Open access publishing & noncommunicable disease prevention in developing countries www.procor.org  a program of the Lown ...
Outline  <ul><li>Non Communicable Disease burden </li></ul><ul><ul><li>Global and local </li></ul></ul><ul><li>Information...
Noncommunicable disease: A new health threat <ul><li>Leading cause (60%) of death globally </li></ul>www.procor.org  a pro...
Cardiovascular diseases  <ul><li>Among NCDs, CVDs are the leading cause of premature, preventable deaths </li></ul>www.pro...
Disproportionate NCD burden in LMIC <ul><li>Nearly 80% of NCD deaths occur in low- and middle-income countries.  </li></ul...
NCDs in Ghana <ul><li>Nearly 40% mortality caused by NCDs </li></ul><ul><li>Nearly 50% CVD-related </li></ul>www.procor.or...
Mortality, Ashanti region www.procor.org  a program of the Lown Cardiovascular Research Foundation Ashanti Region Regional...
www.procor.org  a program of the Lown Cardiovascular Research Foundation
80% of CVD is preventable www.procor.org  a program of the Lown Cardiovascular Research Foundation Age-standardized death ...
Evidence-based strategies are affordable, cost-effective, adaptable <ul><li>“ A full range of chronic disease intervention...
Information poverty: A neglected risk factor <ul><li>“ Improving the availability and use of relevant, reliable health car...
ProCor: Promoting cardiovascular health <ul><li>Founded in 1997 to: </li></ul><ul><li>Promote  knowledge sharing among a g...
Ashanti-ProCor Project <ul><li>Four-year pilot project </li></ul><ul><li>Identify CVD information needs and access prefere...
Methodologies: Learning and listening <ul><li>Learning </li></ul><ul><li>-- Literature review </li></ul><ul><li>-- Knowled...
Findings: Rich human resources <ul><li>Many diverse provider groups  have the potential to play a key role in CVD preventi...
Assets: Awareness and commitment <ul><li>High awareness  of CVDs across groups studied </li></ul><ul><li>Strong commitment...
Leapfrogging technologies  <ul><li>Laptops (often stand-alone) </li></ul><ul><li>USB drives </li></ul><ul><li>Mobile phone...
Barriers: Available resources  <ul><li>Hard copies (textbooks, journals) </li></ul><ul><li>Frequently out of date </li></u...
Online barriers: Cost, time, connectivity <ul><li>Cost </li></ul><ul><ul><li>Service provider contracts </li></ul></ul><ul...
<ul><li>“ Most of the faculty are research oriented and they want up-to-date information. We used to depend so much on jou...
Preferences <ul><li>Email </li></ul><ul><li>Download options </li></ul><ul><ul><li>PDFs (easy storing) </li></ul></ul><ul>...
Role of open access <ul><li>No associated costs for accessing or publishing </li></ul><ul><li>Email alerts </li></ul><ul><...
Potentially more inclusive <ul><li>“ Underrepresentation of developing world health issues in the medical literature is a ...
Future directions <ul><li>Respond to identified need for local/regionally relevant research </li></ul><ul><li>Maximize acc...
Thank you for your attention www.procor.org  a program of the Lown Cardiovascular Research Foundation
Support prevention.  Share knowledge.  Subscribe to ProCor. www.procor.org  [email_address] Benn Grover Editor, ProCor Low...
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Open-access publishing and noncommunicable disease prevention

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Collins Kokuro, Associate Director, Ashanti-ProCor Project and Specialist Physician, Dept. of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana

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  • A major reduction in the burden of NCDs will come from population-wide interventions, which are cost effective and may even be revenue-generating, as is the case with tobacco and alcohol tax increases, for instance.
  • Literature review (1) on information needs of heatlh workers in developing countries, with focus on Africa Knowledge and practice survey of medical students &amp; public health/community health nurses Key informant interviews with stakeholders in medicine, academia, public health, and information services Focus groups with physicians; nurses; students in KNUST’s Colleges of Medicine, Pharmacy, Herbal Medicine; nursing students; information specialists (1) “Information needs of health care workers in developing countries: A literature review with a focus on Africa. N. Pakenham-Walsh, F. Bukachi. Human Resources for Health. April 2009. 20 focus groups Published in open access journal
  • 20 focus groups Published in open access journal
  • The developing world in The New England Journal of Medicine Lown B, Banerjee A Globalization and Health 2006, 2 :3 (16 March 2006) [ Abstract ] [ Full Text ] [ PDF ] [ PubMed ] [ Related articles ] http://www.globalizationandhealth.com/content/2/1/3 Lancet since 1963 401 Lancet Searching journal content for cardiovascular africa (all words) in full text, from Jan 1963 through Oct 2011. New Search Next 10 Displaying results 1-10 of 812 http://www.thelancet.com/search/results?searchTerm=cardiovascular&amp;fieldName=AllFields&amp;op=and&amp;searchterm2=africa&amp;fieldname2=AllFields&amp;year=&amp;volume=&amp;page=&amp;jrnl=&amp;artypes=&amp;advsrch=t&amp;journalFromWhichSearchStarted=&amp;sort=date&amp;order=desc&amp;collectionName=All%20Lancet%20Journals
  • The developing world in The New England Journal of Medicine Lown B, Banerjee A Globalization and Health 2006, 2 :3 (16 March 2006) [ Abstract ] [ Full Text ] [ PDF ] [ PubMed ] [ Related articles ] http://www.globalizationandhealth.com/content/2/1/3 Lancet since 1963 401 Lancet Searching journal content for cardiovascular africa (all words) in full text, from Jan 1963 through Oct 2011. New Search Next 10 Displaying results 1-10 of 812 http://www.thelancet.com/search/results?searchTerm=cardiovascular&amp;fieldName=AllFields&amp;op=and&amp;searchterm2=africa&amp;fieldname2=AllFields&amp;year=&amp;volume=&amp;page=&amp;jrnl=&amp;artypes=&amp;advsrch=t&amp;journalFromWhichSearchStarted=&amp;sort=date&amp;order=desc&amp;collectionName=All%20Lancet%20Journals
  • Open-access publishing and noncommunicable disease prevention

    1. 1. Open access publishing & noncommunicable disease prevention in developing countries www.procor.org a program of the Lown Cardiovascular Research Foundation Collins Kokuro Associate Director, Ashanti-ProCor Project Specialist Physician, Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana
    2. 2. Outline <ul><li>Non Communicable Disease burden </li></ul><ul><ul><li>Global and local </li></ul></ul><ul><li>Information poverty in LMIC </li></ul><ul><li>ProCor </li></ul><ul><li>Ashanti ProCor project and its findings </li></ul><ul><li>Recommendations. </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    3. 3. Noncommunicable disease: A new health threat <ul><li>Leading cause (60%) of death globally </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation The Global Economic Burden of Non-communicable Diseases. World Economic Forum
    4. 4. Cardiovascular diseases <ul><li>Among NCDs, CVDs are the leading cause of premature, preventable deaths </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation Global Atlas on Cardiovascular Diseases Prevention and Control. World Health Organization
    5. 5. Disproportionate NCD burden in LMIC <ul><li>Nearly 80% of NCD deaths occur in low- and middle-income countries. </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation Global CVD mortality rates / Global Atlas on Cardiovascular Diseases Prevention and Control. World Health Organization
    6. 6. NCDs in Ghana <ul><li>Nearly 40% mortality caused by NCDs </li></ul><ul><li>Nearly 50% CVD-related </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation World Health Organization - NCD Country Profiles , 2011.
    7. 7. Mortality, Ashanti region www.procor.org a program of the Lown Cardiovascular Research Foundation Ashanti Region Regional Half Year Report 2010 Double burden of disease NCDs rapidly increasing
    8. 8. www.procor.org a program of the Lown Cardiovascular Research Foundation
    9. 9. 80% of CVD is preventable www.procor.org a program of the Lown Cardiovascular Research Foundation Age-standardized death rates per 100,000 among men age 30 years or older Source Preventing Chronic Diseases: a vital investment World Health Organization (2005)
    10. 10. Evidence-based strategies are affordable, cost-effective, adaptable <ul><li>“ A full range of chronic disease interventions are very cost-effective for all regions of the world, including sub-Saharan Africa. Many of these solutions are also inexpensive to implement .” </li></ul><ul><li>Preventing Chronic Diseases: a vital investment World Health Organization (2005) </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation Komfo Anokye Teaching Hospital, Kumasi, Ghana
    11. 11. Information poverty: A neglected risk factor <ul><li>“ Improving the availability and use of relevant, reliable health care information has enormous potential to radically improve health care worldwide .” </li></ul><ul><li>“ Information needs of health care workers in developing countries: A literature review with a focus on Africa.” N. Pakenham-Walsh, F. Bukachi. Human Resources for Health. April 2009. </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    12. 12. ProCor: Promoting cardiovascular health <ul><li>Founded in 1997 to: </li></ul><ul><li>Promote knowledge sharing among a global community committed to prevention </li></ul><ul><li>Place relevant, timely, reliable information in the hands of those who need it </li></ul><ul><li>Provide access to info via low-cost ICTs </li></ul><ul><li>Prevent the need for high-cost medical technologies </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation Dr. Bernard Lown Founder and chair
    13. 13. Ashanti-ProCor Project <ul><li>Four-year pilot project </li></ul><ul><li>Identify CVD information needs and access preferences of health workers </li></ul><ul><li>ProCor & KNUST </li></ul><ul><li>Funded by Mattina Proctor Foundation, Boston, MA, US </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    14. 14. Methodologies: Learning and listening <ul><li>Learning </li></ul><ul><li>-- Literature review </li></ul><ul><li>-- Knowledge and practice survey </li></ul><ul><li>Listening </li></ul><ul><li>-- Key informant interviews </li></ul><ul><li>-- Focus groups </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation Maude Kwartang-Amening, Medical librarian, Kwame Nkrumah University of Science and Technology A focus group section
    15. 15. Findings: Rich human resources <ul><li>Many diverse provider groups have the potential to play a key role in CVD prevention </li></ul><ul><ul><li>Physicians, nurses in community and district settings </li></ul></ul><ul><ul><li>Providers not typically included in prevention: </li></ul></ul><ul><ul><li>Community pharmacists </li></ul></ul><ul><ul><li>Medical herbalists </li></ul></ul><ul><ul><li>Midwives </li></ul></ul><ul><ul><li>Medical assistants </li></ul></ul><ul><ul><li>Nutritionists </li></ul></ul><ul><ul><li>Health educators </li></ul></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    16. 16. Assets: Awareness and commitment <ul><li>High awareness of CVDs across groups studied </li></ul><ul><li>Strong commitment to addressing CVD in their professional practice </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation Elizabeth Safo Mensah, Nursing Director of Public Health, Komfo Anokye Teaching Hospital
    17. 17. Leapfrogging technologies <ul><li>Laptops (often stand-alone) </li></ul><ul><li>USB drives </li></ul><ul><li>Mobile phones </li></ul><ul><li>Wireless access </li></ul><ul><li>Internet cafes </li></ul><ul><li>Mobile Broadband (MBB) </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    18. 18. Barriers: Available resources <ul><li>Hard copies (textbooks, journals) </li></ul><ul><li>Frequently out of date </li></ul><ul><li>Cumbersome to access </li></ul><ul><li>Online </li></ul><ul><li>Most frequently accessed: Google, Wikipedia </li></ul><ul><li>Low awareness of open-access journals </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    19. 19. Online barriers: Cost, time, connectivity <ul><li>Cost </li></ul><ul><ul><li>Service provider contracts </li></ul></ul><ul><ul><li>Slow download speed > internet café charges </li></ul></ul><ul><ul><li>Subscriptions, cost/article </li></ul></ul><ul><ul><li>Credit card issues </li></ul></ul><ul><li>Unreliable connectivity </li></ul><ul><li>Time constraints </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    20. 20. <ul><li>“ Most of the faculty are research oriented and they want up-to-date information. We used to depend so much on journals but now we can’t afford the subscription. So we depend on the internet. But it can be frustrating when you get to the net and all you can get is an abstract. Then even if you have the money to pay, you don’t have a credit card.” Librarian </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    21. 21. Preferences <ul><li>Email </li></ul><ul><li>Download options </li></ul><ul><ul><li>PDFs (easy storing) </li></ul></ul><ul><ul><li>HTML (fast download) </li></ul></ul><ul><ul><li>Interpersonal knowledge sharing </li></ul></ul><ul><ul><li>Colleagues, faculty </li></ul></ul><ul><ul><li>Social networks </li></ul></ul><ul><ul><li>Locally/regionally relevant data, protocols, programs </li></ul></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    22. 22. Role of open access <ul><li>No associated costs for accessing or publishing </li></ul><ul><li>Email alerts </li></ul><ul><li>Download options </li></ul><ul><ul><li>PDF </li></ul></ul><ul><ul><li>HTML </li></ul></ul><ul><li>Current </li></ul><ul><li>Peer reviewed </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    23. 23. Potentially more inclusive <ul><li>“ Underrepresentation of developing world health issues in the medical literature is a global phenomenon.” </li></ul><ul><li>“ International medical journals cannot rectify global inequities, but they have an important role in educating their constituencies about the global divide.” </li></ul><ul><li>“ The developing world in The New England Journal of Medicine” B. Lown, A. Banerjee. Globalization and Health 2006, 2:3 </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    24. 24. Future directions <ul><li>Respond to identified need for local/regionally relevant research </li></ul><ul><li>Maximize access via mobile formats, local knowledge-sharing networks </li></ul>www.procor.org a program of the Lown Cardiovascular Research Foundation
    25. 25. Thank you for your attention www.procor.org a program of the Lown Cardiovascular Research Foundation
    26. 26. Support prevention. Share knowledge. Subscribe to ProCor. www.procor.org [email_address] Benn Grover Editor, ProCor Lown Cardiovascular Research Foundation 21 Longwood Avenue Brookline, MA 02446 www.procor.org [email_address] www.procor.org a program of the Lown Cardiovascular Research Foundation
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