EDITORIAL: The Value of Learned Journals for Health Professionals

Lindsay Edouard


As we celebrate the twenty-year anniversary of the African Journal of Reproductive Health (AJRH) this year1, it is apt to consider the changing role of learned journals over the last two decades specially with increasing access to the worldwide web. A much-needed and welcome democratization in the availability of information has been accompanied regrettably by a concomitant overload from continual bombardment by email messages and postings from social media and at websites. As much of that information is not sieved, false news spread at an alarming rate with potentially detrimental effects on clinical consultations when misinformed patients query clinical decisions of health providers and demand inappropriate interventions specially drugs with supposedly miracle effects2. Whereas it is imperative to be selective in accessing information sources to avoid fake news, this approach is becoming difficult lately with the unfortunate official promotion of alternative facts in a post-truth context3. With triage becoming increasingly difficult, there is renewed interest in professional journals and textbooks which are now aimed at not only students but also health planners and development practitioners4.
For journal contents, there is the delicate ‗town and gown‘ balance between service provision and academia but that gap is closing with the implementation of evidence-based care. Health journals that developed from broadsheets and newsletters of professional associations5 justifiably continue their role of mouthpiece by including items such as minutes of annual general meeting, reports from committees and administrative notices. Through ownership of a learned journal, a professional association demonstrates that it is not merely a trade union but it is also desirable for the journal editor to be given full independence free from pressure regarding both contents, specially as pertaining to standpoints of the professional association, and financial constraints necessitating advertising revenue. During the first decade of the African Journal of Reproductive Health, three leading medical journals in North America had to revoke their editors over editorial independence6.
Peer review of manuscripts is an integral part of the editorial process to ensure the quality of articles published in a learned journal. Whereas guidelines exist, problems can arise in their implementation7. Having the final word, the editor should be impartial, abandon personal interests and neither give-in to pressure groups nor favor friends: a constraining situation similar to that faced by the Speaker in a Westminster-style parliament8.
For service provider, policy maker or planner, it is much easier to shoot from the hip by taking decisions spontaneously on the spot as opposed to consulting the health literature for up-to-date evidence. With the electronic age, the vade-mecum in the pocket of the white coat of the clinician has often been replaced by bookmarks on personal digital devices to access reliable websites for official guidelines and online journals. Unfortunately, a substantial portion of the health literature is accessible only upon payment thereby making it largely inaccessible in developing countries where practitioners are those most in need.
The decision-making process, whether at the bedside or policy desk, should ideally draw upon evidence specially from research findings9,10. Journal articles should clearly state their contribution to the existing body of knowledge. Therefore, the publication of research articles is part of a two-way process: reporting of findings to supplement existing systematic reviews which must be used to formulate subsequent research projects that will uncover new facts11. With the dearth of pertinent findings from low and middle-income countries, this issue is crucial to generate the information database for their implementation of evidence-based practices.
With the current trend towards quantification of all issues, metrics are assuming more importance in assessing journals through proxy indices, such as impact factor, which have their own limitations. It should not be forgotten that, in the first place, a journal should meet the specific needs of its target readership whereas prominence on the worldwide web is desirable for generating awareness of journal contents during 

literature searches.
Having its origins within a research centre, the African Journal of Reproductive Health has had an exemplary path as pertaining to editorial independence, quarterly periodicity of publication and quality of articles besides availability of issues at a dedicated website and inclusion in PubMed from the very beginning. Having been recognized as the leading regional journal in its field, the challenge now lies in consolidating its multidisciplinary approach, with a wide perspective on reproductive health, to promote its utilization for policy formulation in the quest for achieving the health-related sustainable development goals.

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