open-access publishing and noncommunicable disease prevention
DESCRIPTION
Collins Kokuro, Associate Director, Ashanti-ProCor Project and Specialist Physician, Dept. of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, GhanaTRANSCRIPT
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.
www.procor.org a program of the Lown Cardiovascular Research Foundation
www.procor.org a program of the Lown Cardiovascular Research Foundation
Noncommunicable disease: A new health threat
Leading cause (60%) of death globally
The Global Economic Burden of Non-communicable Diseases. World Economic Forum
www.procor.org a program of the Lown Cardiovascular Research Foundation
Cardiovascular diseases
Among NCDs, CVDs are the leading cause of premature, preventable deaths
Global Atlas on Cardiovascular Diseases Prevention and Control. World Health Organization
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
NCDs in Ghana
Nearly 40% mortality caused by NCDs
Nearly 50% CVD-related
World Health Organization - NCD Country Profiles , 2011.
www.procor.org a program of the Lown Cardiovascular Research Foundation
Mortality, Ashanti region
Ashanti Region Regional Half Year Report 2010
Double burden of disease
NCDs rapidly increasing
www.procor.org a program of the Lown Cardiovascular Research Foundation
www.procor.org a program of the Lown Cardiovascular Research Foundation
80% of CVD is preventable
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1950 1960 1970 1980 1990 2000
USA
Australia
UK
Canada
Age-standardized death rates per 100,000 among men age 30 years or olderSource Preventing Chronic Diseases: a vital investment World Health Organization (2005)
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
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.
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
Leapfrogging technologies
Laptops (often stand-alone)
USB drives
Mobile phones
Wireless access
Internet cafes
Mobile Broadband (MBB)
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
“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
www.procor.org a program of the Lown Cardiovascular Research Foundation
Preferences
Download options– PDFs (easy storing)– HTML (fast download)
Interpersonal knowledge sharing–Colleagues, faculty–Social networks
Locally/regionally relevant data, protocols, programs
www.procor.org a program of the Lown Cardiovascular Research Foundation
Role of open access
No associated costs for accessing or publishing
Email alerts
Download options• PDF• HTML
Current
Peer reviewed
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
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
www.procor.org a program of the Lown Cardiovascular Research Foundation
www.procor.org a program of the Lown Cardiovascular Research Foundation
Support prevention. Share knowledge. Subscribe to ProCor.
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Benn GroverEditor, ProCorLown Cardiovascular Research Foundation21 Longwood AvenueBrookline, MA [email protected]