Ciência e Saúde Coletiva dedicates issue on the importance of Brazilian Collective Health journals

By Lilian Nassi-Calò

Scholarly communication plays a key role in the development and practice of Public and Collective Health. Professionals responsible for formulating public policies and decision makers at national, regional and global levels constantly seek the best evidence to make recommendations and develop strategies and goals for health. Research results, especially those published in peer reviewed journals, subsidize the construction of evidence, and therefore constitute the framework of Public Health knowledge.

Brazil has good international representation in Public and Collective Health publications both in number of articles as journals. It ranks seventh in number of internationally indexed documents with at least one Brazilian author in 2014, according to Scimago Journal Rank/Scopus. In Web of Science (Thomson Reuters) database, they are 260 Public Health journals of 12,679 publications. Brazil currently has 133 journals, four on the topic Public, Environmental and Occupational Health.

One of these journals is Ciência e Saúde Coletiva (C&SC), official publication of the Brazilian Association of Collective Health (Abrasco), which completes this month 20 years of uninterrupted publication and relevant scientific contribution to the field. To celebrate the date, the July issue of C&SC publishes a series of commissioned articles on “The importance of scientific publishing in the development of public health”, bringing together experts and editors of the leading Brazilian journals in the area, besides the President of the World Federation of Public Health Associations (WFPHA), Mengistu Asnake, who signed the editorial of the special issue.

Asnake introduces the topic of the special issue emphasizing that it is aligned to the values ​​of WFPHA, namely to promote the practice, education, training and research in Public Health. In his view, centuries of experience have shown that the impact of public health goes beyond borders, and scientific publications share evidence that translate into public policies and strengthen global health. Moreover, Asnake encourages young public health professionals to write and submit articles to peer reviewed journals in the early stage of their careers, and experienced researchers, journal editors, as well as associations and public health institutions, to guide and support this process.

Everardo Duarte Nunes, a member of the editorial board of C&SC since 2002, analyses, then, the process of institutionalization of Abrasco during the creation of the journal and on the evolution of scientific production in the area. Nunes reports the phases of consolidation of Public Health as a central topic of scientific research, which starts attracting human and financial resources and training specialists to shape a scientific community integrated to communication networks, scientific societies and specific publications. Nunes also analyzes the relevant contribution of C&SC in this process, as well as other Brazilian journals, as Revista de Saúde Pública, Cadernos de Saúde Pública, Revista Brasileira de Saúde Ocupacional and the Revista Baiana de Saúde Pública, among others.

Abel Packer, scientific coordinator of the SciELO Program at FAPUnifesp, highlights, based on bibliometric indicators, the national centrality of the research reported in public health journals edited in Brazil that explains the dichotomy between high international indexing and poor performance in terms of citation of the articles published in these journals. Besides the national focus, many articles are published in Portuguese, which limits readership – and citations – by international authors. Packer points out that the low impact on WoS indexes affects the assessment of national graduate programs in Public Health, since the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) uses indicators based on citation on WoS and Scopus indexes to rank the journals. However, the journals’ performance is much better when considering the SciELO and Google Scholar indexes that have a wider coverage. Analyzing the rankings in international indexes, performance and features of the ten Public and Collective Health Brazilian journals indexed in SciELO, Abel Packer presents a profile of this thematic area and its evolution, pointing out the challenges faced by publishers and paths towards internationalization, professionalization and sustainability of Brazilian publications.

The following articles refer to the trajectories of the three pioneer journals in Brazil in Public and Collective Health, namely Revista de Saúde Pública (RSP), Cadernos de Saúde Pública (CSP) and the very C&SC, reported by their current Editors-in-Chief.

These three journals have common features and similar trajectories, and together comprise what Packer denominated first group among the ten Brazilian Public and Collective Health journals present in SciELO. These publications are indexed in each of the seven regional and international databases considered in his article (LILACS, SciELO Brazil, SciELO Public Health, Medline, Web of Science, Journal Citation Reports, and Scimago/Scopus) and this subset is responsible for more than 64% of articles published between 2011 and 2013 in Public Health journals in SciELO edited in Brazil.

These journals share, beside achievements and recognition of the scientific community, challenges and concerns such as financial sustainability and the difficulty in obtaining quality peer reviews on submitted manuscripts. Regarding financial management, only RSP operates with publication rates (Article Processing Charge), others have resources from CNPq, FAPESP and contributions from the responsible institutions (Abrasco and Fundação Oswaldo Cruz in the case of C≻ Escola de Saúde Pública da USP for RSP and Escola Nacional de Saúde Pública Sérgio Arouca (ENSP) from Fundação Oswaldo Cruz, in the case of CSP). Considering the high number of submissions they receive, it is necessary a thorough evaluation of manuscripts by the Editors-in-chief, in order to avoid overloading referees with low relevance scientific works, which merely reproduce results obtained by other authors. RSP attributes excessive submissions to the publish or perish policy and valuing quantity over quality of articles published in the evaluation of researchers and graduate programs. In this respect, the editors of RSP and the C&SC believe that attributing recognition to the referees’ work is profitable, and also C&SC proposes to disclose referees comments openly as a way to encourage careful evaluations, like journals such as the Public Library of Science (PLoS) collection, BMC journals, PeerJ, and Nature.

The editors of RSP, CSP and C&SC share the view that the issue of internationalization is important, but RSP notes that this topic should be addressed carefully not to become a purpose itself. In this way, there would be a risk of favoring poor foreign manuscripts over good national contributions only to give the journal an international character.

Regarding the topics of the articles, RSP, in its editors words, “has been chronicler of the evolution of traditional Public Health agenda; until the mid-1990s, its articles had accompanied: ‘the reintroduction of Aedes aegypti, the growth of morbidity and mortality from occupational diseases, the growing participation of non-communicable diseases and violence in morbidity […] the reduction of maternal and infant mortality and the growth of the practice of breastfeeding’.” CSP, in turn, publishes articles that contribute to the study of general Public Health, as well as Environmental Health, Public Policies and Health Planning, and Social Sciences applied to Health, among others. The journal publishes one or more thematic supplements on various topics, totaling 53 thematic issues since 1986. C&SC is “a journal with a thematic focus which echoes the philosophical and political principles of Abrasco of subsidizing the discussion on the implementation of the Unified Health System (SUS) and Public Health Promotion in the country”. An analysis of articles topics published in a representative sample of the collection shows mainly articles on Policies, Planning and Health Management, Diseases and Disorders, and Health and Environment, while keeping inseparable commitment to SUS.

The thematic issue of C&SC proceeds with articles devoted to three other relevant journals in the Brazilian research scenario: Revista Brasileira de Epidemiologia (RBE), Interface – Comunicação, Saúde e Educação (ICSE), and Saúde e Sociedade (SeS). These journals correspond to what Packer called second group, since they are indexed in five of the seven bibliographic databases considered in his study.

RBE, ICSE and SeS were created around the same time, the first two in 1997 and the latter in 1992. RBE results from the establishment of the Epidemiology Committee of Abrasco, who decided to create the journal in order to “systematizing the ongoing wide-ranging discussions which were mobilizing the community of researchers, professors and health care professionals in the production and application of knowledge generated in the field”. The authors were mostly Public Health workers dedicated to epidemiological studies participating in the constitution movement of Collective Health in the country, who also published supplements on the role of Epidemiology in the construction of SUS.

The journal ICSE was designed by an interdisciplinary study group in Health Education and Communication at Faculdade de Medicina de Botucatu with support from the Kellogg Foundation. ICSE publishes articles on Education and Communication in Health Practice, as well as interdisciplinary studies in Social Sciences, Humanities and Health.

SeS, in turn, was born at Faculdade de Saúde Pública da USP, with support from Associação Paulista de Saúde Pública, to give vent to the scientific output in the area of ​​ Social Science, Humanities and Health. Its creation took place in a particular historical moment, at the gates of the XXI century and suffering the influence of the Health for All document in the XXI Century, complementing the Alma Ata Declaration of 1978 on Primary Health Care. That year Rio 92 (ECO 92) was held in Rio de Janeiro, Brazil, and Agenda 21presented “Sustainable Development” as a way to ensure economic growth without harming the environment. It is also from this time the first discussions on the Right to Health as a Human Rights and the risks of accelerated technological development for life on the planet and the health of its inhabitants. On the national scenario there was the promulgation of the new Constitution and the creation of SUS.

The topic addressed by articles published by RBE monitors the evolution of Brazilian health. Between 1998 and 2004, 44% of papers were centered in epidemiological studies on communicable diseases and nutrition. Over time, Brazil and the world watched the growing prevalence of chronic diseases, resulting from the increased life expectancy and poor lifestyle such as sedentarism and alcohol and tobacco consumption.

The evolution of scholarly communication in health in Brazil, and the migration of printed journal to the Internet platform in the forthcoming years led to the reformulation of editorial policies of Public Health journals. Indexing in international indexes such as Medline/PubMed, Web of Science, Scopus and SciELO itself led to the need to publish articles in English, or bilingual, to simultaneously address international researchers and Brazil’s health professionals. RBE between 2010 and 2014 increased by 120% the number of articles in English. For ICSE, entering the SciELO Brazil collection in 2005 increased by 500% the amount of submissions to the journal in only three years. SeS also saw the number of submissions increase dramatically from the admission in SciELO in 2008, and from 2010, there was also a greater number of submissions from international authors.

Due to increased submissions, journals had to adapt the editorial management of manuscripts, performing a strict control adjustment regarding scope, originality, scientific relevance and methodological approach, allowing a transparent evaluation process oriented towards valuing the work contemplated by the academic community and public health professionals. As well as numerous journals published in Brazil and abroad, getting quality reviews within the recommended time frames is one of the persistent challenges. ICSE adopts publication ahead of print in order to reduce the publication time of accepted manuscript, and decided in 2012 to discontinue the printed version, following the current trend of preference for the digital version and as a cost reduction measure. SeS also contemplates this possibility in the short term.

RBE, ICSE and SeS publish one or more annual supplements on specific topics that reflect the interests of the community of researchers and health professionals at that time. Similarly to other journals that rely on institutional subsidies and public funding agencies such as CAPES, CNPq and FAPs, these journals face challenges with the financial sustainability and editorial production flow.

The third group includes those journals indexed in two and three of the seven databases from Packer’s analysis. These are Physis: Revista de Saúde Coletiva (PRSC), Revista Brasileira de Saúde Materno-Infantil (RBSMI), Revista Brasileira de Saúde Ocupacional (RBSO) and Trabalho, Educação e Saúde (TES). Of these, only PRSC and RBSO are present in the thematic issue of C&SC.

PRSC is a publication of the Instituto de Medicina Social da Universidade Estadual do Rio de Janeiro and Centro de Estudos e Pesquisas em Saúde Coletiva. It was established in 1991, inserted in the world and Brazilian scenario of important events in the field of Public and Collective Health, as described above. It is, therefore, contemporary to relevant Brazilian journals such as C&SC, SeS, ICSE and RBE, and publishes Collective Health studies with an emphasis in the areas of Human and Social Sciences and Health Planning and Management. The journal publishes one or more thematic issues per year, some of which are characterized by innovation and contribution to the debate in the field of Public Health. Its editorial staff expressed concern with issues – also recurrent to other editors – regarding the quality of published articles, valuing quantity over quality and what the editors of CSP termed “more of the same.” The editor of PRSC, Camargo Junior, cites Richard Horton, editor of the renowned journal Lancet, which states that publishers should not be concerned on how to protect market shares, but rather to explore and enjoy the full value of science to society. Camargo Junior believes that the key instances for the production and dissemination of science in Brazil are not facing properly this task, but the newly created Public Health Editors Forum has been discussing these issues at their meetings.

RBSO, published by Fundacentro, a department of Ministério do Trabalho e Emprego, was established in 1973 during the military government. Its trajectory includes three phases, the first as a vehicle for disseminating knowledge and the accident prevention policy; then, from 1980, opens space for technical and scientific publications, at the same time as it inaugurates the topic Worker’s Health. From 2005-2006, the new independent editorial structure leads to indexing in SciELO Brazil in 2012, when it starts to receive more submissions. The high rejection rate (85%) contributed to significant improvement in impact rates and ranking by Qualis-Capes.

Currently, the journal’s mission is “to publish scientific articles relevant to the development of knowledge and to enhance the technical and scientific debate in the field of Health and Work Safety.” RBSO reflects a complex multidisciplinary area illustrated by the topics of articles published, from studies on Occupational Medicine and Occupational Health, as well as Workers’ Health. The editorial committee currently ahead of the journal believes on the principle of editorial freedom advocated by the ICMJE, and is committed to promoting the qualitative growth of the journal, strengthening the peer review process, and optimizing editorial management. The second principle that guides its work is to function as a quality public service, emphasizing the publication of articles of scientific merit relevant to society.

RBSO publishes thematic dossiers as a way of attracting articles and established a partnership with the Grupo de Trabalho Saúde do Trabalhador of Abrasco. Thus, the journal consolidated itself as a vehicle for the scientific production in the area, mainly by publishing original articles, many of which come from graduate programs in various specialties. The publication has online and print editions distributed free of charge to libraries and government agencies around the country.

The special issue on the 20 years of the C&SC draws, thus, an overview on the current status of scientific research in Public and Collective Health in Brazil and the major publications in the area. Given the limited support from public policies, the achievements that these journals conquered attest the tireless work of editors, the scientific community and institutions involved, and indicate that their future depends on equal – if not greater – commitment to ensure its place next to the most prestigious international publications. In the words of Cecilia Minayo, Editor-in-chief of C&SC, “the scientific journals of the Public Health area, even with all the criticism of their limitations – criticisms from the publishers themselves, showing that there is still a long way to go – can be considered victorious in their academic performance that ennobles Brazilian science and its social meaning that contribute to improving the Brazil’s Unified Health System”.

References

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External Links:

Scimago Journal and Country Rank – <http://www.scimagojr.com/>

Web of Science, Thomson Reuters. – <http://wokinfo.com/>

About Lilian Nassi-Calò

Lilian Nassi-Calò studied chemistry at Instituto de Química – USP, holds a doctorate in Biochemistry by the same institution and a post-doctorate as an Alexander von Humboldt fellow in Wuerzburg, Germany. After her studies, she was a professor and researcher at IQ-USP. She also worked as an industrial chemist and presently she is Coordinator of Scientific Communication at BIREME/PAHO/WHO and a collaborator of SciELO.

Translated from the original in portuguese by Lilian Nassi-Calò.