Every Friday, Kristof Decoster, the editor of the International Health Policies (IHP)  newsletter sends it out to ardent readers from all over the world including those in Africa.

The newsletter is an initiative of the Health policy unit at the Institute of Tropical Medicine (ITM) in Antwerp, Belgium and has been in existence since 2009. It is published in English (there is also a French newsletter, with Basile Keugong in charge) and basically focuses on international and global policy issues that dominate the global health agenda, with some bias towards Africa and emphasis on policy and systems research, ideally research with implications beyond just one (country) setting.

To compile this weekly digest, Kristof checks plenty of (international) peer reviewed journals on a regular basis, as well as mainstream media (including African media), grey reports, Twitter, …  but as he acknowledged in a personal conversation, he almost never includes articles from African public health journals in the weekly digest. There’s a simple reason for that: he hardly ever checks African journals. He admits this is a bias, even if he tries to follow debates in Communities of Practice, media reports, African conferences,…  to partially overcome this problem. (PS: Part of the aim of my stay here in Antwerp is to do something about this bias☺ )

Kristof is certainly not alone when it comes to the relative neglect of African journals. Reasons vary, but naturally African health systems researchers like others in general  prefer publishing in high impact international journals. Even African government research agencies and universities consider peer-reviewed (international) journals to be of more value in evidence-based decision-making and most policy documents also tend to cite them.

“I have published primarily in international journals because there are not very many African journals in health systems research,” said Dr. David Musoke from the department of disease control and environmental health, school of Public Health, Makerere University.

For the few African journals that Dr. Musoke chances on they are not ‘as much’ recognized at his university, Makerere, in Uganda because they have a low impact factor. “From my experience, the African journals’ impact on the global scene is minimal and their citation is also not as much as international journals,” said Musoke.

Popular search engines used in academic settings for finding and accessing articles rarely list African journals either. “Traditionally, the Western journals appear first,” said Shakira Choonara, a PhD fellow, Centre for Health Policy; school of public health, University of the Witwatersrand.

Access is another challenge: one of the ways to access African journals is to go directly to their websites but most of them are not open access due to their business or funding models.

For instance in spite of the partnerships with western journals at the African Journal Partnership Project (AJPP), about only half of the 517 journals on the website are open access. Some of them have embargo periods of 1-3 years.  AJPP is a collaboration between international journals partnered with African journals funded by the U.S National Library of Medicine and National Institutes of Health with the aim to increase the visibility and quality of the African journals. Naturally, if these are invisible then the chances that their content is being used for decision making and influencing policy is also limited.

“The extent to which such journals are being used for decision making and policy making remains questionable and unclear. I have looked in a number of policy documents and most of the documents that I have read do not refer to African journals as source documents,” said Joseph Mumba Zulu, PhD from the University of Zambia.

Focusing more on the South-African picture (where unlike in many other sub-Saharan countries, there are actually a few local HPSR journals), Choonara said: “The African journals do have excellent context-specific information and there is definitely some impact, however they are not as well known to researchers or even decision-makers due to having low impact factors.”  She continued, “In South Africa, some of the context specific journals may feed into decision-making as well as follow-up policy briefs and some authors are engaging directly with the ministry”.

So with all these issues what is the way forward? One African well-published researcher, who does cite local journals from time to time, asked a pertinent question: ‘if we are concerned about getting greater visibility for our local journals how do they increase impact if no one wants to publish in them?’ A vicious circle, in other words, that needs to be broken.

Well, at least on the open access front, there is now a growing movement of African journals transitioning towards open access especially for those published by scientific societies. Young African researchers are following suit by publishing in them.

The Malawi Medical Journal (MMJ) which partnered with the Journal of the American Medical Association (JAMA) under the AJJP programme may set the pace. After seven years of the AJPP and MMJ marriage, submissions have soared from 42 in 2008 to over 150 in 2015. The impact factor of 1.00 remains wanting but it is a progressive process.

‘We are now indexed amongst others on: PubMed, PubMed Central (PMC), Bioline International, Thomson Reuters, and African Journals Online (AJOL)’, said Chiwoza Bandawe, the editor of MMJ, in a June 2016 Editorial.

Yet, open access international journals, targeting LMICs obviously still remain a very attractive option for young African researchers for a number of reasons, going beyond just the impact factor & citation.

“My experience in publishing in HPSR journals, especially in the Health Research Policy and Systems journal, has been very good, there are no publication costs for us, researchers from LMICs”, said Mumba Zulu. “The duration for receiving feedback is reasonably okay and the duration between acceptance and final publication of the article is good.”

“As a younger researcher I find it much more encouraging to publish in open access journals, rejections happen but not at the rate they do with the Lancet, BMC, BMJ etc… most of them also don’t require excessive payments so when funding isn’t available many researchers I know of also turn to them,” said Choonara.

As the open access movement slowly gains momentum in Africa, including for journals on health systems and policy, young researchers in Africa might decide to publish in them more and more. But the road ahead is still long.