Scientific Knowledge Dissemination and Reproductive Health Promotion in Africa: The Case of AJRH.

There are at least three basic reasons for the indispensability of scientific knowledge dissemination to the improvement of reproductive health in Africa. First, Africa is the only major region of the world with extremely heavy burdens of reproductive ill-health, the main causes of which proven low-cost solutions are known but have not been implemented on a massive scale in many of the countries that make up the continent1 . Second, several key reproductive health (RH) issues including family planning (FP), sexual practices, pregnancy, sexual and gender-based violence, sexuality education, abortion, and infertility have persistently been shaped by widespread misinformation, myths, ignorance and a culture of silence2,3. Third, most of the published scientific evidence on a number of critical RH issues in Africa are produced in other geographies and culture areas4,5 . Thus, their associated recommendations and policy prescriptions are sometimes irrelevant or inappropriate to countries in Africa especially for RH outcomes that are largely determined by sociocultural beliefs, attitudes and practices. A key need therefore was for regular production and dissemination of rigorous scientific evidence and analysis on Africa, and especially by Africans, on the determinants, correlates and consequences of the major reproductive health challenges confronting Africa. This was and remains the gap that the African Journal of Reproductive Health (AJRH) has been working so hard to narrow in the last 20 years. Simply put, by continuously disseminating African RH research results to many of those who need to have such information, the AJRH has been shaping with scientific evidence, actions in the RH policy, programme development, and service delivery across Africa. It has by so doing added a lot of value to African RH knowledge production since a research is as useful as the sharing of its results with those who need to know6 . As a scholar-practitioner in this field, I had the rare privilege, for 11 unbroken years as a Senior Programme Officer with the Ford Foundation (1997- 2008), of working to support the efforts of the Women‘s Health and Action Research Centre (WHARC) at building the AJRH into a world-class scientific journal. It is thus from my first-hand experience as a witness to the growth of the AJRH that I am able to further outline some of the specific ways the journal has contributed to reproductive health promotion in Africa and some of the critical success factors in this process. In my considered view, notable among the hitherto often neglected but significant RH issues in sub-Saharan Africa that the AJRH helped to call needed policy and research attention to over the last twenty years are: (i) Level and determinants of HIV serodiscordance among married couples (ii) Etiology of and responses to primary and secondary infertility (iii) Sexual health-seeking behaviors of unmarried adolescents and young adults and related policy interventions including sexuality education and youth-friendly services (iv) Multiple dimensions of unmet need for FP, unintended pregnancy, and unsafe abortion (v) Sociocultural and economic drivers of intergenerational sexual relations (vi) Biomedicine, prevention and management of reproductive tract infections (and cancers) (vii) Key populations (including men who have sex with men) in HIV prevention and impact mitigation (viii) RH needs of persons living with HIV (ix) Correlates and effective solutions associated with preventable maternal mortality and morbidities (x) RH effects of child marriage, female genital mutilation (FGM) and other forms of genderbased violence As exemplified by many of the papers in this issue of the journal, the range, depth, diversity and cross-cutting nature of the issues that have been addressed by the AJRH since 1997 helped to reaffirm the interconnectedness of sexual and reproductive health and rights, and sustainable development, thereby firmly placing the former within the mainstream of public policy discourse across Africa. I strongly believe that it is not a mere coincidence that as the AJRH grew in stature so did we witness a progressive increase in the rate of enactment of strong evidence-based national policies and strategies on critical RH issues in most African countries7.8 . It is to the eternal credit of Professor Friday Okonofua, founder of WHARC, the publisher of the AJRH and his associates and supporters that the AJRH did not suffer premature death or stunted growth. Rather, it successfully navigated several growing pains that made it stronger. Key to this successful evolution of the AJRH into a thriving and credible international scientific journal is a number of factors that deserve to be underlined and these include: (i) Visionary leadership and astute management of the organization behind the journal (ii) Agility and adaptability in the face of operational challenges (iii) Mission fidelity, uncompromising emphasis on quality, and an unwavering Afrocentric-cum-Pan African ethos (iv) Loyal and sustained partnerships with international, academic, civil society, and funding institutions (v) Institutional humility and openness to learning and innovation There are so many other lessons to be learned from the AJRH‘s story, but suffice to say that the foregoing short summary represents a veritable template for making success of scientific journal publishing in Africa. But it is not a journey for the faint-hearted. To continuously publish four times a year an international standard scientific journal in a very challenging business operating environment like Nigeria, and on a specialized subject matter that is full of controversies and sensitivities, is indeed a very tall order. Finally, I want to emphasize the huge contribution that the AJRH has made and continues to make to the academic careers of budding African scholars in the fields of public health, gender studies, medicine and allied disciplines. Truth be told, scientific publishing is neither a completely apolitical enterprise nor a level playing field. It is thus often extremely difficult for a young unknown and locally based African scholar to break into a major international journal9 . We must therefore fully appreciate the role of the AJRH in availing this category of academics the door-opening opportunity to be published on an internationally recognized and respected scientific platform. All those associated with the ARJH are to be saluted for their courage, tenacity, and drive for excellence and are encouraged to stay the course that has led the journal this far. Nonetheless, the crowded and highly competitive world of scientific publishing offers no guarantees even for a successful journal like the AJRH. So, it is recommended that the ARJH begins to focus more on issues and topics related to improving our understanding of the barriers to effective RH-related policy implementation. It needs to also encourage scholars to investigate more rigorously the factors, processes and outcomes associated with institutional adoption of innovations and individual adoption of new behaviors. For we now have across Africa a largely favorable policy environment and know the solutions to the bulk of the RH challenges still confronting the continent. Africa just needs to seriously get on with universalizing the application of the well-documented proven solutions. The AJRH‘s continued relevance and sustained value additionally may well derive from giving increasing attention to this cluster of issues in the years to come.