Improving diversity in Cochrane through capacity building: what are the challenges in Nigeria?

Article type
Authors
Chibuzor M1, Effa E2, Oyo-Ita A3, Oduwole O4, Okusanya B5, Esu E6, Arikpo D1, Udoh E7, Ezebialu I8, Meremikwu M9
1Cochrane Nigeria
2Department of Medicine, University of Calabar
3Community Medicine Department, University of Calabar
4Achievers University Owo
5Department of Obstetrics and Gynaecology, University of Lagos
6Department of Public Health, University of Calabar
7Paediatrics Department, University of Uyo Teaching Hospital
8Department of Obstetrics and Gynaecology, Chukwuemeka Odumegwu Ojukwu University
9Department of Paediatrics, University of Calabar
Abstract
Background: one of the goals of Cochrane's strategy 2020 is to build a diverse and inclusive organization where all regions are amply represented. Currently, while more than 70% of authors come from high-income countries, less than 4% are from lower-middle-income countries such as Nigeria (archie.cochrane.org).

Review authors are often 'recruited' through training workshops. In spite of the researchers trained by Cochrane Nigeria, this has translated to low number of review authors. This research seeks to identify the reasons for this observation, as this ultimately reflects on the diversity we should experience if more of these researchers were to join Cochrane.

Objectives: to determine why:
1) many Nigerians who attend systematic review workshops are not undertaking Cochrane Reviews;
2) challenges they face in completing systematic reviews.

Methods: in February 2019, we prepared a short online survey and disseminated this via email in March 2019 to 285 people who had attended 'Introduction to Cochrane Review workshops' by Cochrane Nigeria. Reminders were sent three times over four weeks. The survey comprised of nine questions (eight multiple choice and one open-ended question) which sought to find out whether the respondents had attempted to register review titles following the workshop, and the reasons for this. It also sought to find out reasons for failed attempts to register titles. Finally, for those who had registered topics, the questionnaire sought to find out their challenges in completing reviews. A total of 57 people took the survey.

Results: the survey showed that 36.84% (21) of respondents, attempted to register a review title following the workshop. Of these, only five registered titles successfully. The most frequent reason for not attempting to register titles was “A Cochrane Review required a lot of work and effort which I could not afford at the time” (22 respondents). This was followed by “I did not know how to go about registering the title” by 18 respondents (Table 1).

Nine respondents indicated they had started reviews, but were unable to complete them. The most common reason for this was lack of time (five respondents (50%)), followed by inadequate skills (four respondents (40%)) (Table 2).

When asked what help they needed to start or complete their review, responses included the following: reminders and proper guidance on title registration; co-authors with whom to do review; mentoring; further training; and dedicated time out.

Conclusions: in order to increase the number of Nigerians doing and completing reviews, the following may be helpful:
1) clear guidance on how to register title during workshops;
2) follow-up of participants through: mentoring, reminders, and assistance to form review teams;
3) additional training;
4) time out for authors.

Patient or healthcare consumer involvement: low involvement of local researchers in Cochrane affects consumers as research priorities and outcomes affecting local health consumers may not be addressed.