Background: Clinical practice guidelines (CPG) constitute an important decision-making tool adopted by healthcare professionals.

Objectives: Nowadays, CPG development is a priority in Tunisia to improve healthcare quality and efficiency, and great efforts have been devoted to implementing CPGs in Tunisia.

Methods:The National Instance for Accreditation in healthcare (INASanté) was created by decree in September 2012, one of its main missions is CPGs development. Many initiatives have been taken by INASanté team to prepare the ground for the implementation of CPGs. Regarding the lack of human and material resources at INASanté, the time requested to develop a CPG,an implementation strategic study has been done and it was decided to opt for CPGs adaptation methodology as an alternative to de novo elaboration. A capacity building collaboration with King Saud university has been set up to train INASanté team and relevant stakeholders on CPGs adaptation methodology.

Results: INASanté has signed 26 partnership conventions with scientific and medical associations. Plenty of healthcare professionals gathered their efforts with INASanté team to develop a contextualised draft of CPG's elaboration guideline. As a result of the capacity building collaboration with King Saud University INASanté has started its first CPGs adaptation project on diabetes and pregnacy. Many other adaptation projects are planned for 2018. In addition, INASanté has joined international networks in order to exchange and to benefit from the international experience in the field. At the same time, a policy of conflicts of interests declaration has been implemented.

Conclusions: Considerable work has been done in Tunisia to implement CPGs via INASanté and its partners. INASanté, with its different missions, is on its way to be considered as an important actor in Tunisian healthcare system reform.