American International Health Alliance

Objectives: Evidence-based medicine (EBM) is a core competency for all healthcare professions including military healthcare personnel. We surveyed military health personnel knowledge and experience with Cochrane, EBM and the Cochrane Library at Defence Force Medical Services in Zambia.
 Materials and Methods: During May 2013 and March 2014, we used a pretested self-administered survey to collect data from the study participants. Categorical associations was tested by Chi-squared or Fisher's exact test. The strength of association between categorical variables was expressed using odds ratio (OR) with 95% confidence interval (CI).
 Results: The overall participation rate was 92% (57/62). The sample consisted of doctors, nurses, clinical officers, medical licentiates and other professions. Nearly 44% worked in military clinics, 28% hospitals, 23% head office and 5% in training schools. Most (79%) of respondents have heard of EBM, but 84% had low knowledge and 88% lacked EBM training. Nearly 77% agreed that EBM was useful in clinical practice, 98% showed interest in EBM training and 46% declared workplace EBM promotion. Awareness about Cochrane was 53% and only two recognized Cochrane South Africa as their reference centre. Awareness and usage of the Cochrane Library was generally very poor and only one knew the database. Medical doctors were roughly five times more likely to cite organizational barriers to the Cochrane Library compared to nurses and clinical officers (Adjusted OR=5.19, 95% CI, 1.15–23.52, P=0.03).
 Conclusions: Military medical personnel encounter considerable barriers to adopt EBM in clinical practice. Addressing their multifaceted barriers would facilitate the delivery of evidence-based healthcare and improve patient outcomes.

Annals of Global Health is a peer-reviewed, fully open access, online journal dedicated to publishing high quality articles dedicated to all aspects of global health. The journal's mission is to advance global health, promote research, and foster the prevention and treatment of disease worldwide. Its goals are to improve the health and well-being of all people, advance health equity, and promote wise stewardship of the earth's environment. The latest journal impact factor is 2.90. Annals of Global Health is supported by the Program for Global Public Health and the Common Good at Boston College. It was founded in 1934 by the Icahn School of Medicine at Mount Sinai as the Mount Sinai Journal of Medicine. It is a partner journal of the Consortium of Universities for Global Health. From time to time, Annals of Global Health publishes Special Collections, a series of articles organized around a common theme in global health. Recent Special Collections have included "Local evidence and strategies in addressing NCDs Non-Communicable Diseases in Tanzania", "Universal Health Coverage through Integrated Care", and "The Minderoo-Monaco Commission on Plastics and Human Health". Global health workers interested in developing a Special Collection are strongly encouraged to contact the Managing Editor in advance to discuss the project.

Social, political, and economic changes in the former Soviet Union precipitated both the collapse of a once-centralized medical education system in the region and the development of individual models in its place. In the context of rapid globalization and international concerns about health, this development of "nation-based" models for the structure, content, language, and duration of instruction generated concerns about regional accreditation; workforce planning; student qualifications; residency training; continuing education; and infrastructure, such as access to literature, an adequate clinical training base, and links to certification and licensure. The World Health Organization acknowledges that the development of human resources for health is a complex and key element in reforming health systems. In Central Asia, international donor agencies facilitated the development of a regional council of rectors and a partnership consortium of medical academies as reform vehicles. International medical education organizations provide counsel and share their organizations' models, greatly facilitating the reform progress. The groups work to address both the political and regulatory environment and the professional and academic environment that affect the quality of medical schools. The council of rectors is establishing credibility as a regional nongovernmental organization that can advise governments about workforce planning, budgeting, admissions policies, accreditation, and licensure. The group sponsors faculty development workshops, bringing together regional educators around educational and institutional issues of mutual concern. Partnership academies collaborate to develop institutional and individual professional capacity, focusing on standardized evaluation, structure and content of the curriculum, pedagogy, and leadership development.