The Challenges of our Nation and Prospects for our Journal; less than half a decade to the MDGs.

A Journey that commenced a few months ago, as a mere figment of imagination of an individual is actually, moving with the momentum that is unparalleled in the history of publishing in Nigeria. Within the short period of existence, we are publishing our next issue, with a strategic plan of attaining the highest international standard by 2015.

It is fascinating to note that the has entered into a new partnership with Medknow publications limited based in Mumbai, India. Medknow today is one of the largest open access publishers in the world, publishing, on behalf of learned societies and associations. It is also the largest open access publisher for journals which do not charge the authors for submission, processing or publication. Due to these achievements, Medknow was recently acquired by Wolters Kluwer, a leading global information source. The relationship that Medknow has with our journal will continue, and no doubt evolve and grow as a part of the Wolters Kluwer portfolio. It means another opportunity for international exposure and impact for our journal. Wolters Kluwer is known throughout the world as the authoritative source of current, highly regarded information & research tools. Wolters Kluwer and its brands Ovid and Lippincott Williams & Wilkins are committed to sourcing locally-written content and using Open Access models to support its discoverability worldwide. We are excited to be part of this laudable initiative.

Consequently, we have moved ahead by establishing an online document management and review process at www.journalonweb.com/amhsr. This method enables authors to register and submit articles on line, also monitor the progress of their articles. There has been considerable improvement in our website, and our journal cover page, which is now wearing a new look in line with our new status. You can visit our new look website at http://www.amhsr.org.

It is also worthy of note that within this short period, Annals of medical and Health Sciences Research has been indexed in . We are working exceptionally hard, and before long, we shall get the endorsement of other indexing bodies.

The Millennium Developmental Goals (MDG) s is less than half a decade to its attainment, however, published, and unpublished information emanating from different parts of Africa continue to cast doubts on the feasibility of this project. Poverty and ignorance has continued to grow at an alarming rate. Maternal/Perinatal mortality and morbidity are not abating. In this issue, therefore, Bako and colleagues, working in a predominantly Muslim population of Northern Nigeria lamented that delay in giving consent is a significant contributor to the delay in managing Obstetric emergencies and thus increase in maternal deaths. In the southern part of Nigeria Ibekwe et al., did not mince words on the continued high perinatal mortality rate, despite the effort to curb the trend. What efforts have been made in terms of information, education and advocacy? If there were efforts, then, they seem not to be yielding the desired results. For instance, one of the known indices that adversely affect feto maternal outcomes (Obesity) is particularly prevalent in our environment. Chigbu and Aja examined this issue and lamented, that obesity in pregnancy is commons in Nigeria. They also suggested that maternal weights should be monitored periodically especially before planning for pregnancy. Furthermore, our pregnant women and indeed some practitioner are ignorant about certain physiological changes in pregnancy. No doubt, in this contemporary age, pregnancy mask is still being treated with antifungal and bleaching creams. Nkwo in his own contribution warned that this practice must stop and that, practitioners should not capitalize on its low prevalence as an excuse for wrong diagnosis and treatment.

There is no doubt that nutritional deficiency is prevalent in pregnancy despite efforts to fortify foods and encourage micronutrient replacements. It thus became a common practice to supplement iron and folic acid; with the purpose of preventing anemia in pregnancy. However, the role of other micronutrients in the prevention of anemia and oxidative damage to red cell membrane has received little attention despite the established fact, that oxidative stress occurs during normal pregnancy,[12] and is further aggravated by the obvious depletion of some anti oxidant micronutrient minerals and vitamins.[34] Consequently, maternal and perinatal mortality and morbidity remained unacceptably high despite extensive efforts to curtail the trend. In an effort to improve the situation, our caregivers resorted to the practice where all sorts of micronutrient replacements were administered, without recourse to the peculiar micronutrient needs necessitated by our varied socioeconomic, cultural and geographic environment.[3] The resultant effect is the infiltration of the Nigerian market with numerous multivitamin and mineral preparations with diverse and varying compositions.

However, Ogamba and Colleagues, working on albino rats, has warned that Vitamin D Over-dosage is detrimental to fetal health. Extrapolating from bench to bedside, this is just the tip of the ice berg, as more studied on other micronutrients may expose the apparent over prescription of some minerals and vitamins.

Indeed, micronutrient replacement should be individualized and replacements based solely on needs assessment. With less than 5 years to 2015, and with the maternal and perinatal indices not showing considerable improvement, it appears disturbingly obvious, that the MDGs are unattainable irrespective of the enormous human and financial resources dedicated to the project.

The Annals of Medical and Health Sciences Research is grateful to all the Doctors practicing in Enugu State in particular and Nigeria in general, for the words of advice and moral support. Those words reinforce our commitment to attain greater heights in a state of apparent lean financial resources. We are also grateful to the Current Executive committee of Enugu state NMA, for always coming to our aid. We also need to solicit for financial assistance, so the journal can stay afloat. We shall continue to do our best and attains the goals which we have set for ourselves. Thank you