Date publishedAuthor Name
Indigenous medicine and biomedical health care in fragile settings: insights from BurundiMonday, February 19, 2018Carla F Rodrigues

As many anthropological and sociological studies have shown, there are multiple factors contributing to different health-care seeking patterns. Many times, tradicional/ alternative/ complementary medicine is sought precisely because people are not happy with biomedical responses to their situation or considers it more harmful and less effective - depending on the situations - than other approaches to their health problems. And this is not based on 'beliefs', but on their actual experiences.

I do not think we can achieve any consensus and improve interactions between health-care users, traditional medicine (or others) and the biomedical system, if we continue using a vertical approach. Otherwise, we are not talking about integration but about control. And I think it is important to acknowledge this in the first place, as it sets up the approach we are taking.

I definitely do consider that more research is needed. Yet, such studies, I believe, would be more fruitful if they included multidisciplinary teams well represented by all parts - in all stages of the research process.
 

Allowing moms to self-weigh babies in BF support groupFriday, February 16, 2018David Werner

I agree very much with Nicholas Cunningham on the importance of involving mothers -- and older siblings and schoolchildren -- in the use and understanding of growth monitoring, using a clear, graphic, easy-to-use "Road to Health" chart. In remote rural areas of Mexico a lot of families with children live in isolated small farms far away from a health post. Therefore health promoters helped the primary childcare-providers (mothers, older sisters, etc.) to become as independent as possible in regularly weighing and recording the weight of the infants, and acting appropriately on their findings. They even helped families learn to make their own essentially no-cost scales out of local materials, so that mothers, often with the help of school-kids, could weigh the under-fives and keep graphic track of their weights in their own homes, as self-reliantly and knowledgeably as possible.

I emphasize the role of school children in growth monitoring because many of the mothers in remote areas still cannot read or write, and their children can play an invaluable role as information readers/sharers and health action-takers. This is especially true in those (sadly too few) schools that promote Child-to-Child activities with a hands-on, discovery-based focus at the community level. Such activities can include growth monitoring, basics of good, low-budget child nutrition, and the constructing and calibrating of low- and no-cost scales.

Allowing moms to self-weigh babies in BF support groupThursday, February 15, 2018Mohammad Ali Barzegar

I oblige to thank Prof. Nicholas Cunningham, for reminding us the important issues of growth chart and Road to Health.

We have initiated growth chart issuing for children aged 0-5 years old in two copies. One copy be kept with the CHW (BEHVARZ), in Health House (Khaneh Behdasht), and one copy with child's mother. At the beginning we had some problems of losing the chart by mother due to poor housing situation. But later on when they have been trained properly by CHWs that the slope of road to health is a guarantee for their children's health, they rarely lost it. Some of the mothers were saying that we will take care of the growth chart like our Marriage Certificate.  Even some mothers who their children did not grow well were trying to learn from successful mothers and  follow the food pattern which they were given to their children. Need less to say that in this regard CHWs were the facilitators. Now days about 40 million population are covered by more than 20,000 Health House staffed by CHWs, where all of the children 0-5 years old are having growth child. Therefore their nutritional status either malnourished or over weight easily could be monitored.

It should be mentioned here that the most difficult part of training program for CHWs was growth chart. Therefor CHWs trainers/ instructors should make sure that growth chart is well understood and practiced by CHWs. 

Allowing moms to self-weigh babies in BF support groupWednesday, February 14, 2018Nicholas Cunningham

Growth monitoring and regular developmental assessments are key components of what all parents need in order to rest assured that their infants and toddlers are on track or, if not, so that they can intervene early on, before any deviations affect the child's future.

If parents own their own children's growth & development charts, they will be able to see if the child is on what David Morley (who, with the nurse-midwife, Margaret Woodland invented the "Under FIves" growth chart) called the "Road to Health". This "road" is marked on the card with a dotted line delineating the 95% weight for age for each month of age 0-60, and the bottom line indicating the 5% limit. When receiving the card, the parents are educated to understand that it's the slope of the child's weight gain (that is, the velocity of growth), not the absolute weight that is indicative of healthy growth. When the slope levels off for more than a week or two in the newborn or for a month or two in the toddler, they are taught to seek help. And where, as in the West, obesity is prevalent, a steep slope provides early warning.

The Under Fives Card is a wonderful teaching aid for the family, all of whom will become interested and involved. Since it's the family's responsibility to feed the child, they are the ones most interested in the child's growth. They therefore should own the growth chart. David Morley even invented a simple, direct-read hanging scale, such that each centimeter of stretch of the spring translates into a Kg. of weight on the UFC. Mothers are in my extensive experience highly unlikely to lose these UFC cards and can easily remember to bring them on each doctor or practitioner visit. Health personnel can & should copy the parents' chart at each visit, and advise as needed. 

The electronic health record cannot function in this manner. It perhaps could if a computer was designed to accept the UFC belonging to the mother and update it at each clinic/office visit with that day's weight, and the doctor or nurse practitioner's notes; in this way the visit could be simultaneously recorded for both the family and the health facility. Relying on the EHR doesn't help the family, and doesn't provide a complete record since many families travel widely, appear at various emergency facilities, and children engage in all sorts of activities (sports etc.) with health consequences which the parents know about and can record on a UFC but which don't appear on the EHR. Furthermore, many doctors are becoming fed up with the EHR and may not study it adequately!

Medical Aid Films - New film empowering girls and women with knowledge about processes that occur during pubertyFriday, May 26, 2017Will Sanderson

The lack of effective reproductive health education and sanitary products are some of the key factors resulting in as many at 1 million girls in Kenya not going to school. Girls in Uganda have been found to miss up to eight days of school each term (11% of their total learning days each year) for the same reasons, and it has been estimated that 1/10 girls across the whole of Africa will miss school when they have their period.

The combination of this lack of access to information, need for sanitary pads and stigmatisation leaves young girls susceptible to disease, unplanned pregnancies, early marriage, and female genital mutilation, which can result in unnecessary dropout rates amongst teenage girls in school. To put it simply, adolescence can lead to the end of education for many girls around the world.
 

Systematic Reviews (18) Perceptions of systematic reviewsFriday, May 19, 2017Jamie Guth

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. Several people told me they had never been invited before this to hear about a research study, and some researchers told me they had never been involved in reviewing the evidence with those who might actually take it up and use it. They were very appreciative of the opportunity, and I think that more opportunities need to be provided so people can experience the value of this process firsthand and advocate for it. In fact, for some types of research, I would suggest that this should be a standard process at the end of the research that should be planned and budgeted.

The study investigated the use of community healthcare workers providing scheduled screening and treatment of malaria among pregnant women. This was done in Benin, Burkina Faso and the Gambia. We invited technical policy-makers in malaria, maternal and child health, transportation and finance, as well as researchers, NGOs and healthcare providers. The community healthcare workers who were part of the study were also critical contributors.  There was such a rich discussion, everyone learned from the process and valuable recommendations came out of the panels.
 

Access to Health Research: Priorities for advocacy and action (4) African Index Medicus (2)Monday, May 15, 2017Najeeb Al-Shorbaji

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. It's sad to note that only one person works on the indexing of these journals. This, I am sure, at the expense of quantity and quality. The Regional Office should take corrective action to remedy such situation.

Traditional medicine, false beliefs and rhino hornFriday, April 14, 2017David Werner

The use of rhino horn to treat impotence is a perfect example of the "pseudo-homeopathy" (belief that like cures like) found in traditional healing... That big hard horn is intuitively seen as a remedy for failure to get an erection. For men whose impotence is partly psychological, of course, a strong belief in the power of rhino horn might indeed be effective. This no doubt is the reason why the demand is so great and persistent.

In terms of debunking this deceptive, rhino-exterminating belief, health education clarifying the lack of any physiological/medicinal effect of rhino horn (beyond that of deception) should perhaps be tied to awareness-raising about the "pseudo-homeopathy" (or placebo effect) of countless forms of "magical" or traditional healing in many countries.

The power of suggestion does of course have an important place in healing - especially in traditional medicine. In their preparation, community health workers need to learn - and help their people to learn - to recognize the strengths and weaknesses of both "modern" and traditional medicine.

Community Health Worker Programmes in the WHO African Region (3)Wednesday, March 22, 2017Nicholas Cunningham

Generally, CHW's sort themselves into two groups: older, more seasoned & settled workers who value their work and are valued by the community, and younger, often more educated and more ambitious workers. The former are often content to continue their work, and remain settled. The latter, to remain content, need opportunities for advanced training, and if adequately educated, a career ladder which may take them out of the community. 

Internet health information seeking and the patient-physician relationship: a systematic review (3) Sunday, March 5, 2017Malcolm Brewster

Online information seeking is a skill which some people, including patients, have acquired rather better than others. I can think of 4 categories based on my own experience. Some patients have told me that they are not confident that they can find reliable information online because they do not have the skill to do so. Another group of patients do look for information online but find that sources disagree. A further group is more skilled at finding the reliable information that they need. Finally, I have had conversations with a patient who has used the internet to seek out 'information' to confirm their beliefs which were quite contrary to scientific evidence.

CHWs (158) Community Health Workers' symposium statement Wednesday, March 1, 2017Nicholas Cunningham

CHW's are unique in the provision of community based health care in that ideally, they, like the Greek god Janus, are two faced...but  in a positive, not a pejorative sense. CHW's should answer both to the community that they serve, and to the health professionals with whom they serve.

Factors Impacting the Effectiveness of Community Health Worker Behavior Change: A Literature Review (3) Performance-based incentivesWednesday, June 22, 2016

... We need a universal definition of the term 'performance based finance' or 'performance based incentives' in order to understand better as to how they enhance the motivation of CHWs.

In India, performance based incentives are demotivating the CHWs. 

My understanding (please correct me if I am wrong) is that a performance based payment is made in addition to the salary.

There is a country wide CHW program called the ASHA program in India. This program is a part of the public/government health care services. These CHWs called ASHAs receive only task-based incentives from the government for their work. There is no other payment nor salary for the ASHAs (CHWs). 

Some states do give the ASHAs (CHWs) a set monthly amount and incentives in addition. However the amount varies among these few states as well.

Thus unlike the success stories in other countries, in India, task-based incentives tend to demotivate ASHAs (CHWs) because varying amounts are received every month. Secondly, the status of the ASHAs (CHWs) is not that of the other salaried government employees within the health care system as well as the community.  

Task-based incentives also reduce the bargaining power of the local CHW organisations.  

For detailed analysis please see the reports and studies conducted by myself and other researchers on my website http://www.ashavani.org

 

How can health research from LMICs be made more accessible? (6) Sunday, June 12, 2016Neil Pakenham-Walsh

Glazsiou & Chalmers noted the following in relation to global health research:
1. 'We know from follow up of registered clinical trials that about 50% are never published in full, a figure which varies little across countries, size of study, funding source, or phase of trial.' This begs two questions: What percentage of *all* health research (clinical trials plus non-trial health research) is published? And what percentage of health research in LMICs (whether clinical trials or otherwise) is published.
2. 'Published reports of research must also be sufficiently clear, complete, and accurate for others to interpret, use, or replicate the research correctly. But again, at least 50% of published reports do not meet these requirements'. This is the estimated percentage for global health research. What is the percentage for research undertaken in LMICs?
3. There is also the partial waste (not included in Glazsiou & Chalmers analysis) that results from publishing in journals that are inaccessible. For example, any paper published in a restricted-access journal immediately restricts access to the content. In this respect, what percentage of research from LMICs is published in open-access versus restricted-access journals? Also, if a journal is not indexed by major indexes such as Medline (which has been charged with having a bias against research in LMICs, and against non-English journals), this will further reduce the accessibility of research.
Percentage waste of funding for health research in LMICs is therefore possibly even worse than in other parts of the world. 

Evidence-informed country-level policymaking (60) Motivating researchers to communicate evidence for policymaking (2)Thursday, March 10, 2016Elizabeth Corley

We have found that it takes a person with a communications background to develop content that is readily accessible for a policymaker… The motivation for the researcher to assist in such an endeavor should be to see the research culminate in improved health outcomes. I still think you need a communications person to bridge the divide between academic and policy worlds.

 

 

Evidence-informed country-level policymaking (59)Thursday, March 10, 2016 Cindy Crawford

Convening the key stakeholders up front in order to formulate the key questions necessary for making decisions from all perspectives should be the first step in any research in order to bring the evidence to bear for decision making to occur… Samueli Institute has the expertise and the management processes in place to allow these kinds of stakeholders to come together for their voices to be heard, drive the research questions to evidence based conclusions and recommendations that then can be made with all stakeholders involved.

 

 

Evidence-informed country level policy making (10)Thursday, February 25, 2016Javed S Ahmad

In one country I was involved in a donor funded project that was designed precisely to encourage decision makers to use evidence in making policies on public health issues, particularly mother and child health. Donor project gathered all available research and evaluation data reports in a CD. They provided that CD to all relevant officials. In addition urged professional columnists to highlight the issues in news media, and by organizing monthly meetings. In other words this was the utmost effort anyone could make to persuade health officials to use evidence for policy and decision making. Unfortunately, the effort ended up showing too many flaws in government policies and apathy. Too little funds were allocated to health sector and too many children were dying from preventable causes. Government did not like the embarrassing initiative and the project was shut down within 3-4 months.

Moral of the story: an innovation is not likely to be welcomed on intrinsic value. There are other pre-requisites. You can succeed in your intervention if its application is likely to improve government's image. Meanwhile, try your interventions with NGOs.

Evidence-informed country level policy making (3)Monday, February 22, 2016Javed S Ahmad

Donors regard research and evaluation as non-essential activities... It is usually political expediency rather than objective decision-making that is practiced... On the one hand there is little data available or accessible. On the other when time comes to make a decision, data are ignored because they [policymakers] don't know how to interpret or read statistics. To be sure you will find various survey reports are just stacked on the office shelves gathering dust.

Evidence-informed country-level policy-making (2) EVIPNetMonday, February 22, 2016Jackeline Alger
However, at least in the Americas, this initiative is not progressing nor it is being extended.  Honduras is one of the several countries that is not part of the initiative.  It seems that one of the reasons that the initiative is not thriving is lack of a driving force from the MOH, its main user.  Here is a link to an opinion paper published in Revista Medica Hondureña, where we comment how EVIPNet could be a very effective option before the necessity to translate scientific researtch into action in Central America: http://www.bvs.hn/RMH/pdf/2013/pdf/Vol81-2-4-2013-15.pdf
Forum 2015 - Access to Health Research: Open access (5) Pubmed/Medline (2)Sunday, August 2, 2015Bryan Pearson

And there is a further imbalancing twist. While authors from Africa find it difficult to get published in journals in the USA and Europe... publishers from LMICs find it difficult to get accredited by the US and European 'regulators' of what is respectable and what isn't...

But where is the voice from the South among the judges?

 

 
IRIN: Psychologists stay home: Nepal doesn't need you (2)Saturday, June 6, 2015Shishir Dahal

Sometimes driven by our generosity we forget to account the actual need of the very people we are trying to help. Last Saturday I visited remote villages of earthquake affected Dhading district where indegenous "Chepan "community live.

I ask one question to all of them, what three things they need most? To my surprise their answer was "Corrugated sheet" "Corrugated sheet" and "Corrugated sheet".
And another question, what three things they want to build with "Corrugated sheet". They prioritise as rebuilding 1. Their homes 2. School 3. Health post.

In the same region reputed INGO with the support of local NGO was busy distributing "Dignity Kit" with sanitory napkins (they have never used it and not going to use this time as well).

 

Quality of care for pregnant women and newborns — the WHO vision (10)Monday, May 25, 2015Shobha Arole

I do indeed have some more to contribute to this discussion on safe deliveries and I would like to add to more names to this list...one is dr, coke (colin) mc cord many of you know him... who worked in africa and taught many young 10th or 12th grade pass students caesarians as well as many other emergency surgeries with a very good outcome which my late father, raj arole followed years later in the same countries in africa and the good work was still continuing where there were no skilled surgeons or obstetricians...

Quality of care for pregnant women and newborns - the WHO vision (3) Traditional birth attendantsMonday, May 25, 2015Joseph Ana

The [WHO] vision will take many decades to happen whilst thousands of pregnant women and babies (children) are dying avoidable and preventable deaths every hour across the third world.

There must be practical and affordable measures to fill the gap until every part of the world has enough skilled health staff, who are distributed equitably within and between countries, to where the need is: e.g. health system strengthening especially primary health care; task shifting (skill-mix); recognition, training and monitoring of currently unskilled people such as Traditional Birth Attendants; etc. They can be taught how to avoid/reduce whatever harm they are prone to at present because they have no iota of training and operate outside established health system... The thought of banning / prohibiting unskilled people who are ubiquitous in remote, underserved, and difficult to reach corners of every third world country will only drive them underground out of reach and supervision. Meanwhile the villagers who are mostly poor and uninformed will seek them out and patronise them like their grandmothers and mothers did before them.

Joseph Ana.

 

​Quality of care for pregnant women and newborns — the WHO vision (9) Wednesday, May 20, 2015Emmanuel Otolorin

Even though I am an advocate of task shifting, I just want to add that while it may be easy to teach a carpenter to conduct a common Caesar, the decision making process leading to that Caesar is more important than the operation itself. 

Furthermore, the skill to prevent complications and/or manage the complications must be assured before embarking on the procedure in a rural area where there may be no one to offer technical assistance. Too often, inexperienced resident doctors have ligated both ureters at Caesarean section or have done Caesarean section for suspected obstructed labor where the baby ended up weighing 1.2 kg!   

 

Quality of care for pregnant women and newborns — the WHO vision (8)Tuesday, May 19, 2015Simon Lewin

The recent WHO recommendations on optimizing health worker roles for maternal and newborn health (OptimizeMNH: http://www.optimizemnh.org/) include a number of recommendations for lay or community health workers (which was defined to encompass trained TBAs), including misoprostol administration to prevent PPH, continuous support for women during labour and a range of health promotion activities (see http://www.optimizemnh.org/intervention.php ). The administration of oxytocin to prevent and treat post-partum haemorrhage was recommended in the context of rigorous research in this guidance. 

Quality of care for pregnant women and newborns — the WHO vision (5) Monday, May 18, 2015Nicholas Cunningham

if smart lay persons can be trained to correct vesico- and recto- vaginal  fistulae safely, and they have been, then clearly they can be trained to do relatively simpler "Caesars" (Caesarian sections). And they should be! So why the omission?
 

Quality of care for pregnant women and newborns — the WHO vision (4) Traditional birth attendants (2)Monday, May 18, 2015David Werner

Not everything need be or can be done at once. But some simple measures could make a substantial difference. For example "severe" postpartum bleeding is a major cause of maternal mortality in poor communities where up to 70% of women are visibly anemic, many of them severely so. Provision of oxytocics to TBAs, with adequate precautionary training to use only after the baby is delivered, could probably save a large number of women's lives...

The major obstacle to systematically enabling lay practitioners to perform tasks exclusively reserved for titled "professionals" is the resistance from the medical establishment. Years ago I argued with the MOH directors in Colombia about the question of teaching health workers and TBAs to use oxytocin to control postpartum hemorrhage, and they were afraid to even consider it. This was not because they didn't believe it could save many women's lives, but because they feared the criticism they would get from the medical establishment if a mother died after a TBA used oxytocin -- as was occasional likely to happen even though far more women's lives would be saved. In short, the decision-makers in the MOH were more concerned about protecting themselves than about protecting the lives of poor rural women.  

 

The world needs a free, high-quality, independent international formularyTuesday, May 5, 2015Neil Pakenham-Walsh

Please find below the abstract of a paper from 2013 that closely supports previous arguments on HIFA that there should be a high-quality, independent international formulary, similar to the British National Formulary and freely available to all prescribers and users of medicines, on the internet, on mobile phones and as a free PDF download. Universal basic information on commonly prescribed medicines, identified by their generic name, would save many lives and reduce suffering. 

We have discussed this with both the British National Formulary and the World Health Organization. We pointed out: "If money is an issue, we think we can help you get financial support for this, because we are convinced that a major funder such as the Gates Foundation can be persuaded of the need for such a formulary". But so far we are not getting through...

Int J Clin Pharm. 2013 Jun;35(3):386-92. doi: 10.1007/s11096-012-9744-x. Epub 2013 Mar 28.
Worldwide analysis of factors associated with medicines compendia publishing.
Arguello B, Fernandez-Llimos F.  [Full text is restricted access]

 

New report: Use of an Interactive Voice Response System to Deliver Refresher Training in SenegalMonday, May 4, 2015Carol Bales

For the 222 million women who have an unmet need for modern contraception, increasing access to high-quality family planning services is essential. 

As countries work to scale up the number of health workers, it also makes sense to focus on the existing workforce. In-service training can improve the quality of family planning services by updating health workers' knowledge, but it is often expensive and requires providers to leave their posts during the training. 

CapacityPlus developed and deployed an innovative mLearning system to deliver refresher training to family planning providers. The system, which uses a combination of interactive voice response technology and SMS text messaging, was piloted among 20 midwives, nurses, nursing assistants, and health agents in Senegal.

Use of an Interactive Voice Response System to Deliver Refresher Training in Senegal: Findings from Pilot Implementation and Assessment, shows how the mLearning system delivered training via simple mobile phones and was found to be feasible, well-liked by participants, and associated with sustained gains in knowledge.

Read the new report (http://www.capacityplus.org/files/resources/ivr-system-refresher-trainin...) and a related article (http://www.capacityplus.org/new-publication-spotlight-interactive-voice-...). 

Earthquake in Nepal (54) Poisoning with "antiseptic hand wash"Sunday, May 3, 2015Shishir Dahal

I am sending this message just to communicate one incident, when one elder man was brought in emergency with alleged poisoning with "antiseptic hand wash" distributed by relief team. He drank the solution because he thought it was "juice". Although the situation was not serious at all and the person was sent back with few antacid, it shows how things may go wrong if we send goods or even medicine without proper situation analysis.

Day before yesterday Minister of finance in his press meet specifically asked donors stop sending myoniose [*mayonnaise - see note below] which no one eat in villages.

[*Note from HIFA moderator (Neil PW): I googled this and found the following:
"We have received things like tuna fish and mayonnaise. What good are those things for us? We need grains, salt and sugar," Finance Minister Ram Sharan Mahat told reporters Friday.
http://www.usnews.com/news/world/articles/2015/05/01/the-latest-on-nepal...  ]

Health literacy: towards system level solutions (2)Saturday, May 2, 2015Olayinka Akanke Abosede

Health Literacy is crucial to a lot of the challenges the health sector is facing now especially concerning resistance to many drugs (e.g. antibiotics, anti-malarials etc) and escalating renal and hepatic damages from unsafe self-medication. Instead of consulting health care providers (often because of cost implications), a very high proportion of people in low and middle income countries who now have access to the internet simply find out information about "signs and symptoms" and start using drugs that they purchase from patent medicine store attendants. Many of such drugs should never be sold without prescription but they are hawked in markets and public transports...

The most recent reminder of the need to address religious and socio-cultural beliefs that retard the progress of health literacy in Nigeria is the arrogation of death from methanol poisoning to offense of a deity in Ondo State Nigeria. More than 20 commercial motorbike riders died or became blind from consuming a locally brewed gin (a common practice early in the morning by commercial transporters) but community members were appeasing an angry god! There are health workers and influential, educated community members who must join efforts to discuss issues with community members without tagging them as being "ignorant"...

 

Request for images of parasites (2)Thursday, March 12, 2015Elisabeth von Muench

This is my collection of 12 photos of what a helminth infection can do to the human body that I was able to put together since starting my hunt for photos in October last year: 
https://www.flickr.com/photos/gtzecosan/sets/72157648282032913
They are from South Africa and the Philippines.

These 12 photos are the results of about 100 e-mails to all sorts of people and it is such a sad state of affairs that not more photos are easily available (I will continue to try and hunt them down one by one). I have been given links to WHO, CDC, Wiley books and other image libraries. But upon closer examination they either had no photos of helminth infections or they were not open access.

 

Access to BNF online would be a milestone in improving access to reliable medicine information for presribersThursday, March 12, 2015Andrew Oluga

Unfortunately, when I tried to access [BNF] through the link http://www.evidence.nhs.uk/formulary/bnf/current , this is the response I got: 

"This site has detected that you are accessing it from Kenya. 
Unfortunately this site is only available from Great Britain.
We apologise for any inconvenience."

My colleagues within East Africa, (Rwanda, South Sudan, Tanzania and Uganda) tell me the same...

The severe paucity of reliable sources of readily accessible medicine information may be the main driver for wide-scale irrational use of medicines and its consequences which range from Adverse Drug Reactions, Anti-Microbial Resistance and Wastage of per capita income.

In East Africa for instance, the prescribing practice is heavily influenced by the commercially biased information from the medical representative, who in addition, use several unethical ploys to influence the prescribers. It is worse in rural settings where nurses, who play an pivotal role in primary healthcare, prescribe up to 80% of the medications. The prescribing patterns and practices are more or less influenced by several important dynamics including personal experiences, information from colleagues and sometimes out-dated sources of information.

 

 

Wikipedia and Medicine: Quantifying Readership, Editors, and the Significance of Natural Language (2) ParasitesMonday, March 9, 2015Nancy Gertrudiz

Last week, I have organized a health information workshop with some clinical laboratory technicians, they idenfied lack of open access to atlas about parasites for training new technicians and as reference. And I also found that a 2014 FAO report related with food parasites, FAO mentioned "Despite their huge social costs and global impacts, information is generally lacking regarding just where these parasites come from, how they live in the human body, and - most importantly - how they make us sick.". 

Developing a common scientific understanding of 'reliable medicine information' (2)Friday, March 6, 2015Larry Sasich

 

Finally, emphases must shift to patient drug information.  Prescribers already largely have free access to independent high quality useful scientifically accurate drug information in English on the Internet.  The question is still open if prescribers use this information effectively?...
 
I would propose that HIFA endorse US FDA sources of drug safety information for promotion to members as useful and scientifically accurate information with a deadline for a final endorsement.  This suggestion is based largely on the facts that the information is written for patients in non-technical language; it is free; updated in almost real time; and transparency that allows verification of the information by the public.
Developing a common scientific understanding of 'reliable medicine information' (2)Thursday, March 5, 2015Larry Sasich

The difference between a poison and a drug is information. These comments will focus on drug safety information written in non-technical language for patients that is useful and scientifically accurate and is available free of charge or at a very low cost.
... 

Prescribers already largely have free access to independent high quality useful scientifically accurate drug information in English on the Internet.  The question is still open if prescribers use this information effectively?...

I would propose that HIFA endorse US FDA sources of drug safety information for promotion to members as useful and scientifically accurate information with a deadline for a final endorsement.  This suggestion is based largely on the facts that the information is written for patients in non-technical language; it is free; updated in almost real time; and transparency that allows verification of the information by the public.

Ebola in West Africa (188) Empowering frontline workers to provide intensive supportive careTuesday, March 3, 2015Neil Pakenham-Walsh

The focus of current news stories is on the development of new drugs that *might* reduce mortality in Ebola. (One of these, ZMapp, has recently been abandoned amid rumours that it costs $100,000 for a course of treatment.) We should not forget that most deaths could be avoided through *existing* supportive measures, in particular fluid replacement. It is no accident that death rates from those treated in West Africa were as high as 80%, while those treated in the USA and other high-income countries have been close to zero. The priority is to empower frontline health workers in West Africa to provide intensive supportive care. 

WHO: Manual for the care and management of patients in Ebola Care Units / Community Care CentresSunday, February 22, 2015Neil Pakenham-Walsh

We are all aware of the severe financial constraints under which WHO has to operate, including for its publications and information services. This important practical manual from WHO was published in January 2015. I would be interested to know if it might have been published much sooner, when it was most needed, if WHO had been properly supported financially. (I am constantly impressed by the volume and quality of publications produced by WHO, despite resource constraints. WHO is probably the single most important provider of healthcare information worldwide, and demands increased investment accordingly.)

 

Why is e-Health so hard? (5)Thursday, February 19, 2015Kiran Sinha

...Dissemination of information needs trained local people. When I talk to young people who have researched their problem on the Internet before coming to see the doctor, I am often amazed at the disconnect between their clinical features and the things they have looked at. If my local health worker does not want to spend time learning about the different causes of itchy skin, leaflets on managing scabies are not going to help. And this too would need some time to read and understand and cannot be a 'one liner' which he may prefer. My point is about how eHealth is used. It cannot replace face to face teaching but should be an 'add on'.

 

 

The Ebola.com Web Domain Just Sold for $200,000Tuesday, October 28, 2014Neil Pakenham-Walsh

Occasionally one reads news that is stranger than fiction. It is reported that the owners of the website Ebola.com have sold the domain name ebola.com for more than $200,000 in cash and stock, to a Russian-registered firm called Weed Growth Fund. the latter paid $50,000 USD in cash plus $150,000 USD shares in Cannabis Sativa, apparently a subsidiary that promotes medical uses for marijuana. 

'The reasons for the sale were not clear, but Cannabis Sativa chief and former New Mexico Gov. Gary Johnson has publicly said he thinks marijuana may be used to treat the deadly disease.'

https://www.yahoo.com/tech/the-ebola-com-domain-just-sold-for-200-000-10...

 

The rise and rise of free and open access publishingTuesday, October 28, 2014Neil Pakenham-Walsh
In the last 1-2 years, I have noticed marked increase in the proportion of papers that are freely accessible, as opposed to restricted-access. This includes papers in journals that were previously restricted-access. The change is quite remarkable. 2 years ago, I would estimate that only about 25% of papers I looked at are free-access, whereas now the proportion is about 80% and rising. Many journals that were previously entirely restricted-access now give authors/institutions an option to pay a fixed sum for their papers to be freely available, and clearly many authors/institutions are willing to pay this.

Perhaps the key driver of these trends is the progressive policy of research funders and governments, who increasingly recognise the value and ethical imperative of open access of health research. Increasingly, the costs of publishing/dissemination are included as a (usually relatively small) budget line in overall research costs, so that individual authors/institutions are not left out-of-pocket. This promises long term sustainability in the quality *and* availability of health research. And it would mean that a key barrier in the global healthcare information system - availability of research findings - would finally be addressed.

Requesting WHO to Consider the Use of an Open License (3) Friday, October 24, 2014Alex Little

In my opinion, all health information content, and especially that which has been publicly funded (including WHO, DFID, USAID, amongst many others), should be available under an open, preferably Creative Commons, license.... The content we're using and all the videos/media we have integrated into this training were available under a Creative Commons license. Had this not been the case, our project might have been a non-starter - either we'd have to agree to restrictive licensing conditions (which may include paying the creators), or we'd have to create our own content (at large expense)...

There is probably some fear by some organisations that, by using open licenses, they'd lose acknowledgement/attribution for their efforts, or risking reputational damage if their content was re-used or adapted in a 'wrong' way... in fact, completely the opposite, it increases their reputation.

One of the many benefits I see of open licensing is the opportunity for innovation - being able to freely re-use existing content, in ways that may not have been imagined by the original creators, is going to be vital to address the huge global health challenge

Requesting WHO to Consider the Use of an Open LicenseThursday, October 23, 2014James Heilman

One of the major stumbling blocks to achieving health information for all is the lack of use of open licenses by all those working to achieve this goal.

Thus we from Wiki Project Med Foundation recently sent the following letter to the World Health Organization requesting that they consider moving to open licensing of their content.
https://docs.google.com/document/d/1rJUlMXd15EUKjbZdhO9OIQLYDednH0Y99GbW...

ICANN urged to freeze sale of .health top-level domainThursday, October 23, 2014Neil Pakenham-Walsh

The ".health" top-level domain was recently allocated to a commercial for-profit company with inadequate safeguards. Many of us have expressed concern about the potential negative impact this could have on global health. This impact is likely to be diffuse and is impossible to quantify, but it is well recognised that the internet is full of misinformation and commercially biased information that could be detrimental to an individual's health. Furthermore, those who are already vulnerable are most likely to be misled, including and especially citizens in low-income countries...
The full text is available here:
http://www.atlarge.icann.org/correspondence/statement-public-interest-co...

 

Communication: The key to containing Ebola (2) WHO belongs to us all Thursday, October 23, 2014Joseph Ana
I think that the nearest thing to 'a single reliable source' that Scot Ratzan has advocated is the World Health Organisation (WHO) source for advice on Ebola epidemic.

 

And I think that it should be so, because any other source will come from one country or the other and will carry the burden of being misconstrued as that country's politics (which may be wrong anyway). The world must remember the debacle that afflicted the global fight against Polio when religious and political opinion 'leaders' in those vulnerable, poor countries claimed that the West was using Polio vaccine to check populations!!!. The world has not yet recovered from that debacle - we read of health workers on anti polio campaign killed by these misguided and misinformed people.

 

Politics and religion have become so virulent in today's world, that the only 'single' source, if that is possible at all, should be the WHO because it is seen as belonging to ALL.

 

Even if a single source is not possible, the way to overcome illiteracy in poor countries is Local language translation of health information irrespective of how many sources!.

 

 

 

 
HIFA at World Health Summit in Berlin (3) EbolaThursday, October 23, 2014Neil Pakenham-Walsh

The Ebola crisis is the result of a collective failure of global research, publishing, info services & health education - it would probably not have happened if healthcare information for all were a reality today. This was the core message of a presentation by HIFA Steering Group member Martin Carroll at the World Health Summit in Berlin yesterday. You can see it here (7 minutes) on YouTube: http://youtu.be/EoBR8XeapyI

 

Communication Initiative: Ebola Communication and MediaWednesday, October 22, 2014Neil Pakenham-Walsh
The Communication Initiative has established a 'theme site on Ebola Communication and Media as a coordinated and independent way to (a) gather and share the knowledge being generated in support of everyone's work and (b) to discuss and debate the best ways forward from a communication and media perspective'.

http://www.comminit.com/ci-ebola/category/sites/global/ebola

The site has several useful resources, including a short animated video "Ebola: A Poem for the Living", 'created for use in West Africa to help dispel myths about how Ebola is spread, and to prevent infection and further spreading of the disease'.
Elsevier Provides Free Online Access to Medical Information for West African Countries Stricken with Ebola Outbreak Friday, October 17, 2014Ylann Schemm

Dear colleagues, I'd like to share the following announcement. Best regards, Ylann Schemm Program Director - Elsevier Foundation
http://www.elsevier.com/about/press-releases/health-sciences/elsevier-pr...

 

How can we do better to meet the information and learning needs of Community Health Workers?Friday, October 17, 2014Jackton Kaijage

In the health care sector, we should acknowledge that still there is inadequate coordination of resource sharing between key players especially for cross cutting issues like dissemination of CHWs' information services. 

If we may draw the CHWCs' Information Plan in an open and trustworthy manner, I am quite sure that CHWs' existing information needs can be made more available cheaply than when each key player struggles on his/her own to meet those needs and sometimes in a narrow-manner. During this era of information age, we should strive at all cost to team-up in delivery of services and products we offer instead of competing.


To clarify my contribution, let me share with you what would happen for CHWs served by multidimensional agencies owned by the Kibaha Education Centre (KEC) and neighbouring agencies in Kibaha Township in Coast (aka Pwani) Region in Mainland Tanzania.

Since KEC owns Kibaha Public Library (KPL), Tumbi Nusery School (TNS), Tumbi Primary School (TPS), Kibaha Secondary School (KSS)-a purely boys school, Kibaha Girls Secondary School (KGSS), Tumbi Secondary School (TSS), Kibaha Clinical Officers Training College (KCOTC), Kibaha Folk Development College (KFDC), Tumbi Regional Referral Designated Hospital which serves the entire Coast region and neighbouring regions and the regional health care sector from the Village and/or Mtaa level to the regional level, conducting a baseline CHWs Information Plan could easily help to identify and document in an open and transparent manner: expressed and felt information needs of CHWs in Coast region and the key CHWs' information providers and how the dissemination of existing information by diverse service providers may be disseminated in a more coordinated manner say through supporting and modernising jointly Kibaha Public Library, which is the widely used library in Coast region by over 4,214 library users.

In order to maintain monitoring and evaluation of this initiative, key players should establish an Advisory Committee drawing members from all responsible agencies in this regard and an Action Plan should be developed and followed up accordingly within an agreed set time-frame say for the period of 3 to 5 years before reviewing it afterwards taking into consideration changes and new developments after the set time-frame.
BBC launches WhatsApp Ebola serviceThursday, October 16, 2014Neil Pakenham-Walsh
The BBC has launched an Ebola public health information service on WhatsApp, aimed at users of the service in West Africa.

The service will provide audio, text message alerts and images to help people get the latest public health information to combat the spread of Ebola in the region.

Content will be limited to three items a day, and the service will be in English and French.

To subscribe, send 'JOIN' via WhatsApp to +44 7702 348 651
Launch of the Ebola Communication Network (ECN)Tuesday, October 14, 2014Laura Raney
Today, the Ebola Communication Network (ECN), was launched. The ECN is an online collection of Ebola resources, materials and tools from and for the global health community.

The ECN (www.ebolacommunicationnetwork.org) is populated with more than 120 resources, including not only SBCC materials like posters, brochures and infographics, but also Demographic and Health Surveys of affected regions, customized maps and peer-reviewed journal articles. The site is responsive to mobile devices and optimized for low bandwidth situations. It includes an RSS feed of Ebola-related news that is updated in real time. 

ECN’s faceted search allows users to find materials based on language, type (e.g., public service announcements, posters, and fact sheets), topic (e.g., prevention, treatment, safe burial practices), audience (e.g., community health workers, governments, health care providers) and any other facets deemed necessary. Users can also upload their own materials, which are posted after a brief review process.

ECN continues to expand as new resources are added each day. Because it is built on an open-source platform, ECN can be enhanced with a host of new features as the crisis unfolds. 

Those working in the fight against Ebola can use ECN to search and share resources, and help build the collection by uploading quality communication materials they have developed for use in the field.

The ECN was developed by the Health Communication Capacity Collaborative (HC3) with input from UNICEF, CDC, USAID, IFRC and WHO. HC3 is a USAID-funded project designed to strengthen developing country capacity to implement state-of-the-art health communication programs.
A Community Health Worker logic model (2) Relative importance of performance versus needs of Community Health WorkersMonday, October 13, 2014Kavita Bhatia

It would be an interesting exercise to do a systematic literature review to simply screen the number of studies of performance versus studies on the needs of CHWs.

Only when we know the needs, and then respond and dialogue with the CHWs, will there be lasting changes in their performance. Current knowledge is based in favor of the views of experts. The experts might contribute better by listening more to the CHWs in my opinion...

 

Information about Ebola is being released by publishers, but what does this say about restricted access to vital health information in general?Monday, October 13, 2014Neil Pakenham-Walsh
Vital information on Ebola that is usually restricted-access is increasingly becoming available as publishers release their content. An intervention by HIFA, for example, led to agreement by the publisher of the leading medical resource UpToDate to make their Ebola content freely available to all:

http://www.uptodate.com/contents/diagnosis-and-treatment-of-ebola-and-marburg-virus-disease


Now, thanks to WONCA, the leading medical textbook Harrison's Principles of Internal Medicine has similarly made its Ebola content available here:

http://accessmedicine.mhmedical.com/content.aspx?bookid=331&sectionid=40726956


Also, the publisher of the classic text Manson's Tropical Diseases has made their Ebola chapter freely available also. This can be accessed via MedBox here:

http://www.medbox.org/ebola-toolbox/viral-haemorrhagic-fevers/preview?q=manson


HINARI continues to play a major role. 'HINARI Programme set up by WHO together with major publishers, enables low- and middle- income countries to gain access to one of the world's largest collections of biomedical and health literature. Up to 13,000 journals (in 30 different languages), up to 29,000 e-books, up to 70 other information resources are now available to health institutions in more than 100 countries, areas and territories benefiting many thousands of health workers and researchers, and in turn, contributing to improve world health.'


Credit is also due to The Lancet, which makes all of its global health content available free (after free registration).

But the greatest credit is due to the whole range of open-access journals and publishers such as PLoS, BioMed Central and of course Wikipedia.

It is becoming increasingly untenable to restrict access to vital health information. While Ebola content is being released specifically to help address the current crisis, key information on all other aspects of aspects of health - from childhood malaria and pneumonia, to maternal and reproductive health, and to cancer and heart disease - are out of reach to those who most need it.
Ebola: the need for Health PersonnelMonday, October 13, 2014Dr Bintu Mansaray
As a medical doctor currently working in Sierra Leone I just shake my head at the outrageous comments people make. We're fighting a disease knew nothing about. I had a one page note on ebola whilst in medical school in Sierra Leone because it wasn't endemic to my region instead we extensively studied Lassa Fever, Yellow Fever, Rabies etc under haemorrhagic fevers. Nurses have never even heard the word ebola so for some people to be blaming health personnel who are dying that we're being careless is heartrending. Have lost colleagues and friends to this fight that has no end in sight. We work in hospitals with no running water. We tell people about handwashing when they get their water from streams. We have patients coming into the hospitals lying about their symptoms. Everyone now knows the symptoms of ebola and they carefully deny each one. But in Sierra Leone we're still working. The things we've seen and are still seeing just breaks my heart. You wear a PPE and in an hour you're sweating like you're in hell. You've got 50-80 patients to check on and by the time you're on patient 20 you can no longer breath in that PPE. Ebola is a scourge that should soon be eradicated. My prayer is on the vaccine. In Sierra Leone we have 136 doctors for about 6 million people. 5 are dead. All we depend on now is on international help. We need health personnel. The more health workers in treatment centers the less often health workers enter into the treatment tents, thus lowering the risk of infection. Organisations like Doctors Without Borders and Emergency Surgical Centre has been such tremendous help there's no way the people of our countries can say thank you. I am pleading for more health personnel. My people are suffering and dying and such helplessness we feel is psychologically daunting.
Nigeria Uses Android App With Facebook to Fight Ebola (2) Reflections on Massive Chikungunya epidemic in JamaicaSaturday, October 11, 2014Mary Sloper

In Jamaica we have been fighting a fortunately less deadly, but even faster growing, massive epidemic of Chikungunya. 

Our problems have been lack of leadership, in that the epidemic was denied for several weeks and doctors were accused of misdiagnosing Dengue and Influenza for Chikungunya. This left an information vacuum which was filled with rumours (Chikungunya caused by plane crash, by biological warfare, by the breeze)... 

An app such as the Ebola one described would have been invaluable, indeed still would be. Rapid reporting of suspected cases, and dissemination of a working case definition, would have allowed our Public Health team to have retained credibility and thus would have allowed control of rumours, also dissemination of prevention and treatment advice. 

Dr Mary Sloper

World Mental Health Day 2014, theme Living with Schizophrenia (2)Saturday, October 11, 2014Didier Demassosso
It is still so obvious that there is a huge  need  for mental health professionals to be informed and educated about best practices on the management of schizophrenia. Moreover, capacity building and training taking into acount EBM/EBT is fundamental as well. I believe that  access to accurate information builds competence and professionalism.
 
I have done psychoeducation with patients suffering with schizophrenia and their families. What is interesting to note is that the presence of a person suffering from schizophrenia in Cameroonian families seems to plunge the family in a dsyfunctional state. The parents seem in this process to accuse thesmelves multually and there seems to be blatant ignorance of the lived experiences of the patient itself as the remarks and treatment made on the patient are often harsh. I think information and access to information about the illness is fundamental. I beileve if families could have access to reliable sources of information the relapses which are very frequent would reduce. 
Development Media International: midline results updateSaturday, October 11, 2014Will Snell

Development Media International (DMI) is conducting a three-year randomised controlled trial in Burkina Faso, to test the proposition that a radio campaign focused on child health can reduce under-five mortality. This is the most rigorous trial ever conducted of a mass media health intervention. For details, visit http://www.developmentmedia.net/proving-impact 

... the first randomised controlled trial to demonstrate that mass media can cause behaviour change. We expect the endline results to be stronger still.

 

African medical journals partner with leading journals to boost impact (3) Much of the research done in Africa is hard to findTuesday, October 7, 2014Mark Lodge

There should definitely be a debate, that's for sure, because there is so much research that has been conducted in Africa and reported but it is all in separate pots.  If we think of just the pots we know of (or have been made aware of; e.g. Bioline -thanks Barbara) then we must recognise that this multiplicity of sources offers us a challenge as well as a solution. 

As an exercise, it's useful to try to name the globally accessible databases that contain references to African research in your own area of care. (Please note that local intramural archives and databases of theses and dissertations are not allowed for this game.) I'll start for cancer: "African Index Medicus, AJOL, ASCO, Biological Abstracts, Bioline, CAB, Embase, EMR Index Medicus, Global Health, INIS, Medline, Popline, PsychInfo, Pubmed (different from Medline), Scopus, Web of Science..."

Therein lies our problem: the particular piece of evidence that we might want or need to identify could be almost anywhere, like the proverbial needle in a haystack. That is why it is hard to find - for scientists locally or anywhere else in the world. 

 

Ebola: Creating Community ResilienceMonday, October 6, 2014Elizabeth Wainwright

In a joint statement released this week, 34 NGOs came together to respond to the epidemic. As part of that statement, six key ways that the international community can respond were outlined. One of those referred to the importance of community mobilisation:
4. "Donors, governments and INGOs must support community mobilization efforts.Treatment will never be enough unless we use effective community mobilization, including support for local media, to reduce transmission and dispel rumours and misunderstanding about Ebola. This can be done far more effectively through the many community groups and associations who are active in treatment and messaging on Ebola. Donors should support these community mobilization efforts and provide logistical support to appropriate community-based activities. Governments and INGOs must work closely with local groups, consulting them before disseminating health promotion messaging, and ensuring that communities have access to accurate information about Ebola."

CHGN will be responding to this. We have ideas, and we would love to hear yours. Specifically:
1. We are creating and partnering to disseminate a community-focused Toolkit to increase access to relevant information and practice in communities. If you have resources to contribute, or if you could help us distribute, let us know. It will include basic hygiene, burial practices, nutrition, infection control, referral, and more. 
2. We want to form a consortium of community-focused organisations that can facilitate support for community mobilisation and messaging in Sierra Leone. It will also amplify community voices and act as a point of contact for these. If you are interested in joining us, please get in touch. 

 

 

First Wikipedia Article Passes Formal Peer Review and is Published Friday, October 3, 2014James Heilman

The first Wikipedia article has passed formal peer review and been published today in the journal Open Medicine
http://hesp-news.org/2014/10/02/dengue-fever-a-wikipedia-clinical-review/

Editorial is here http://www.openmedicine.ca/article/view/652/565 [*see note below]

My hope is that this will encourage academics to contribute.

Confusing drug packaging contributes to death of 15 children in Syria (2)Monday, September 29, 2014Neil Pakenham-Walsh

Below is a statement by WHO concerning the recent iatrogenic deaths of children in Syria.
http://www.who.int/mediacentre/news/statements/2014/interim-findings-idl...

It says: "The Atracurium ampoules were incorrectly added to vaccination packs prepared in one District Vaccine Distribution Centre in Idleb Governorate and distributed to four vaccination teams on the second day of the measles campaign." Curiously, the statement does not acknowledge that atracurium and sterile water vials both have similar purple color labels, as reported in the media.

As I said in a previous message, this was an accident waiting to happen. The statement below was an "interim statement". I hope that WHO will soon issue a definitive statement calling on the pharmaceutical industry to ensure that packaging of dangerous drugs such as atracurium is *strikingly* different from packaging of innocuous diluents such as sterile water. This kind of mistake has happened too often in the past. It should not happen again...

Ascel Bio Assessment ReportSunday, September 28, 2014Ekezie Ralueke Oluchukwu
Ascel Bio LLC, a group working in the Ebola rocked West African Countries, wrote to Nurses Round requesting the most recent assessment of the situation be put up to the public. Ascel Bio LLC is the same team that created the Haiti Epidemic Advisory System for Haiti after the earthquake.  This system promoted situational awareness for all responders during the cholera disaster.

Ascel Bio assesses the situation in West Africa is largely unchanged. Ascel Bio ranks these countries by the level of Ebola-caused community disruption [from worst to best]:
(6/5) Liberia and Guinea conditions are the worst;
(4) Sierra Leone community disruption is only slightly less than Liberia and Guinea;
(3/2) Conditions in Nigeria and Senegal are better than Liberia, Sierra Leone and Guinea; and

(1) Ascel Bio is monitoring conditions in DRC, where reports are sparse but suggestive of better conditions.

Over the past two weeks, Ascel Bio has become increasingly concerned about information suppression, which interferes with accurate assessments. In the week ending 20140913, Ascel Bio noted an insistence by Nigeria to journalists to soften their reporting on Ebola, citing fear and panic as unnecessary side effects. In the week ending 2014-09-21, both Liberia and Guinea reported a similar insistence on reducing media coverage, with the government restriction on media being called “an alarming assault on press freedom.”

Download and read the full report from here : http://goo.gl/YtFhjk
Confusing drug packaging contributes to death of 15 children in SyriaSaturday, September 27, 2014Neil Pakenham-Walsh
5 years ago a problem was reported with the packaging of atracurium, a deadly muscle relaxant used in surgery... ... Last week, at least 15 children died after being vaccinated against measles in northern Syria. "While someone was preparing the vaccines, instead of putting the regular diluent for the vials, he mixed it with atracurium, which has the same colour bottle and same patch on it", said Khaled Almilaji, health department manager at the Assistance and Coordination Unit, which was instrumental in organising the measles campaign. "An investigation is underway to specify who this person was."
 
The authorities seem to be scapegoating the health worker. But this is a patient safety issue, with multiple contributing factors - not least that the country has been in civil war for 3 years, making any mistake more likely. The manufacturers of the atracurium must bear some responsibility. If the manufacturers of dangerous medicines would packages their products more clearly, and differently from common diluents such as sterile water, these mistakes would almost never happen.
 
The news report in The Lancet is freely available here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61710-4/fulltext
 
The negative health impact of this accident will go far beyond the deaths of the above children:
 
'Health experts warned that the vaccine mix-up would severely damage trust in health services in opposition-held areas. "It's a catastrophe", said Annie Sparrow, public health expert and deputy director of the Human Rights Program at Icahn School of Medicine, NY, USA. "It's hard to see any parent letting their child be vaccinated in Syria ever again. It is just awful on so many levels."'
 
Ebola in West Africa: resources from the National Library of Medicine (NLM)Friday, September 26, 2014Cindy Love

***As the West Africa Ebola outbreak continues, here's a reminder of NLM resources that may be of value.***


All of these resources, and others, are listed on the guide "Ebola Outbreak 2014: Information Resources" at http://disasterinfo.nlm.nih.gov/dimrc/ebola_2014.html. The guide is frequently updated and now has a section on "Situation Reports" and has added links to "Free Resources from Publishers."


Disaster Lit continues to add guidelines from CDC, World Health Organization and others; reports; government documents; factsheets and more.
http://disasterlit.nlm.nih.gov/search/?searchTerms=ebola+OR+hemorrhagic&search.x=45&search.y=11&search=Search 


The NLM Emergency Access Initiative, http://eai.nlm.nih.gov/, is available through October 17 for free access to 650 journals, 4,000 reference books and databases. Virology, epidemiology, and infectious disease textbooks have been the most popular.


*NEW* The "Virus Variation: Ebolavirus Resource" for genome and protein sequences is now available from the NLM National Center for Biotechnology Information. http://www.ncbi.nlm.nih.gov/genome/viruses/variation/ebola/


Ebola topic pages for the general public are available from MedlinePlus in English (http://www.nlm.nih.gov/medlineplus/ebola.html) and in Spanish (http://www.nlm.nih.gov/medlineplus/spanish/ebola.html).
Community care workers in TB care: identifying and meeting their information needsThursday, September 25, 2014Community care workers in TB care: identifying and meeting their information needs
My name is Ida Okeyo. I am doing a masters in pharmacy practice which is focused on the development of TB information materials for community care workers working with TB patients in Grahamstown, South Africa.
 
It has been a bit of a struggle to try and find resources and literature similar to what my project. I would like to know if anyone would recommend any resources or literature similar to my interests or any study that has been similar to what I am trying to accomplish.
 
My project is a multi-phase study which starts with discussions with local community care workers about what they do and this is followed by a TB knowledge questionnaire to check how much they know about TB. Afterwards, I will design the information materials and distribute them to the community care workers and ask them to use the materials when counselling patients. After a three to four month break, I will then interview the care workers again with the same questionnaire and have a discussion later on to see whether the information materials have been useful.
 
 
 
Ebola in West Africa (146) Using SMS to inform the public about EbolaThursday, September 25, 2014Francois Laureys

Following the recent mHealth initiatives in Ghana, Malawi and Uganda, IICD (International Institute for Communication and Development) and TextToChange support the Ministry of Health in Mali with an information and sensitization campaign to prevent the spread of Ebola... How does it work? Over a period of 2 weeks, people in Mali can SMS the word EBOLA to short code 36011 and will receive several text messages on Ebola during 2 days. This service is completely free of charge for the end-users and at the moment available on the Orange network. The messages contain information on disease characteristics, prevention, transmission, protection and where to report cases of Ebola...

Palliative Care FormularyWednesday, September 24, 2014Neil Pakenham-Walsh

I would like to remind HIFA members about the Palliative Care Formulary, described on HIFA in 2012 by HIFA member Dr Robert Twycross. I am assured that web access to the publication continues to be free for those in HINARI countries. However, it is not possible to download the resource for offline use, which limits its usefulness in low-bandwidth environments. It is a difficult challenge to persuade publishers to make formularies available free for offline use in low-resource settings. Perhaps a derivative of the publication could be made available without harming the commercial sales. Alternatively, third parties could fund the publication, as is the case of the Indian Government, which funded the Indian National Formulary and thereby makes it available free for all, for offline use. Any thoughts?

Ebola in West Africa (132) Helping the general public to understand Ebola (4)Monday, September 22, 2014Neil Pakenham-Walsh

Information about Ebola is currently scattered on thousands of different websites and it is not easy for people to differentiate reliable from unreliable information. Also, it is not easy for people to find reliable information in languages other than English. Nor is it easy for members of the general public in an affected country to find reliable information - that is clear and easy to understand - on how they can protect themselves and what they should do if they develop symptoms. Meanwhile, myths and misinformation continue, contributing to unncessary death and suffering. What more can be done to facilitate the availability of reliable information for different user groups? Should more be done to promote existing sites that are seen to be providing reliable information, such as WHO? What more can be done to support ministries of health in their communication efforts with the general public. A month ago we noted some serious deficiencies in public information on the websites of the ministries of health of Liberia and Nigeria. Today, clear information on the Liberia website is now available, but the Nigeria MoH website has not yet addressed the inaccuracies we pointed out on their fact sheet for the general public. Meanwhile, it appears that the Guinea MoH does not yet have a website. It adminsters a blog - http://mspguinee.blogspot.ch/ - but this site contains no news at all since 2013: nothing about Ebola.

Ebola in West Africa (138) Ebola information in French (4)Monday, September 22, 2014Sieglinde Mauder

The innovative online library MEDBOX.org has generated and just recently updated the new EBOLA TOOLBOX www.ebolabox.org comprising all publicly available disease-specific documents to ease access for the teams on the ground... MEDBOX is a new and innovative online library aimed at improving the quality of health care in humanitarian action, worldwide. Based on the assumption that humanitarian health workers around the world can act effectively if they have access to the necessary tools, MEDBOX collates the increasing number of professional guidelines, textbooks and practical documents on health action available online and brings these into the hands of aid workers: when they need it, where they need it.

Ebola in West Africa (130) The Lancet Ebola Resource CentreSunday, September 21, 2014Neil Pakenham-Walsh
On the inside front cover of this week's print issue of The Lancet (20 September), there is a full-page announcement about The Lancet Ebola Resource Centre.

'The Lancet wishes to assist health workers and researchers working under difficult and dangerous conditions to bring this outbreak to a close. In an effort to support the vital work being done, all related content from The Lancet is freely accessible on our online Ebola Resource Centre. Visit www.thelancet-ebola.com

You are also encourgaed to share your front-line experiences at www.thelancet-ebola.com'

Thank you to The Lancet for making content on Ebola freely available to all. It is vitally important that policymakers, health professionals, researchers and the general public have access to reliable information about Ebola. People are dying (and, tragically, killing others as in Guinea) because of lack of understanding of Ebola. 
Ebola in West Africa (117) Ebola Messages for ChildrenFriday, September 19, 2014Clare Hanbury

At Children for Health we have put together a short resource for those working in Ebola affected communities. This is in response from a request from people working in an affected area. We believe that children can play a role in helping to protect their own and other children's health.http://www.childrenforhealth.org/messages-for-children-to-learn-and-shar... We have prepared 20 messages. 2 messages to answer 10 key questions which we think children might be asking. We hope you find these messages useful and we welcome your feedback, stories and experiences...

Ebola in West Africa (115) Helping the general public understand Ebola transmissionWednesday, September 17, 2014Neil Pakenham-Walsh

WHO's "Ebola: What you need to know" (http://www.who.int/csr/disease/ebola/en/) says simply: "The risk of Ebola transmission is low. Becoming infected requires direct, physical contact with the bodily fluids (vomit, faeces, urine, blood, semen, etc.) of people who have been infected with or died from Ebola virus disease (EVD)." This statement is accurate, but is it not likely to be misinterpreted to suggest that Ebola transmission occurs only through direct contact with an infected person? I reviewed the rest of the WHO guidance for the public (http://www.who.int/csr/disease/ebola/what-you-need-to-know/en/) and was unable to find anything there about the danger of transmission through contaminated items. Contamination is addressed in some of the WHO technical papers, but these are unlikely to be read by members of the general public.

Ebola in West Africa: Helping people find the healthcare information they needWednesday, September 17, 2014Neil Pakenham-Walsh
If you do a search on Google for Ebola health education materials, you get 9,340,000 results. I am reminded of the metaphor of trying to drink from a fire-hose, describing the increasing problem of not being able to find the information you need in an ocean of information that you don't need.

Meanwhile, we have learned how misinformation about Ebola has spread like wildfire. And we have even seen a disconnect at the 'higher' levels of information, for example the Nigerian Ministry of Health website which, as we highlighted 3 weeks ago, continues to carry inaccurate information for its citizens - including the disastrous implication that it is not safe for citizens to attend health facilities.

The health information and education aspects of the Ebola outbreak illustrate what is wrong with the global healthcare information system today. Over the past 10 years, the focus has been on improving technological access, and there have been massive improvements. The priority over the next 10 years is to enable people to find the content they need: content that is reliable and in the right language, format, and educational level for the user, and appropriate to the user's context... *and* to help people (especially citizens and those who are most vulnerable to misinformation) to differentiate reliable, relevant information from the vast mass of other information that is either unreliable and/or not appropriate to their context.

Please refer to the links below for useful protocols and resources.
Guide for US hospitals evaluating suspected Ebola pts (Han 364):  http://emergency.cdc.gov/han/han00364.asp
CDC infection and prevention control recommendations for US hospitals: http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html
CDC Advice for students and colleges about ebola in West Africa: http://wwwnc.cdc.gov/travel/page/advice-for-colleges-universities-and-students-about-ebola-in-west-africa

WHO information and resources including response, information control, patient care and more: http://www.who.int/csr/resources/publications/ebola/en/

Medbox clinical management pocket guide for front line workers: http://www.medbox.org/ebola-toolbox/clinical-management-of-patients-with-ebola-pocket-guide-for-front-line-workers/preview
Medbox infection prevention and control guidance: http://www.medbox.org/ebola-toolbox/interim-infection-prevention-and-control-guidance-for-care-of-patients-with-suspected-or-confirmed-filovirus-haemorrhagic-fever-in-health-care-settings-with-focus-on-ebola/preview

WHO ebola factsheet: http://www.who.int/mediacentre/factsheets/fs103/en/

MSF ebola information: http://www.msf.org.uk/ebola

--

'Here are some low literacy Ebola educational materials in multiple languages:'

UNICEF: http://www.unicef.org/cbsc/index_73157.html

SOS International: https://www.internationalsos.com/ebola/index.cfm?content_id=398&language_id=ENG 

--

There are some excellent references on the CDC website:
these two links provide information for people who are not healthcare providers: 

http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa.html
http://wwwnc.cdc.gov/travel/page/humanitarian-workers-ebola

this is a link to infographics that provide basic information about the disease, symptoms and prevention.
http://www.cdc.gov/vhf/ebola/pdf/ebolakeymessagesupdated.a2.july1.14.pdf

UNICEF guidelines for ebola in the community

http://www.unicef.org/cbsc/files/Guidelines_for_Ebola_in_a_Community.pdf

the UNICEF website also has some information in Bantu, and some other languages common in the countries affected.
--

The CDC has radio messages in English and local languages for download: http://www.cdc.gov/vhf/ebola/outbreaks/guinea/radio-spots.html
Health information on Wikipedia is going from strength to strength (9)Wednesday, September 17, 2014James Heilman
...The reason I write for Wikipedia rather than a specialized wiki is that Wikipedia is what the world is reading. While one may have less control on Wikipedia than a specialized site, only through working together will our shared goals be achieved more quickly or likely at all.
Client-held Maternal & Child Health Record bookletsTuesday, September 16, 2014Luther-King Fasehun
In Nigeria, the Wellbeing Foundation, working in partnership with global and local stakeholders in the field of maternal, newborn and child health (MNCH), including the Perinatal Institute (U.K.) and the MNCH Core Technical Committee of the Nigeria Federal Ministry of Health, had developed an integrated MNCH Personal Health Record (PHR) in 2009, as an important tool that helps to organise all the health-relevant information about a mother and her child, from the moment she falls pregnant, through the delivery and birthing process, and till the child attains the age of 5 years, including growth monitoring through sex-specific growth charts. As an additional benefit, this PHR has a great health information dissemination potential, with its appendix-based health educational information on evidence-based best practices on common health concerns of mothers and children, including malaria, diarrhoea, nutrition, personal hygiene, etc.
 
As you will agree, and particularly so in a country as vast and diverse as Nigeria, the collection of all these health and care information in one single, client-held booklet allows for easy cross-referencing of information, especially when families easily shift their domiciles from one State/region of the country to another, for mainly socio-economic reasons. It is also worthy of note that the duplication of the record pages of the client-held PHR allows healthcare facilities to retain a record, as exactly copied on the client-held, home-based PHR...
 
 
 
How best to recruit and retain community health workers (2)Tuesday, September 16, 2014Kavita Bhatia
It was fascinating to see Zambia's Ministry of Health's work with economists to determine how best to recruit and retain community health workers. This is in reference to their finding that "Using a randomised experiment the findings illustrate that there is no tradeoff between career incentives, skills and social values. Providing career opportunities attracts more skilled individuals who perform better and seem to be equally socially motivated."
 
I have done a study on CHWs in India and the findings are similar. Growth aspirations, incentives and the service motivation  were not contradictory drives but complementary values among the CHWs known as ASHAs. Please see the report at:
http://www.hifa2015.org/hifa2015-forum/hifa2015-member.files/ 
 
 
 
Introduction: Lourdes Herrera, Japan (2) Maternal and child health recordsSaturday, September 13, 2014Luther-King Fasehun
In Nigeria, the Wellbeing Foundation... had developed an integrated MNCH Personal Health Record (PHR) in 2009, as an important tool that helps to organise all the health-relevant information about a mother and her child, from the moment she falls pregnant, through the delivery and birthing process, and till the child attains the age of 5 years, including growth monitoring through sex-specific growth charts. As an additional benefit, this PHR has a great health information dissemination potential, with its appendix-based health educational information on evidence-based best practices on common health concerns of mothers and children, including malaria, diarrhoea, nutrition, personal hygiene, etc.
 
This presents a window of opportunity for bilaterals, multi-laterals, and the private sector... to make a renewed PHR available to all who need it, and harmonising the PHR across all States of Nigeria (in a manner that doesn't deny the existence of some other forms of records like the 'Green Card' and the 'Yellow Card,' that still exists in some parts of the country).
Introduction - mHealth Expert Learning Program (mHELP)Friday, September 12, 2014Helen Alexander
The mHealth Expert Learning Program (mHELP) seeks to provide health implementers (govts, NGOs, UN agencies etc) with all the resources they need to get mobile health successfully integrated into their health programs. This includes advice and support around mHealth, access to written resources (How to guides, Frequently Asked Questions etc) and access to highly skilled mHealth experts around the world who are part of our Expert Network...
Perceived role of journal clubs (3) How to organize evidence-based journal clubsTuesday, September 9, 2014Irina Ibraghimova
I have compiled a list of resources on organizing evidence-based journal clubs
 
Here are a few guides, if you are interested in more resources I can send you the whole list as Word document (16 pp.)
 
Journal Club Handbook
The Handbook includes guidance for the presenters, FAQs, and recommended reading. From Birmingham Women's Hospital. 2012
http://jcbwnhsft.pbworks.com/w/file/fetch/52465647/BWH%20JC%20Handbook%2...
[...]
 
 
Women's Access and Provider Practices for the Case Management of Malaria during Pregnancy (2)Monday, September 8, 2014Wycliffe V. Matende
In practice, there is a tendency for practitioners to go for "what really works". With experience, healthcare providers discover regimes which work better to them and so unlikely to stick to the recommended guidelines and protocols. In most health institutions, a doctor is respected for his knowledge and skills. When a doctor prescribes, even if it is not as per WHO guidelines, nurses or dispenser should follow. We should not forget the issue of personal influence. Doctors or indeed, leaders, have people they inspire. Nurses, Clinicians or any prescriber may emulate and follow the personalized doctors' prescription. In the long run, one finds that the recommended protocol or guidelines is entirely sidelined.
 
Though doctors are said to be culprits according one study, nurses are also guilty parties to changing prescriptions according to what really works for them...
Health information on Wikipedia is going from strength to strength (7) Medline Plus (2)Monday, September 8, 2014James Heilman
Wikipedia can be improved and is in 278 languages so far. The NIH [National Institutes of Health, US] cannot be.
 
 
Health information on Wikipedia is going from strength to strength (5)Friday, September 5, 2014Ghaiath Hussein
Unlike many who keep on casting doubts on the reliability and credibility of the health-related content in Wikipedia (WP), I think WP has the potential to be the best peer-reviewed resource ever. We, in the community of science, believe in the publication model as the 'gold standard' because it minimizes the conflicts of interests and increases the credibility by having the research content reviewed by neutral experts. At best, up to 3 reviewers review the research content before being published. In the WP model, theoretically at least, the content can be reviewed and scrutinized by 100 reliable expert. No journal can compete with that. Moreover, the readability of the content in WP is way more than what any scientific journal can claim or even dream of. This is also means of credibility because the readers/editors can (again theoretically) change any uncredibile content in days. Contrarily, journals take sometimes year to retract falsified research publications. 
 
 
 
Wikipedia Working to get Ebola Content into as Many Languages as PossibleMonday, September 1, 2014James Heilman

We at Wikipedia are busy translating content on Ebola as well as many other key diseases into as many languages as we can find volunteers per here https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Translation... ... We have recently added a new collaborator to our efforts, Rubric who have volunteered their expertise and helped us get content into an additional dozen or so African languages. ... Grassroots efforts to develop healthcare content, through models such as Wikipedia, IMO is the only way we will achieve health care information for all in the language of one's choosing.

Ebola in West Africa (103) Empowering primary health workers to respond to EbolaSunday, August 31, 2014John Dada
I work as a volunteer for a rural NGO in Kafanchan [Nigeria]. The Kaduna State Government has been MUTE about the EVD [Ebola Virus Disease], as far as we rural workers can tell, and like many others I am at a loss where to look for help. We have done what we can, photocopying some health information which we produced, in Hausa and English, and distributing to household heads and holding dialogues with youths and women... The communities ask for and expect leadership from our team of primary healthcare workers, but we have very little to give them
 
 
 
 
 
 
Ebola in West Africa (97) What is Health Knowledge and how should we use it? (3)Friday, August 29, 2014Joseph Ana
a few years ago, I went to inspect a hospital and was told that the medical head of the hospital had taken ill with stroke but had been taken to a native doctor for 'cure' by his family on his say so. I asked to be taken to see him at the native doctors 'clinic' and he told me he thought that his own stroke as different. He blamed his enemies for striking him with the stroke !!.
 
Again when HIV / AIDS was considered a death sentence, there were several reports of persons who once told that they had the disease went about infecting people with the virus. Many of them were educated people too.
 
So, it is not so much the level of education of the person, as it is the lack of consideration for others, fellow human beings. There are illiterates or uneducated people who have innate milk of human kindness in them who would not harm their fellow human beings...
 
 
Use of bednets: Household training vs mass education (2) Thursday, August 28, 2014Nicholas Cunningham
Health care is founded on trust, so it shouldn't surprise us to learn that people are more likely to believe (and act on) information that is hard to understand without scientific education, when it comes from the lips of someone they know, than from an anonymous "all points bulletin"!
 
One big reason for integrating curative with preventive health care is that each time someone gets help in recovering from a "felt need" illness, the trust in "western" medicine and the health workers providing it, is enhanced. Then, when someone from that health care system offers preventive advice or services about bed nets, nutrition, family planning, immunizations, seatbelts, HIV prevention, smoking/other harmful practices etc., it's far more likely to be received positively!
 
Ebola in West Africa (95) Ebola information in French (3)Wednesday, August 27, 2014Neil Pakenham-Walsh
I am still unable to find WHO guidance in French. It is now 18 days since the English-language guidance was published (Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola). 
 
There is an interesting question to explore here about the delay between initial publication of guidance in an emergency and its translation tomake it accessible to those who need it. Does it indeed take more than 2 weeks to translate essential emergency guidance into another language? What are the causes of this delay in translation and how can such delays be avoided in future?
 
 
Cervical Dysplasia Center (6)Wednesday, August 27, 2014Sarah Wallace
I note that many of you point to the need for improved education and communication on cervical cancer, we at Medical Aid Films fully recognise this and have developed 3 training films on cervical cancer screening and awareness.  The first is for general awareness and education for communities and health workers - so can be shown in clinics on TV screens to patients or shared on mobile phones. Films 2 and 3 are for skilled health worker training only, showing various screening and treatment options available with film 3 going into more detail on VIA & VILI specifically (All films are available in English, French, Swahili and very soon in Somali).
1. CERVICAL CANCER: UNDERSTANDING PREVENTION, SCREENING AND TREATMENT - http://medicalaidfilms.org/our-films/cervical-cancer/?v=81493051
2. CERVICAL CANCER: SCREENING AND TREATMENT OPTIONS - http://medicalaidfilms.org/our-films/cervical-cancer/?v=81489247
3. CERVICAL CANCER: HOW TO CONDUCT VIA AND VILI SCREENING TESTS - http://medicalaidfilms.org/our-films/cervical-cancer/?v=81485387
 
 
Ebola: What information are Ministries of Health providing to citizens? (2) Saturday, August 23, 2014Joseph Ana
Thank you for pointing out some errors in the information Fact sheets of West African countries. After my communication with you and Julie Storr, I forwarded your comments to the Minister of Health of Nigeria for his information and action...
Health promotion in Guinea - lack of information in French Saturday, August 23, 2014Neil Pakenham-Walsh
I was interested to see this new paper, published yesterday. The research was undertaken in Guinea, a French speaking country in West Africa that is currently at the heart of the Ebola outbreak. The paper is published in an English-language journal and is inaccessible to those who do not speak English. I would be interested to know if researchers, policymakers and health professionals sometimes resort to using Google Translate, contributing to errors in policy and practice. Isn't it time that journals should make abstracts available in the language of the originating country?
 
CITATION: The value of building health promotion capacities within communities: evidence from a maternal health intervention in Guinea
Ellen Brazier, Renee Fiorentino, Mamadou Saidou Barry and Moustapha Diallo
Health Policy Plan. (2014)
doi: 10.1093/heapol/czu089
First published online: August 22, 2014
 
Ebola: What information are Ministries of Health providing to citizens?Friday, August 22, 2014Neil Pakenham-Walsh
All of the countries [Liberia, Sierra Leone, Guinea and Nigeria] appear to give detailed information on numbers of cases [on their Ministry of Health websites], but practical information on how Ebola is transmitted, and how to protect oneself, was incomplete (except in the case of Sierra Leone) and sometimes misleading. 
 
Liberia... Practical information on Ebola was not easy to find. There were brief guidelines, hidden in previous press releases. One press release invited people to download a  copy of the "list of assorted personal protective equipment to the government", which appeared to show an MoH procurement sheet for gowns, gloves, boots and other equipment. http://www.mohsw.gov.lr/documents/listing_of_items_frm_who.pdf
 
...Nigeria... a fact sheet on Ebola... (http://www.health.gov.ng/doc/Ebola%20Fact%20Sheet.pdf) appears to contain some important inaccuracies that could be seriously misleading:
"Ebola VD is usually spread within a health care setting."
"Ebola VD could be spread through the following:...
Inhalation of contaminated air in hospital environment"
"Who is at risk?... People that go to hospitals with poor hygiene and sanitation practices"
HIFA opens up Ebola content on UpToDateFriday, August 22, 2014Neil Pakenham-Walsh
I wrote to the publishers of UpToDate, requesting that their Ebola article be made freely available to all, in full, "to assist in global and local efforts to contain the epidemic".
 
I am delighted to report that they have agreed to this request, and the full content of the Ebola section is now freely available here:
 
Epidemiology, pathogenesis, and clinical manifestations of Ebola and Marburg virus disease
http://www.uptodate.com/contents/epidemiology-pathogenesis-and-clinical-...
 
Diagnosis and treatment of Ebola and Marburg virus disease
http://www.uptodate.com/contents/diagnosis-and-treatment-of-ebola-and-ma...
 
 
Ebola in West Africa (75)Thursday, August 21, 2014Neil Pakenham-Walsh
In a previous message (10 August), I asked: "If all abstracts of research undertaken in francophone countries in West Africa had been available in French, might this have made it easier for public health professionals and policymakers in Guinea to review and synthesise the evidence? I shall put this question also to our French-language sister forum HIFA-EVIPNet-Francais, which is run in collaboration with WHO Geneva."

I have since looked for information in French about Ebola on the WHO website, and have failed to find any. I understand that the recent new guidance from WHO, published 12 days ago, was fast-tracked for translation into French (and other languages), but the translations are not yet available, while the number of deaths in the region increases to more than 1,200.

As a general comment on WHO's programme of publications (in all areas of health), I am amazed by how much this organisation is able to produce, with consistently high quality, despite having a very constrained budget. Furthermore, all WHO publications are freely available from their website. The Ebola outbreak reminds us how vital WHO is to global health, and how important it is that their publications and information services are properly supported.

Meanwhile, the National Library of Medicine announced on 14th August that previously restricted (English-language) literature on Ebola is now available thanks to the "generosity" of publishers who have agreed to make the content temporarily available for "those affected by the disaster or assisting the affected population". I do not doubt that this gesture will help, but does this not raise serious ethical issues around the continuing restricted access of health literature that is vital to inform policy and practice?...

Lessons need to be learned from all this so that the world is better prepared for the next global health crisis.

 

A proposal to address health top-level domain concerns Wednesday, August 20, 2014Mark Selby
Summary: This proposal seeks to address concerns within the health community triggered by ICANN's auction of the .health generic top-level domain (gTLD) in September 2014.  It seeks to improve the value of the broader health Internet and minimize risks to the online community through the creation of an Ethical Governance Fund (EGF) to finance structured programs. These programs would include the evolution and administration of a peer-review community governance model and the education of parties seeking and offering trusted health information, products and services. It calls on ICANN to finance the EGF in accordance with its stated mission(12) of supporting the online community and informing and educating stakeholders...
 
Lyon Declaration on Access to InformationTuesday, August 19, 2014Paola De Castro

On August 18 the Lyon Declaration On Access to Information and Development was launched by IFLA at the World Library and Information Congress in Lyon, France. The Declaration that is available at http://www.lyondeclaration.org/ ... I think this Declaration is particularly relavant for HIFA, sharing many objectives therein included... 

Ebola in West Africa (67) NLM Launches Emergency Access Initiative to fight EbolaTuesday, August 19, 2014Neil Pakenham-Walsh
 
The offer is only available to "those affected by the disaster or assisting the affected population". 
 
(One day, within the next 10 years, we shall all look back and think it absurd that humans used to restrict access to the information they need to protect their health and the health of others.)
 
News Release: NLM Launches Emergency Access Initiative, Granting Free Access to Books and Journals for Healthcare Professionals Fighting Ebola Outbreak
http://www.nlm.nih.gov/news/ebola_emergency_access.html
 
 
The news media and Ebola (5) The Church and EbolaSunday, August 17, 2014J K C Emejulu
 
Beyond the traditional news media that we are aware of, our churches in Nigeria have done a great deal of information dissemination and pro-action in controlling the spread of the Ebola virus. Last week, the Catholic Church in some parts / dioceses / archdioceses in Nigeria gave a directive, temporarily suspending close contacts between members of the congregation during the rituals of a typical mass session...
 
 
Ebola in West Africa (60) The news media and Ebola (4)Sunday, August 17, 2014Neil Pakenham-Walsh

In general, the news media have a huge role in public communications to help contain an epidemic such as Ebola. With this comes a responsibility to be accurate. The BBC is widely trusted as a reliable provider of information, which brings with it even greater responsibility than other broadcasters to maintain accuracy. I would like to comment on the 60-second video on the BBC news website http://www.bbc.co.uk/news/health-28105531 with the caveat that I am not an expert and would welcome comments from others. In my view it is good as a brief general overview of Ebola, for a global audience. However, it should not be seen as a health education video. If this video were seen by a person living in West Africa, looking to learn what they should personally do to prevent Ebola, the person is likely to be misled by the content of the video... 

Ebola in West Africa (52) Community radio to save lives through effective communicationSaturday, August 16, 2014John Dada
 
As the ebola epidemic goes almost unchecked amidst the frantic professional efforts and global commitments for its containment, may be this is as good a time as any for Nigeria to fast-forward its delay in approval of licenses for COMMUNITY RADIOS.
 
It is now agreed that the widening trust between the public and healthcare professionals is a major obstacle in the containment of this disease. In Uganda, a simple but highly effective approach that was employed to gain the trust of the populace was through intensive communication, using all available means, engagement of community and traditional leaders to support Healthcare Staff. The absence of effective communication with the populace helped to spread the rumour about the curative powers of salt water and bitter kola. These misinformation are easily checked through relevant and quick messages in local languages on Community Radios. 
 
The process of obtaining Community Radio license has so far been made so difficult as to be beyond the reach of the communities that need it most. Those Nigerians who will benefit the most from Community Radio health messages do not have access to newspapers, television or social media: they most certainly have access to a transistor radio. The Nigerian Federal Ministry of Communication needs to rise up to the Ebola challenge by working closely with civil societies to streamline the application process while retaining essential checks to prevent abuse.
 
Community radio provides the Government and the health official a cost­effective medium to communicate essential information in a timely fashion in the peoples' dialects. Let us grab this opportunity to save lives through effective communication
 
 
Imagine If Thousands of Medical Researchers Could Have a Quick Conversation: PubMed CommonsFriday, August 15, 2014Neil Pakenham-Walsh

Please find below the opening of an article about PubMed Commons, an important new facility to enable post-publication discussion of individual research papers. Ironically the article is copyright-protected, so I am unable to reproduce it in full here, but those with easy web access can read it in full online: http://www.govexec.com/excellence/promising-practices/2014/08/imagine-if... Currently one is only allowed to use this service if one is already an author of at least one paper on PubMed. I queried this with NIH several weeks ago, and was told they aim to widen participation in future - hopefully this will eventually be available to all, as it should be.

The role of librarians in Evidence Based Medicine (4)Wednesday, August 13, 2014Mark Lodge
Both Information/Knowledge Management and Clinical Practice/Research/Policymaking are two very broad, separate and dynamic fields of specialisation. Whenever I provide training to clinicians on how to identify studies for systematic reviews I strongly advise them to partner up with a skilled librarian or information specialist who will have kept abreast with the advances in information retrieval, because not all the lessons they may have learned from a librarian in, say, 2007 will still apply in 2014.  Much the same applies to clinicians seeking to access the latest relevant information to help them make treatment decisions.