Access to electronic health knowledge in five countries in Africa: a descriptive study in postgraduate doctors

Article type
Authors
Smith H, Bukirwa H, Mukasa O, Adeh-Nsoh S, Mbuyita S, Honorati M, Orji B, Garner P
Abstract
Background: Electronic access in sub-Saharan Africa is improving, but subscriptions to electronic medical journals are expensive. The Health InterNetwork Access to Research Initiative (HINARI) is a World Health Organization initiative to allow free access. We conducted the first formal evaluation in postgraduate doctors, which included questions about awareness of The Cochrane Library.

Objectives: To compare awareness and use of initiatives that promote free access to medical literature; and explore factors that might influence their use.

Methods: Self-administered questionnaires with postgraduate doctors in teaching hospitals (four countries) and research scientists at a medical research institution (one country); semi-structured interviews with key informants.

Results: Surveyed were 334 respondents from Cameroon, Nigeria, Tanzania, Uganda and The Gambia. More than 70% reported textbooks were their main source of health information. Internet use for health information was common (66% within the last week); cybercafés were the main access point in two countries. Most (90.5%) rated connections as adequate. They had heard of PubMed (91%) British Medical Journal online (75%), The Cochrane Library (53%), HINARI (52%), and BioMedCentral (23%). Eighty percent of respondents reported being regular users of PubMed, but only 24% did so for The Cochrane Library. Qualitative data suggested that sometimes librarians limited students' access to HINARI.

Conclusions: Textbooks are important to postgraduate medical studies, and internet use is common, but use of The Cochrane Library is limited. Organizational issues within institutions need to be tackled to make HINARI more effective.