Providing access to evidence-based information in reproductive health: the WHO Reproductive Health Library for developing countries

EDITORIAL

Providing access to evidence-based information in reproductive health: the WHO Reproductive Health Library for developing countries

A Metin Gülmezoglu; José Villar

Lack of access to up-to-date, reliable and comprehensive medical information is one of the biggest problems health care workers in developing countries face. This problem is even more important when the effectiveness of health care interventions are considered. Without this information being accessible to the majority of health workers, the removal of ineffective practices and instatement of beneficial practices will depend largely on ad hoc incidental events such as conferences, meetings and visits to other countries. Having continuous access to good quality up-to-date information on the effectiveness of health care interventions may prove to be a more cost-effective way of improving the health status of populations¹.

For developing countries, most subscription journals are not only expensive and delivered late and erratically, but also lack the systematically reviewed, comprehensive information to influence practices in a specific topic or speciality. The reviews published in these journals are usually narrative and traditionally prone to the bias of the authors. Our experience with both narrative² and systematic reviews^3,4,5, and also the emphasis placed by others^6,7 on the importance of systematic approaches to reviewing the effects of health care, have convinced us to take systematic reviews as the gold standard in reviewing health care interventions. In recent years systematic reviewing has become an efficient tool for providing such comprehensive information. The Cochrane Collaboration, founded in Oxford in 1993, is an international network of individuals around the world aiming to help people make well-informed decisions about health care by preparing, maintaining and ensuring the accessibility of systematic reviews of the effects of health care interventions⁸. Cochrane reviews are systematic reviews using rigorous, explicit methodology, with thorough search for relevant studies, and are updated as new evidence becomes available. Hence, they are increasingly acknowledged as a reliable source of information on effectiveness of health care interventions⁹.

The World Health Organization has taken the lead in disseminating up-to-date reliable information on the effectiveness of reproductive health interventions based on Cochrane reviews to all regions, by embarking on the WHO Reproductive Health Library project for developing countries¹⁰. The project is a collaborative activity between WHO, the Cochrane Collaboration and health workers in Latin America, Africa and South-East Asia, represented by an editorial board. The first issue of the WHO Reproductive Health Library contains, on one floppy diskette, 27 Cochrane reviews on topics of high priority for developing countries. The special feature of the WHO Reproductive Health Library is the commentaries on the relevance of review findings to developing countries. These commentaries and a corresponding section on practical management have been written by health workers in developing countries or by people with experience of living and working there. Although these commentaries reflect the views of a small group of individuals, they clearly call attention to relevant issues relating to the reality of services in developing countries. They are all peer reviewed before being accepted for publication.

The WHO Reproductive Health Library will be published annually by WHO and will be distributed on a free subscription basis to health workers in developing countries. The first issue will be published only in English, although active efforts to provide translations into major widely-spoken languages are currently underway.

The dissemination of the WHO Reproductive Health Library will be made through several routes to ensure that health workers who would like to use it are accessed. WHO regional and international networks^11,12, collaborating centres, medical libraries in developing countries, and collaborators in multicentre international trials of importance to developing countries, will participate in dissemination. Assistance from Cochrane Centres in Brazil and South Africa will be extremely valuable in this respect. This project was initiated and took shape in a relatively short period (less than one year) due to the willingness and commitment of health workers in many developing countries, from Thailand to Brazil, Zimbabwe to Indonesia. However, the real success of the programme will only be measurable in terms of its impact in practice, which will be evaluated by appropriately designed studies. We look forward to fruitful collaboration with colleagues in Brazil in order to reach Brazilian health workers who would be interested in using the WHO Reproductive Health Library. We also look forward to comments and criticisms from the users that will be crucial for the improvement of the programme.

• 1. Pakenham-Walsh N, Priestly C, Smith R. Meeting the information needs of health workers in developing countries. BMJ, 1997; 314:90 (11 January).
• 2. Belizan JM, Villar J, Repke J. The relationship between calcium intake and pregnancy induced hypertension: Evidence up-to-date. Am J Obstet Gynecol, 1988; 158: 898-902.
• 3. Carroli G, Duley L, Belizan JM, Villar J. Calcium supplementation during pregnancy: a systematic review of randomized controlled trials. Br J Obstet Gynaecol, 1994; 101: 753-758.
• 4. Villar J, Carroli G, Belizan JM. The predictive ability of the meta-analysis of randomized controlled trials. Lancet, 1995; 345: 772-776.
• 5. Gülmezoglu AM, Gamer P. Interventions to prevent malaria during pregnancy in endemic malarious areas. In: Garner P, Gelband H, Olliaro P, Salinas R, Volmink J, Wilkinson D (eds.). Infectious Diseases Module of The Cochrane Database of Systematic Reviews [updated 3 June 1997]. Available in The Cochrane Library [database on disk and CD-ROM]. The Cochrane Collaboration; Issue 3. Oxford: Update Software; 1997. Updated quarterly.
• 6. Chalmers I, Haynes B. Reporting, updating, and correcting systematic reviews of the effects of health care. BMJ, 1994; 309: 862-865.
• 7. Oxman AD. Checklists for review articles. BMJ, 1994; 309: 648-651.
• ⁸
  The Cochrane Collaboration: Preparing, maintaining and disseminating systematic reviews of the effects of health care. The Cochrane Collaboration Brochure, Oxford, 1997.
• 9. Bero L, Rennie D. The Cochrane Collaboration. Preparing, maintaining and disseminating systematic reviews of the effects of health care. JAMA, 1995; 274: 1935-1938.
• 10. Gülmezoglu AM, Villar J, Carroli G, Hofmeyr GJ, Langer A, Schulz K, Guidotti R. WHO is producing a reproductive health library for developing countries. BMJ, 1997; 314:1695 (7 June).
• 11. Villar J, Belizan JM, Carroli G. Multicentre randomized controlled trials in developing countries: The experience of the Latin American Network for Perinatal and Reproductive Research (LANPER). Archives of Public Health, 1996; 53: 134.
• 12. Villar J, Ezcurra E, Perez-Palacios G, Hogue C, Gunner de la Fuente V. Expanding research capacities to improve reproductive health in the Americas. World Health Organization. WHO/HRP/RFR 1994, Geneva, 1994.

Publication Dates

• Publication in this collection
  05 Nov 2008
• Date of issue
  Aug 1997