas through increased retention. I also became involved in producing another set of guidelines that required even more work to get it through the GRC, because it was so different to other guidelines: it was about transforming and scaling up professional health education."

Shortly after this he was nominated for a position on the GRC, recognising his perspective as someone involved not only in frontline healthcare, but also in health systems development and the management of clinical practice.

According to Couper, the GRC has relevance and importance on many levels. “The GRC was established by the WHO director-general in 2007 to ensure all guidelines are evidence-based and not simply the opinion of a group of experts. As a result, all WHO documentation containing guidelines or recommendations for use by governments and health services throughout the world, have to go through the committee. The GRC also has to be transparent and evidence-based in its decisions. Every guideline is reviewed during two different stages of development: at the planning stage and again in the final stages."

Couper says it's important for the WHO to achieve a balance between making sure the guidelines are technically correct and accessible to everybody. “The whole review process and how evidence is used and then applied is very technical. Yet, most people who read and use the guidelines are not technical."

Another challenge, and one he believes he can assist with, is that of addressing both well-resourced countries and less-resourced countries, and the range in-between, in the way that guidelines are being delivered.

Couper doesn't fly to the WHO's head office in Geneva, because the GRC holds monthly web-based meetings to ensure that the ball keeps on rolling. “I wasn't expecting a reappointment. I think that it's a validation of my role and the contribution that I've been able to make."