Global knowledge for global change: dropping the pebble
JBI is deeply invested in our relationships with health professionals working in low and middle-income regions. It is an investment made with our vision and mission front of mind – to improve health outcomes for communities globally. It is informed by our values of mutual respect between nations, professions and cultures; professionalism and ethical conduct; and a robust and transparent approach to the production of high quality, accurate information for health professionals and citizens internationally. However, it is clear that we will need to work much harder to truly realise our goal and to maximise our impact.
JBI’s global impact cannot and should not be defined merely by the number of collaborating entities or subscribers it has across the world. If we are truly working in earnest, with the restlessness and sincerity that we claim, to achieve difference, then we have to take our view of impact much further. We need to understand how we contribute to the improvement of the multiple contexts in which we operate and to establish how we can break into and affect change in the contexts we do not currently have a presence in. We need to find solutions that create multidirectional value. It is becoming increasingly important to identify strategies to overcome the current juxtaposition of science and business in our organisation and to leverage our greatest strength: knowledge.
According to Kofi Annan, “Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family.” Knowledge is power. Of course, in academia it is a mantra we live by and we are creating knowledge every day. Indeed, there are nearly 2 million scientific articles published every year. Unfortunately, it takes on average about 17 years for that knowledge to make an impact.
The Joanna Briggs Institute (part of the Faculty of Health and Medical Sciences at the University of Adelaide), was founded 20 years ago. We now have more than 70 collaborating entities across the world and together with these groups we synthesise only the best, highest quality research, package it in easy to use formats and provide tools, education and support for health professionals to use that evidence at the point of care to inform their clinical decisions. We are one of the top organisations in the world doing this work. We have thousands of subscribers worldwide… but (probably not surprisingly) most of these are in “developed” nations.
I would like to share a personal story with you to help put this in perspective. Last year I gave birth to my first child, Evie. She was born in a not for profit, community owned, private hospital in the north eastern suburbs of Adelaide, South Australia. It was an uncomplicated and relatively “easy” delivery (said no mother ever!). Private room, en suite, double bed so my partner could stay too, three meals a day, access to a range of professionals to check on us and help us along. Evie was a little jaundiced and not feeding well so we were kept in for five days. We had excellent care.
In JBI over the last few years we have heard many stories from health professionals working in disadvantaged communities about their work with mothers and babies. In Uganda, animal manure (cow dung) was being used on the umbilical cord site of newborns; there was no hand washing protocol in their paediatric special care unit (sometimes no soap or running water); and mothers were giving their newborns water and sugar while waiting for their milk to come in. In Kenya, clinicians were lacking in knowledge, skills and equipment to assist with newborn resuscitation and across Africa labouring women frequently have to bed share (cloaked in my white, privileged naivety I am embarrassed to confess that I actually had to ask what this meant – exactly what it says: women giving birth had to take turns sharing a bed in order to rest). Even in remote Australia, Indigenous mothers were using Vegemite and water in bottles to feed their babies. Stories like these are numerous and they never get any less heart breaking to listen to.
Hearing their stories reminds me of what a privilege it is to be an Australian; to have access to the healthcare system that we have; and to be involved with an organisation like JBI because, in all of the aforementioned cases, the clinicians involved were given access to the best research evidence, provided with tools and education on how to use it and without exception they significantly improved outcomes for their patients. Some of the differences between my experience and these stories are clearly about infrastructure, equipment and funding, but most were simply about access to good quality evidence (knowledge).
The JBI vision and mission relate to improving global health. In order to achieve that everyone should have access to the best available knowledge to make decisions about the care they give and receive... and we have a long, long way to go. JBI’s logo is representative of a pebble being dropped into the ocean; a red “pebble of knowledge” that we believe has the potential to have a ripple effect across health systems internationally. We don’t see evidence in isolation as a zero-sum game, but rather as a mechanism to bring about improved health outcomes to more people. Globally.