Problems with passwords, electricity power outages and meddling librarians often come between African postgraduate doctors and free online journal articles. But according to independent research published in the online open access journal BMC Health Services Research, these doctors in training are making regular use of online medical literature, even if some have to use their local Internet café to gain access.
An international group from five countries in Africa and the UK set out to assess how effective open access publishing initiatives are in Africa. The researchers surveyed over 300 postgraduate doctors and research scientists to determine their use and awareness of online medical information and free access initiatives. They then used follow up interviews with a smaller group of the participants, who were from University of Yaoundé, Cameroon; Lagos College of Medicine, Nigeria; Muhimbili University College of Health Sciences, Tanzania; Mulago Teaching Hospital, Uganda; and the externally-funded Medical Research Council (MRC) Laboratories in the Gambia.
Textbooks remained a central pillar of postgraduate doctor training in the African institutions, with 70% of the postgraduate doctors reporting that these were their main information source. However, 66% had used the Internet for health information in the last week. In Lagos and Yaoundé, Internet cafés were doctors' main point of access. Most postgraduate doctors had heard of PubMed (90%) and the BMJ website (78%) but were less likely to have heard of the Cochrane Library, BioMed Central or the World Health Organization's HINARI initiative. Users also reported HINARI password distribution and interface difficulties.
PubMed's accessibility without a password was popular: the other password-based services often failed to deliver the full article text, or in some cases librarians' overzealous password control thwarted or delayed doctors' access. Most researchers at the externally funded MRC had heard of HINARI, PubMed and BMJ, which they accessed via office Internet connection (89%).
Power interruptions and inadequate computing facilities continue to limit online journals' use in Africa, the authors conclude, and awareness of free access to journals remains variable.
Access to electronic health knowledge in five countries in Africa: a descriptive study
Helen Smith, Hasifa Bukirwa, Oscar Mukasa, Paul Snell, Sylvester Adeh-Nsoh, Selemani Mbuyita, Masanja Honorati, Bright Orji and Paul Garner
BMC Health Services Research (In press)