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Several countries have initiated national clinical guideline programmes [ 16, 18, 36].
However, recent studies have reported that the methodological quality of many guidelines is modest and is heterogeneous between the different guidelines and different guideline programmes (Shaneyfelt et al, 1999; Grilli et al, 2000; Lacasse et al, 2001; Burgers et al, 2003a).
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Christine Carson, clinical guideline programme director for NICE, said: "Every woman should ultimately have the freedom to choose where she wants to give birth and be supported in her choice.
It should also be remembered that the NICE guideline programme is not the NIHR HTA Programme's only customer.
Most GPs judged the DCGP's clinical practice guideline programme in general and the guideline on CHF in particular, positively.
The developers of the SOR clinical practice guideline programme deserve commendation for their efforts to meet these information needs.
In Finland, national evidence-based guidelines have been developed and published since 1994 in the Current Care Guideline Programme for both primary and secondary care, under the auspices of the Finnish Medical Society Duodecim.
Moreover, most guidelines programmes rely on external review, as well as internal review.
This led to several opportunities in terms of policies, guidelines, programmes and investments for improving maternal health.
Based on this diversity, the experiences of the various initiatives are heterogeneous, as shown by an international survey of 19 guidelines programmes.
To ensure that guidelines are of high quality, they should be preferably developed within a structured and coordinated guidelines programme (Table 2> ).
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