The Cochrane African Network (CAN) is a network of three hubs representing different regions of the Sub-Saharan African continent, and one coordination hub, all managed by experienced Cochrane review contributors including authors, editors, mentors and trainers.
Overarching aim and goals
CAN aims to increase the use of evidence to inform healthcare decision making in the sub-Saharan African region. CAN’s goals are to support the production of high-quality, relevant Cochrane reviews; make relevant evidence accessible; advocate for evidence-informed policy and practice; and, build a sustainable network.
Background
Recognising that where disease burden and health system challenges are greatest, the need for evidence to support decision-making and resource use is most critical. Global capacity to timeously conduct systematic reviews is limited, particularly in low- and middle-income countries (LMICs).
CAN, an innovative, African-led network, was conceptualised in 2007 to support the Cochrane mission to promote evidence-informed healthcare decision making by producing high-quality, relevant, accessible Cochrane reviews and other synthesised research evidence.
CAN builds on years of experience in collaborative projects regionally and internationally. These projects aim to build research capacity to conduct systematic reviews, advance teaching and learning of evidence-informed healthcare, and to promote knowledge translation.
CAN has a track record in conducting Africa-relevant Cochrane reviews including active engagement and communication with stakeholders across the continent. Wherever possible, CAN will engage with existing projects and networks to build synergies in promoting evidence-informed healthcare decision making in Africa. The activities CAN will be involved in include:
- Addressing research gaps by synthesising relevant research evidence in Africa.
CAN will undertake sub-region driven priority setting exercises to identify questions for which evidence is required, and summarising and disseminating results to all relevant stakeholders. CAN will also build partnerships to promote evidence to inform healthcare-informed decision making in the region.
- Building recognition of evidence-informed healthcare and Cochrane’s work in Africa
The network will have a major focus on expanding and cementing understanding of the concept of evidence-informed healthcare in the African region and will aim to promote the work of Cochrane wherever possible in all its activities.
Building capacity to conduct and use research in Africa
Capacity building will include training for researchers to conduct high-quality systematic reviews and for users of evidence such as practitioners and policymakers to find, appraise and apply best-available evidence.
Case Studies
Malaria
Two high-priority reviews completed by the West Africa hub were used to formulate recommendations in the World Health Organization Guidelines for the treatment of malaria, the most recent was in April 2015.
Citation: Esu E, Effa EE, Opie ON, Uwaoma A, Meremikwu MM. Artemether for severe malaria. Cochrane Database of Systematic Reviews 2014, Issue 9. Art. No.: CD010678. DOI: 10.1002/14651858.CD010678.pub2.
Citation: Meremikwu MM, Donegan S, Sinclair D, Esu E, Oringanje C. Intermittent preventive treatment for malaria in children living in areas with seasonal transmission. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD003756. DOI: 10.1002/14651858.CD003756.pub4.
Tuberculosis
The EVidence to Inform South African TB policies: EVISAT Project - To contribute to evidence-informed policy development in South Africa, the EVISAT: Evidence to Inform South African Tuberculosis policies project, led by the CEBHC, provided oversight, quality assurance and management for the conduct of robust systematic reviews on the epidemiology of and programmatic response to Tuberculosis (TB) in South Africa, while taking stock of international systematic review evidence on strategies to prevent, diagnose, manage and offer services to those with TB.
HIV/AIDS
A review on the efficacy and safety of abacavir-containing combination antiretroviral therapy for HIV-infected children was used in the WHO HIV guidelines – directly informing policy and practice in the region and internationally.
Citation: Adetokunboh OO, Schoonees A, Balogun TA, Wiysonge CS. Efficacy and safety of abacavir-containing combination antiretroviral therapy as first-line treatment of HIV infected children and adolescents: a systematic review and meta-analysis. BMC Infect Dis 2015;15(1):469.
Cochrane SA led reviews on task shifting and decentralisation of care in HIV/AIDS informed HIV guidelines.
Citation: Kredo T, Adeniyi FB, Bateganya M, Pienaar ED. Task shifting from doctors to non-doctors for initiation and maintenance of antiretroviral therapy. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD007331. DOI: 10.1002/14651858.CD007331.pub3.
Citation: Kredo T, Ford N, Adeniyi FB, Garner P. Decentralising HIV treatment in lower- and middle-income countries. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD009987. DOI: 10.1002/14651858.CD009987.pub2.
Cameroon is - apart from Canada - the only other bilingual country with both French and English as official languages. However, French is the predominant language in Cameroon. The Centre for Development of Best Practices in Health (CDBPH) in collaboration with the Effective Health Care Research Consortium (EHCRC) is working on a five-year project to enhance the uptake and use of up-to-date health research evidence primarily from the CDSR. Efforts to reach non-English-speaking health stakeholders in Cameroon were hampered by language barriers, notably in building capacity for conducting Cochrane Reviews, reading and applying the evidence, or communicating it to policy makers. Consequently, significant resources were diverted to providing translations of Cochrane Review abstracts and plain language summaries. A list of priority reviews on topics relevant to Cameroonian stakeholders and EHCRC targets was established. The quality of these translations was verified by the French Cochrane Centre and Cameroonian teams.
The CDBPH also started producing bilingual evidence assessments – summaries of Cochrane Reviews adapted to the local context. These translations have led to a higher uptake of Cochrane products, with more downloads from the CDBPH website (www.cdbph.org) and demands for other evidence products, such as Policy Briefs and Rapid Responses.
An important aspect of the work of Cochrane is to ensure that evidence-based health information reaches the public. In September 2016 Cochrane Nigeria received media coverage in one of the prestigious daily newspapers – Business Day – based on developing and disseminating a press release on an important Cochrane Review.
The review showed that taking an oral Vitamin D supplement in addition to standard Asthma medication is likely to reduce severe Asthma attacks. Asthma is a common disease affecting an estimated 300 million people worldwide. The detailed information on the review and on Cochrane was published in the Health section of the newspaper.
Business Day was established in 2001 and is a daily business newspaper based in Lagos. It has both daily and Sunday titles and is circulated in Nigeria and Ghana.
Hubs and Partners
West Africa Hub
Cochrane Nigeria, Institute of Tropical Diseases Research & Prevention, Calabar University, Nigeria
Martin Meremikwu
Emmanuel Effa
Geographic scope: Nigeria, Ghana, Gambia, Liberia, Sierra Leone
Francophone Africa Hub
Centre for the Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
Pierre Ongolo-Zogo
Lawrence Mbuagbaw
Geographic scope: Cameroon, Madagascar, Benin, Senegal, Ivory Coast, Democratic Republic of Congo, Mali, Burkina Faso
Southern and Eastern Africa Hub
Centre for Evidence Based Health Care and consultant Cochrane South Africa
Taryn Young
Tamara Kredo
Geographic scope:
Southern Hub - South Africa, Malawi, Zimbabwe, Swaziland, Lesotho, Botswana, Namibia, Zambia, Mozambique, Mauritius, Seychelles, Angola
Eastern Hub - Kenya, Uganda, Tanzania, Comoros, Eritrea, Somalia, Ethiopia, Rwanda
Cochrane South African Coordinating Unit
Cochrane South Africa
Solange Durão
Tamara Kredo
Ameer Hohlfeld
Charles Wiysonge
Taryn Young
*Countries in italics are not CSA reference countries; CAN will aim to reach these countries in the longer term.
Phone: +27 21 938 0256
Email: ameer.hohlfeld@mrc.ac.za
Or cochranesa@mrc.ac.za
