Bridging the gaps across the income divide: A review of The Collaboration’s efforts to date and recommendations for the future

Hasifa Bukirwa

Background: Systematic reviews (SRs) pertinent to developing countries (DCs) are comparatively few [1] and results of Cochrane reviews are less utilised in DCs compared to developed countries. Developing countries are un-arguably resource constrained, but if The Cochrane Collaboration offers them an opportunity to access high quality up-to-date health information quickly and less expensively, why the apparent slow embrace of the Collaboration? There is need to develop effective dissemination strategies, and to encourage a culture of research synthesis and evidence based practice in DCs.
Objectives: To review documented Cochrane effort to involve DCs to date, identify appropriate strategies and recommend a framework for the future, and
To present the results of a one-year project dedicated to creating awareness and dissemination of results of SRs in Uganda.
Methods: We are reviewing all the documented Cochrane activities towards DCs including involvement data for over the last decade and problems already identified by DC reviewers. A project to promote awareness and use of SRs in Uganda targeted ministry of health officials, health personnel and medical students through workshops, seminars and lectures. We will assess this project for effect on evidence based decision-making and obstacles encountered.
Results: The institutional, cultural and structural dimensions of developing countries vary and the issues involved are complex [2]. In addition in developing countries patients who are the ultimate beneficiary of good quality healthcare information (Cochrane product) have had limited formal education, restricting their competence to use information technology (major route of review dissemination) even when access is not constrained [3] and ministry of health officials remain largely unaware of the relevance of the evidence provided by the Cochrane reviews. There is thus no pressure for the healthcare provider to provide quality and evidence based healthcare.
Acknowledgements: Cochrane Infectious Diseases Group Editorial base for continued support.
References: 1. The Cochrane Collaboration in Developing Countries: Proceedings of the Joint RGC/TSC meeting 11th Cochrane Colloquium Barcelona, 26 October 2003. 2. Crewe E, Young J. Bridging research and policy: context, evidence and links. Working paper 173. Overseas Development Institute 111 Westminster Bridge Road, London SE1 7JD UK 3. Chandrasekhar CP, Gosh J. Information and Communication technologies and health in low-income countries: the potential and the constraints. Bull World Health Organ. 2001;79(9):850-5.

Ottawa 2004 O-006