Marge Berer presentation to the 13th congress of the European Society of Contraception, Lisbon May 2014

1. Transformative
writing:
~~~~~~~~~~
writing for
publication to
change the
world
Marge Berer
Editor, RHM
~~~~~~~~~~
29 May 2014
13th ESC Congress
Lisbon

2. Finding time for writing
 Telling others about the work we are doing to achieve
sexual and reproductive health and rights is as
important as the work itself. Otherwise, no one but us
will know about it or understand its purpose and
importance, nor will they understand how we do it.
 Few NGO people or health professionals have enough
work time to write about what they do.
 The time for writing has to be stolen ‒ from nights,
weekends, and holidays.
 That's how it is.
 This talk is to inspire you to do it anyway… and to do it
creatively in order to share your knowledge.
 I use examples throughout from Reproductive Health
Matters, which is not a typical journal.

3. Knowledge transfer and the role of journals
 We are rich !
 There has never been so much research in health as
there is today nor so many institutions and people
conducting research, nor so much information about
health, nor so many means of disseminating and
using it.
 This is as true in sexual and reproductive health and
rights (SRHR) research as in many other areas of
health.
 From a field with very few non-clinical journals 30
years ago, there is now a long list of journals
addressing SRHR issues.

4. Many journals: many audiences
 Reprod Health Matters; Culture Health & Sexuality;
Studies in FP; International Perspectives on SRH;
Contraception; Pop&Dev Review; Fertility& Sterility;
STDs; STIs; Repro Health; BMC Pregnancy &
Childbirth; PLoS One; Birth
 Int J STDs & AIDS; AIDS Care; other AIDS journals
 IJOG, national obs/gyn and national FP/RH journals.
 Euro J Contraception; African J Repro Health; AJPH &
other public health journals
 Broader health journals covering SRH a lot: Lancet;
BMJ; WHO Bulletin; Global Health; Health Pol & Plan;
Health Policy; SocSciMed.
 Journals on law and health; health & human rights;
social/medical anthropology.
 New open access journals ‒ an epidemic of them.

5. Choosing a journal

6. What does the journal cover? Who reads it?
 What kind of articles/type of research does the journal
publish – medical/clinical, legal, health policy and
programme analysis, service delivery issues,
commentary, other?
 What are the journal's editorial policy and aims as
regards its contribution to the SRHR field?
RHM has readers in 188 countries who work in one or
more of these categories:
 Half in academic/research institutions
 A third in medical/health services
 Half in NGOs, charities, women’s health/feminist groups
 One in ten in government/ministry/UN agency
 One in ten in media.
(2009-2010 RHM readers’ survey data)

7. Who is your priority audience?
 Choosing a journal is, first, about figuring out who
your audience should be, which is based on what
your subject is.
 Will your paper be of value for people all over the
world? That is, can people from all over the world
learn something from it? In other words, does it have
international significance?
 Or does it have most significance for your own region,
e.g. Europe or South Asia, or more specifically for
your own country?
 Or even for specific people in your country, e.g.
contraception or abortion providers?

8. Who do you want to influence?
 Answering this question not only affects where you
seek to publish but also which language you write the
paper in.
 A paper in a widely read national journal will reach a
national audience and have a different influence from
a paper in an international journal. If you want to
promote provision of vasectomy in your country’s
sexual health clinics, or talk about how to get sexually
active adolescents to use contraception based on a
national or local study, choose a national journal.
 Many authors think publication in an international
journal is more prestigious, so they go for that no
matter their subject, but reaching the people who can
use the information and knowledge you want to share
to me is the point.

9. Other criteria for choosing a journal
 Is the journal free or on subscription?
 Or is it open access, funded through fees to authors?
 Do you have a grant to pay an open access fee, or is
there a graded or waived fee structure for authors
without grants?
 Is it published in print only, online only, or both?
 What is the impact factor − does that matter to you?
 Who are the editor, the authors and peer reviewers,
and the members of the editorial board, have you
heard of any of them?
 Thanks to open access, there are many “start-up”
journals that will publish anything. They may or may
not have bona fide peer reviewers, and they may or
may not provide copyediting and proofreading.

10. Get to know the journal you submit to… first
 Read the submission guidelines and follow them.
 Look at back issues and see whether your paper is a
good fit. E.g. if your paper is full of statistical analyses
and complicated tables, don't choose RHM!
 Check whether the journal you’ve chosen has published
on your subject before. If so, reference it.
 Find out the timetable for submissions/publication, plan
accordingly. Avoid asking to be an exception!
 Don't send the editor an abstract for an opinion on
whether to write/submit a paper. The editor will say…
 Ensure you can complete the paper (including revision
after peer review/proofreading) in time for publication −
before you submit.
 Never say: Sorry, I don’t have time to finish it. Why?

11. Will readers of the journal use what you write?
RHM’s readers read RHM papers for:
 professional/academic interest
 increasing public awareness
 research
 writing reports/presentations/articles
 training and teaching,
 improving service delivery
 designing educational materials
 designing projects or programmes
 advocacy work
 developing policy or guidelines
 for personal as well as professional and political use.
(2009-2010 RHM readers’ survey data)

12. Presenting and disseminating your work

13. Ways to present your work
 Standard articles and research reports ‒ background,
methodology, participants, findings, discussion,
conclusions and recommendations.
 Commentary or discussion paper.
 Qualitative studies based on focus group discussions,
interviews, case studies, participant observation.
 Narrative history of events or activities, or in diary
form, e.g. about a project or a campaign or how a
service is delivered or a form of surgery carried out, or
how your NGO/clinic works.
 Literature review, e.g. on a new or controversial topic.
 Analysis of laws, policies and/or practice.
 A narrative report on the making and use of a video(s)
or other media.

14. Newer forms of publication, but…
 On the website of your organisation ‒ a huge number
of excellent reports are published this way today.
 A blog (people sign up to receive these).
(But who reads them?? RHM has two blogs − mine
and staff/authors − average readers/month 450)
 No matter where/how you publish your work, it needs
to be disseminated.
 It's a very competitive world out there and we are
swimming in information these days.

15. Dissemination: RHM as an example
 Distributed in print (English 5,000 copies x 2; 15,000
in seven language editions) and 263,000 article
downloads from web through ScienceDirect, RHM-
Elsevier, HINARI and Jstor.
 Free print/web subscriptions for developing country
groups and institutions.
 RHM website.
 CDs, Facebook, Twitter, 2 blogs.
 Press releases, listserves.
 Listings in 20+ indexes, e.g. PubMed, Popline.
 Copies/leaflets to conferences, education & training
courses.
 Elsevier marketing, library magazines.
 Via RHM board members and authors in their work.

16. Writing skills

17. Writing ‒ yes, it's very hard!!!
 Very few people enjoy writing.
 Editing is the largest part of the work of writing and
even fewer people like editing.
 I like to compare writing and editing to sculpture. You
sculpt a piece of stone until your vision appears in the
material itself.
 Or painting ‒ you paint millions of dots and lines, you
add something, you take some away, you make it
bigger or darker or brighter.
 Or knitting, one stitch at a time… it needs patience
and thought. Edit and edit again!
 With editing, you’re only done when nothing important
is missing, and you can’t remove a single word more.
 The end product makes it all worth it!

18. Language: options
 Write/edit in your own language first, and then have it
translated. Getting an excellent translation is not easy
+ it also needs editing!
 RHM editions in translation ‒ in both Chinese and
Arabic the editors decided to create a glossary of
translated terms. Even the translation of "reproductive
health" did not exist or was too clinical, e.g. in French
and Chinese.
 Writing in English from the start ‒ yes but then help is
needed from an editor (or someone else) who
understands your English (and if possible your own
language) so as to be able to edit/correct it.

19. Writing for an international readership
 Remember you are writing for many speakers of
English as a 2nd/3rd language, and people with little
knowledge of your country, its history and institutions.
 So − don't use very long sentences with complex
structures. Do give adequate background. Don't use
lots of acronyms that are local and used only in your
own country or profession.
 Acronyms are like cancer − avoid them. Remember
that many have more than one meaning − e.g. ART.
 Don’t forget your national readership, too, who may
want to see key terms or organisations’ names in your
own language. And who will be looking for references
in your own language, not just from northern journals.

20. Using formulas: study articles to discern them
 A good abstract serves as the outline of the paper,
reflecting the main sections of the paper, saying what
the main findings, conclusions and recommendations
are. In those 200 words, you provide an outline and
state everything important in the paper. Use sentences
from the paper and trim them down.
 Methodologies also follow formulas. Study published
papers and use them as models.
 Other good practice:
 answer: who, what, where, when, why, how.
 when you are recounting a history, present the
information in historical order. Don't jump back and forth
in time.
 use the referencing format the journal asks for and
check your references for completeness, and see that
the web links work.

21. From the editor’s point of view

22. Choosing papers to peer review
 First impressions
 EASE article 2005: science journal editors take an
average of 8 minutes to read and make an initial
judgement on a paper.
 Favourable impression: title grabs interest, abstract
with key points, straightforward style of writing, but
most important is the interest value of the topic.
 Unfavourable: Dear Sir, no indication they’ve ever
even looked at the journal, national significance only,
quantatitive data only, full of tables and figures but no
qualitiative content, double the maximum word length,
typos, jargon, sloppy references.
 Open peer review policy based on constructive
criticism and detailed suggestions for improvement.

23. What does a useful peer review do?
 Few papers need only a little work, or cannot be
improved. I want peer reviewers to tell authors what is
good and not good about their papers; what is
missing or inaccurate; critically assess the findings
and analysis; and make concrete suggestions on how
to improve every part of the paper wherever possible,
so that it will end up being an excellent paper instead
of a good one or a potentially good one.
 The more work the author needs to do, the more I
expect from the reviewer.
 If the reviewer feels the paper is not publishable, to
say why in a respectful and helpful manner.
 I’m happiest when the reviewers each take a different
perspective on what needs improving and therefore
help the author in different ways − this happens a lot.

24. What is a poor peer review
 Peer reviewers need to respond to the paper as it is
and to what it says it is about.
 A poor review either praises the paper only, or says
little or nothing of value to help the authors improve
the paper, or asks the author to write a different paper
from the one they’ve actually written.
 I suspect there are as many inexperienced reviewers
as there are authors, but overall RHM gets very good
reviews.

25. Role of the editor in a changing world
 The main role of the editor is to ensure the journal’s aims
and editorial policy are reflected in what it publishes.
 The technical role of the editor is to consider
submissions, arrange peer reviews, accept and reject
submissions, and as I see it, support authors to improve
their papers to the highest possible extent. That includes
making her/his own editorial comments, commenting on
peer reviews, copyediting and proofreading.
 Copyediting ‒ I was asked to review a paper for an open
access journal recently and the guidelines said that if the
language was hard to follow, I should make copyediting
remarks and give details of how to improve the English.
The journal, they said, did not have the staff or funds to
do it themselves. This is what happens when journal
editors are not paid (enough) to do their job.

26. Editorial policy: RHM
 Authorship: “More authors from developed countries
than from developing countries have access to the
resources to publish in international journals, including
to do research and write articles about developing
countries. To help to redress this imbalance, RHM will
give preference to papers about developing countries
by authors from those countries or written with authors
from those countries.”
 As a result of this policy, RHM has a higher proportion
of authors from the global South than most other
international journals.
 Editorial support to authors: especially young and
inexperienced authors and those whose first language
is not English.

27. From research to social change:
time and other barriers
 Research –> evidence –> dissemination –>
implementation of evidence-based practice –>
universal access –> social change –> research…
Barriers
 Ideology trumps evidence.
 Cost and commercial considerations override public
health needs.

28. Some questions to take away
 Who is responsible for knowledge sharing in the SRHR field,
especially given the growing number of journals and technical
means of communication and dissemination of information?
 Are the changes in funding of research and publishing of journals
affecting sustainability of journals and their outreach?
 If all journals become online-only journals, how will that affect
access to knowledge?
 Does open access improve access? For whom?
 Are the growing number of journals competing or cooperating to
produce knowledge for the field? What about researchers and
other authors?
 Is knowledge being produced and disseminated in the best
possible way? Is access to knowledge improving, and if so, for
whom?
 Is the publication of an increasing number of papers succeeding
in changing the world for the better?