I don't know how we can go beyond journals. In addition to the fact that journals fulfil a limited need, many African health practitioners are too overwhelmed to seat down and write an article on their daily experiences & tie this with broad health literature. If we limit knowledge sharing to journals and their rigorous reviewing processes, we miss a lot of real-time 'truths'. Emphasis on journals suggest the written word is the only way knowledge about health issues can travel.
All my career years in WHO (over 29 years) I always believed that the electronic publishing should not replace paper based publishing. They should complement each other. Publishers who think that electronic publishing should replace paper publishing are wrong. I made this position very clear and implemented it when I was director in WHO.
Many will be familiar with the need for "research to policy" or R2P. But that in itself is a shortened form of "research to policy to practice" or R2P2P. Clearly, health policies should be based on the best and most appropriate research. But that is not enough. If sound health policies don't then go into clinical practice, they are just empty words. Effort needs to be devoted to each link in this chain.
Najeeb al-Shorbaji hit the nail on the head last year when he wrote in a submission to this email list: "Health workers and most practitioners in the field do not need scientific articles written by academicians. They need practical information, best practices, case studies, stories from the field, lessons learned and guidance on how to do things".
At Africa Health journal, that is precisely what we have tried to do since launch in October 1978.
Herbal medicine has been accepted as a component of global health. The current investment going into research and development of herbal products is unprecedented. It is very sad to note that in country like Nigeria where over 80% of her population relies on herbs for daily health needs, only few of such herbs have been validated using research. In a recent study conducted in Ibadan, it was discovered that of the herbal products evaluated, only about 20% of the products were validated using clinical trial. In spite of this, over 80% of the manufacturers made various treatment claims.
It is important to have a diagnosis done. For each medical contact a diagnosis must be 'suspected' by the doctor and then written down on the Health Booklet that the patient has with him.
Some factors that might be attributed to too much medicine may include the following:
Some Lab. Technicians and to a lesser extent pharmacists prescribe drugs for their friends, colleagues and relatives on request outside patientclerking;
Thus, it's a multifactoral issue involving several areas from upbringing (social-cultural) factors; in most African societies like where I come from people have been sensitized that the more drugs you get the better and also that 1st line drugs are no good e.g. paracetamol, secondly people /clients prefer to spend money at a private clinic/hospital because it is assumed they will get better drugs as compared to government/public hospitals.
A significant determinant of population health outcomes is the quality of care provided for noncommunicable diseases, obstetric, and pediatric care. We present results on clinical practice quality in these areas as measured among nearly 4,000 providers working at more than 1,000 facilities in 6 Eastern European and Central Asian countries.
1. Health providers (doctor, clinical officer,nurse etc) should have adequate time with each consumer (client/patient) of health services. At least 20-30 minutes if possible. This will assist to get the complaints, assess, investigate (laboratory, radiology) and make a diagnosis/provisional diagnosis which will be a basis for prescribing
2. Health providers need to concentrate on what the consumer is saying (listen, observe, feel, ask) and not to rush in prescribing drugs even before the consumer has finished explaining as we see/observe happening in our many public facilities