Access to prescribing and medicines information in developing countries like Nigeria has become more haphazard, and the information is of low quality and often unreliable and unreferenced. In recent years pharmaceutical companies in trying to make more money have stopped engaging qualified pharmacists as 'Drug Reps', they rather employ any graduate, often not even science graduates, as Reps.
The main limitation of systematic review (SR) is that because research result from low and middle income countries rarely get into the major journals or indexes, the context of these countries may not be reflected in the world literature /sources used to produce systematic reviews. In addition systematic reviews are expensive to run and as such LMICs find it difficult to do. Practitioners in LMICs also have difficulty accessing systematic reviews in the traditional journals because they cannot afford subscription fees.
In March, I led policy panels in Benin, Burkina Faso and the Gambia to review research evidence on a specific study. While this was not a systematic review, I believe that the response from those invited would be the same as for a systematic review. What I heard numerous times was real pleasure in being invited to hear about the research, discuss it and consider how to use it.
The Regional Index Medici play a major and central role in improving access to health research from developing countries. This is evidenced by the statistics you have provided but also from the fact that research published in journals from the global south is only or at least mainly published in local journals. The efforts made by other WHO regional offices and by WHO/HQ to create the Global Health Library which includes the region indexes needs to be highlighted as a major sources to access research from developing countries.
The current figures and the projections of the deaths and cost that result from inappropriate and excessive prescribing of drugs, are staggering. Let me also add that besides the BNF, other countries and NGOs also have their formularies. Sometimes the guidance in these formularies varies, which creates confusion for the users.
Mental health is an integral part of health and a fundamental aspect for suitainable developement. Following a recent movement on mental health in Cameroon brought to light concretely on the First Cameroonian Days of Mental Health in 2015. I have taken resolution, to work to make mental health a priority in my country. Again, the context of mental health is characterised by a lot of ignorance, stigma, discrimantion and reject of sufferers. Of utter most importance is the absence of sources for adequate and reliable (mental) healthcare information.
Amref Health Africa has developed a mobile app that has in it the Ministry of Health household data collection tools that CHWs are tasked to use. The app works on line and off line allowing CHVs in hard to reach or poor network areas to still collect data. The CHWs can therefore collect data with their own mobile phone and only need to use bundles/ internet connection to allow the data to be transmitted to the DHIS. This has seen a significant improvement in data collection, quality of data and reduced cost of printing data collection tools as well as
There is a need to improve the availability and use of information for prescribers, dispensers and users of medicines in LMICs especially the north-eastern part of Nigeria in particular Adamawa State, because most of them continue to prescribe drugs that were use in the 90's. Example is a senior doctor at Adamawa State University clinic who most a times prescribe drugs that causes complications in patients after taking the prescribed drugs; I was once his victim.
For a couple of years I have found myself in a dilemma while working on information management during disease outbreaks, in conflicts areas or during emergencies.
Setting a reporting system amid insecurity, high mortality/morbidity or other calamities proves to be an uphill task. You end up using any scanty information you get which might end up misleading the planners or implementers of interventions on the ground which may hamper the life-saving efforts. Another issue is to verify/validate whatever information you've received from the field.
Evidence shows that malaria is one of the diseases with many variations in treatment. If you have one hundred health care workers today to treat uncomplicated malaria, you will probably have more than 50% treat malaria differently (emphasis is mine). Most times policy is not followed in providing malaria treatment. Efforts have been made in training health care workers in the public sector on malaria treatment but not enough has been done for the private sector.