SOME PROBLEMS FACING SCIENTIFIC MEDICAL PUBLICATIONS IN NIGERIA

Abstract

Although one of the earliest recorded medical publications was recorded in Europe about the middle of the 17^th Century, the earliest medical publication in West Africa was in the 1920s – three centuries later. However, since then, a number of other biomedical journals have been published, a few of them regularly, and only a fraction of them have met the criteria for indexing in PubMed. This, therefore, has made a large number of medical articles published in Nigeria and West Africa unavailable to the outside world as the search engines would be unable to pick these publications. Despite the efforts of many researchers in Nigeria and other West African countries to publish in medical journals in the industrialized countries, most have not been able to meet the high standards of these journals due to paucity of resources, infrastructure and training. This, therefore, underpins the need for regular update courses on medical manuscript writing in the West African sub-region with a view to enable authors in the sub-region meet the standards set by indexed journals in various parts of the world; such courses will also help journal editors keep abreast with current demands in editing, review process and publication in order to meet the criteria for indexing.

Introduction

It is really not known for certain when the first clinical research paper was published but records show that there were exchanges of letters between scientists after the Renaissance. The closest to the present day journal was the “Philosophical Transactions of the Royal Society of London” which was credited to Henry Oldenberg. This “journal” started around 16651,2 and could be regarded as the first scientific journal.

Since then, research and journal publication had become an essential aspect of academic institutions and among academics, even in a young developing country like Nigeria.

Due to inadequate record keeping,, it is difficult to identify the first medical scientific journal in Nigeria but available evidence indicates that the West African Medical Journal was established in Nigeria during the colonial era in the 1920s. Drs. George Munn Gray and Aitken reported two cases in the journal of two Yoruba women with “Pressure fistula following protracted labour”3,4. This is the condition now referred to as vesico-vagina fistula (VVF). Also, in 1930, Dr. Gray published a paper titled: Tropical Pyomyositis5. Gray and Aitken also published in 19286 an article in the West African Medical Journal. The two also published many articles in the journal on: Spinal Anaesthesia in Surgery as well as articles correcting the misconception that Africans did not suffer from peptic ulcer, disease and that yellow fever in its early stages was difficult to differentiate from malaria fever7,8. All these show that West African Medical Journal and by implication scientific medical publishing had been in existence at least since 1928. Since that time there has been a proliferation of medical journals in Nigeria and other West African countries, some of them are of high quality and indexed in the PubMed.

The purpose of this paper is to highlight the problems of medical scientific publishing in Nigeria.

Financial Constraints

Sustaining a regular journal publication is an expensive business. In developed countries this is usually supported financially by pharmaceutical and medical companies through appropriate advertisement of their medical products. But this is not the case in some African countries especially Nigeria where advertisement of medical products in biomedical journals is still low.

How then do the journals in Africa survive? Actually, not many do. But those that do, resort to three methods: 1. The organization that owns the journal levies all members of the organization to make financial contribution annually – the annual due – in order to sustain the journal. 2. The editorial board charges publication fee on every accepted manuscript before the papers are published. 3. The editorial board charges assessment fee on every manuscript even before it is assessed. This amount is not refundable whether the article submitted is published or not. This third option is not very favoured by prospective authors because of the risk of losing their money if the article is rejected. As a result, the journals that practice this option may have limited patronage.

Poor quality of some articles published

One main reason why there is an increase in the number of biomedical journals in Nigeria is because of the patronage by some authors who allege that their papers are not published by internationally reputed journals because of some sort of “discrimination”. Yet in actual fact, many of these authors have poorly conducted research would not meet the standard required for publication. Some academics therefore feel that the solution to this perceived “discrimination” is to “start our own journal”. It is therefore not unusual for a group of academics to get themselves together to “start a scientific medical journal” overnight. This type of “journal” is easily recognized because many of the issues will contain about three or four articles from the editor, or members of the editorial board in a single volume! This process is fuelled by the unwritten law “publish or perish” since academic promotion is directly linked to the numbers of published work. Such journals tend to have a short life span, do not meet indexing criteria, and are usually regarded by cynics as “throw away” journals, for want of a better description. We are convinced that articles cannot be rejected on the basis of “discrimination” against any author since scientific journals exist to convey information, and not to block it9.

However without good research facilities and adequate funding, there can only be few good research papers. This seems to be the problems in many developing African countries.

It is true that most top class reputable academic institutions consider only publications in referred biomedical journals which are indexed and abstracted in Excerpta Medica and listed in the Index Medicus and other recognized international media with recognized minimum standards such as Medline, PubMed, ISI Web etc. In order to meet these international standards, emphasis should be placed in educating medical scientists in Nigeria and the West African sub-region on how to produce standard biomedical manuscripts and the provision of sustainable up-to-date research facilities as well as information and communication technology skills acquisition.

Problems of journal assessment

Low quality journals are sustained by the desperation among academics to publish for promotion. Some of these low quality journals appear to publish equally low quality papers. Because of this, many experienced assessors, who are contacted for promotion exercises of academics in the universities have devised various methods of grading journals10 where articles to be considered for promotion are published. The various methods of ranking journals apart from the impact factor11 have been well documented by Tom Lang12. These include, as espoused by Tom Lang, weighted impact factor, PageRank for electronic journals and the Eigen factor for print journals.

For visibility and ranking of published papers, authors are encouraged to publish in highly rated and indexed biomedical journals. That notwithstanding, the quality of a scholarly paper should not be entirely based on the rating of a journal that has international recognition. Great contributions in science have come from ‘Letters to the Editor’ and some inexperienced authors have had top quality manuscripts published in little known biomedical journals that are not indexed.

Journal editors and assessors with limited experience in medical journal publishing

It is not unusual in developing countries to have someone with a limited experience in scientific medical writing as the Editor-in-Chief of a journal. This is not a widespread phenomenon, but it does occur. Sometimes a single person serves as the Editor-in-Chief of two different journals at the same time. To us, this is like being made the chairman of two different political parties at the same time! This may be because of the perceived prestige, power, and influence believed to be associated with the position of editor-in-chief. With an inexperienced editor, there is a possibility of selecting also assessors with limited experience. This will be reflected in the articles published and those rejected

The net effect of all these is to have a journal that is not indexed, substandard, makes irregular appearances with poor visibility, have a short life span, and contains articles with poorly conducted research.

Problems of journal indexing

Recently, there was an article in the Journal of American College of Surgeons which described what the authors referred to as “ghost publications” in the resume of applicants for a general surgery residency position from foreign medical graduates13. This is because the articles mentioned in the curriculum vitae of the applicants as their publications were not found in Medline, PubMed, ISI Web of Science and Google. So the inference was that the articles did not exist.

But there was a good rejoinder that rightly pointed out that many of these foreign medical graduates published in their local journals which were probably not included in Medline, PubMed, ISI Web of Science or searchable in Google14. As this has shown, the international community may not be aware of such publications, especially, since the majority of journals in developing countries are not indexed.

Therefore many of the journals in Nigeria are being encouraged to get indexed. Some reputable local journals in the country enforce this by not accepting as reference to an article, citations from a journal that is not indexed. There are certain criteria a journal must fulfill before qualifying to be indexed15. These criteria improve the quality of local journals in all aspects.

Reaction of authors to rejected articles

We don’t know whether this is due to academic immaturity or desperation for promotion, but some authors react unpleasantly to an assessor or the editor when their articles are not recommended for publication. While it is probably true that some assessors may not qualify to assess the paper they recommend for rejection, the author has the option of submitting the article to other biomedical journals16,17. In order to prevent unpleasant behaviour by authors whose manuscripts are rejected and to protect the identity of the assessors, the recommended practice is to “blind’ the assessors as well as the authors. This is not the usual practice in some developed countries where the open method of assessment is practiced.

Conclusions

All the problems highlighted here do contribute immensely in a negative way to scientific medical publishing in Nigeria and other West African countries. They retard the progress of medical scientific communication in the sub-region. Identifying these problems and conducting regular update workshops on quality medical manuscript writing are the first steps in upgrading the standards of the medical manuscripts from authors in West Africa, as well as the quality of the journals where they are published in the sub-region.