Open-access publishing and noncommunicable disease prevention

www.procor.org a program of the Lown Cardiovascular Research Foundation

Open access publishing & noncommunicable disease prevention in developing countries

Collins KokuroAssociate Director, Ashanti-ProCor ProjectSpecialist Physician, Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana

Outline

• Non Communicable Disease burden

Global and local

• Information poverty in LMIC

• ProCor

• Ashanti ProCor project and its findings

• Recommendations.



Noncommunicable disease: A new health threat

Leading cause (60%) of death globally

The Global Economic Burden of Non-communicable Diseases. World Economic Forum


Cardiovascular diseases

Among NCDs, CVDs are the leading cause of premature, preventable deaths

Global Atlas on Cardiovascular Diseases Prevention and Control. World Health Organization


Disproportionate NCD burden in LMIC

Nearly 80% of NCD deaths occur in low- and middle-income countries.

Global CVD mortality rates / Global Atlas on Cardiovascular Diseases Prevention and Control. World Health Organization


NCDs in Ghana

Nearly 40% mortality caused by NCDs

Nearly 50% CVD-related

World Health Organization - NCD Country Profiles , 2011.


Mortality, Ashanti region

Ashanti Region Regional Half Year Report 2010

Double burden of disease

NCDs rapidly increasing


80% of CVD is preventable

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1950 1960 1970 1980 1990 2000

USA

Australia

UK

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Age-standardized death rates per 100,000 among men age 30 years or olderSource Preventing Chronic Diseases: a vital investment World Health Organization (2005)


Evidence-based strategies are affordable, cost-effective, adaptable

“A full range of chronic disease interventions are very cost-effective for all regions of the world, including sub-Saharan Africa. Many of these solutions are also inexpensive to implement.”

Preventing Chronic Diseases: a vital investment World Health Organization (2005)

Komfo Anokye Teaching Hospital, Kumasi, Ghana


Information poverty: A neglected risk factor

“Improving the availability and use of relevant, reliable health care information has enormous potential to radically improve health care worldwide.”

“Information needs of health care workers in developing countries: A literature review with a focus on Africa.”N. Pakenham-Walsh, F. Bukachi. Human Resources for Health. April 2009.


ProCor: Promoting cardiovascular health

Founded in 1997 to:

Promote knowledge sharing among a global community committed to prevention

Place relevant, timely, reliable information in the hands of those who need it

Provide access to info via low-cost ICTs

Prevent the need for high-cost medical technologies

Dr. Bernard LownFounder and chair


Ashanti-ProCor Project

Four-year pilot project

Identify CVD information needs and access preferences of health workers

ProCor & KNUST

Funded by Mattina Proctor Foundation, Boston, MA, US


Methodologies: Learning and listening

Learning

-- Literature review

-- Knowledge and practice survey

Listening

-- Key informant interviews

-- Focus groups

Maude Kwartang-Amening, Medical librarian, Kwame Nkrumah University of Science and Technology

A focus group section


Findings: Rich human resources

Many diverse provider groups have the potential to play a key role in CVD prevention

• Physicians, nurses in community and district settings

Providers not typically included in prevention:• Community pharmacists• Medical herbalists• Midwives• Medical assistants• Nutritionists• Health educators


Assets: Awareness and commitment

High awareness of CVDs across groups studied

Strong commitment to addressing CVD in their professional practice

Elizabeth Safo Mensah, Nursing Director of Public Health, Komfo Anokye Teaching Hospital


Leapfrogging technologies

Laptops (often stand-alone)

USB drives

Mobile phones

Wireless access

Internet cafes

Mobile Broadband (MBB)


Barriers: Available resources

Hard copies (textbooks, journals)

Frequently out of date

Cumbersome to access

Online

Most frequently accessed: Google, Wikipedia

Low awareness of open-access journals


Online barriers: Cost, time, connectivity

Cost•Service provider contracts•Slow download speed > internet café charges•Subscriptions, cost/article•Credit card issues

Unreliable connectivity

Time constraints


“Most of the faculty are research oriented and they want up-to-date information. We used to depend so much on journals but now we can’t afford the subscription. So we depend on the internet. But it can be frustrating when you get to the net and all you can get is an abstract. Then even if you have the money to pay, you don’t have a credit card.” Librarian


Preferences

Email

Download options– PDFs (easy storing)– HTML (fast download)

Interpersonal knowledge sharing–Colleagues, faculty–Social networks

Locally/regionally relevant data, protocols, programs


Role of open access

No associated costs for accessing or publishing

Email alerts

Download options• PDF• HTML

Current

Peer reviewed


Potentially more inclusive

“Underrepresentation of developing world health issues in the medical literature is a global phenomenon.”

“International medical journals cannot rectify global inequities, but they have an important role in educating their constituencies about the global divide.”

“The developing world in The New England Journal of Medicine”B. Lown, A. Banerjee. Globalization and Health 2006,2:3


Future directions

Respond to identified need for local/regionally relevant research

Maximize access via mobile formats, local knowledge-sharing networks

Thank you for your attention



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Benn GroverEditor, ProCorLown Cardiovascular Research Foundation21 Longwood AvenueBrookline, MA [email protected]

Open-access publishing and noncommunicable disease prevention

Education

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