www.thelancet.com/lancetgh Vol 4 November 2016 e
Irish Centre for Fetal and Neonatal Translational
Research, Department of Obstetrics and
Gynaecology, University College Cork, Cork, Ireland
(GM); Gravida: National Centre for Growth and
Development, University of Auckland, Auckland,
New Zealand (GM); Division of Epidemiology and
Biostatistics, School of Public Health, Faculty of
Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa (GM); Oregon Health
and Sciences University, Department of Family
Medicine, Portland, OR, USA (LK); Department of
Paediatrics, Kothari Medical Centre, Kolkata, India
(DD); Department of Biochemistry and Genetics,
La Trobe Institute for Molecular Science, La Trobe
University, Melbourne, VIC, Australia (TMAS);
Department of Geriatrics, University Hospitals
Leuven, Leuven, Belgium (MRL); and Faculty of
Medicine, Department of Emergency Medicine,
University of British Columbia, Vancouver, BC,
1 Lawn JE, Blencowe H, Waiswa P, et al, for
The Lancet Ending Preventable Stillbirths Series
study group, with The Lancet Stillbirth
Epidemiology investigator group. Stillbirths:
rates, risk factors, and acceleration towards
2030. Lancet 2016; 387: 587–603.
2 Blencowe H, Cousens S, Jassir FB, et al, for
The Lancet Stillbirth Epidemiology Investigator
Group. National, regional, and worldwide
estimates of stillbirth rates in 2015, with
trends from 2000: a systematic analysis.
Lancet Glob Health 2016; 4: e98–108.
3 WHO. Making every baby count. Geneva:
World Health Organization, 2016.
pdf?ua=1 (accessed Aug 19, 2016).
4 Wikipedia. Stillbirth. https://en.wikipedia.
id=730929233 (accessed Aug 19, 2016).
5 Heilman JM, West AG. Wikipedia and
medicine: quantifying readership, editors,
and the signiﬁ cance of natural
language. J Med Internet Res 2015; 17: e62.
6 Laurent MR, Vickers TJ. Seeking health
information online: does Wikipedia matter?
J Am Med Inform Assoc 2009; 16: 471–79.
7 Google Play. Medical Wikipedia (Oﬄ ine).
(accessed Aug 19, 2016).
8 Wikimedia Foundation. Wikipedia zero.
Wikipedia_Zero (accessed Aug 19, 2016).
9 Heilman JM, Kemmann E, Bonert M, et al.
Wikipedia: a key tool for global public health
promotion. J Med Internet Res 2011; 13: e14.
10 Wodak SJ, Mietchen D, Collings AM, Russell RB,
Bourne PE. Topic pages: PLoS computational
biology meets Wikipedia. PLoS Comput Biol
2012; 8: e1002446.
Medical journals and
Wikipedia: a global
Approximately 7000 stillbirths
occur daily worldwide, and the vast
majority of them (98%) take place
in low-income and middle-income
countries (LMICs).1 Despite this
enormous burden, progress to reduce
the death toll is slow and insuﬃ cient.2
WHO released its Making every baby
count3 guide in 2016, which includes
strategies aimed at addressing the
challenge of stillbirths. Given the ﬂ urry
of activity and attention on stillbirths
from the Lancet Stillbirth Epidemiology
investigator group and WHO, we expect
that the wealth of information about
stillbirths that is generated will ﬁ lter
down in a timely manner to where it is
needed most: the general public.
As is often the case for Wikipedians,
we found that the stillbirth page4 on
the English language Wikipedia was
missing important information—eg,
the major causes of stillbirth (malaria
and syphilis) were not mentioned,
and details on epidemiological aspects
were scarce.1 Unsurprisingly, the
Wikipedia pages on stillbirth in about
20 other languages were less detailed
than the English language version.
This worried us because not only
is Wikipedia the world’s most used
source of health information online,
but it is also one of the most widely
used sources by medical students,
doctors, and other health-care
providers.5,6 It is not difficult to
imagine that the ﬁ rst online port of
call for a woman, her partner, or her
family following a stillbirth would be
Wikipedia. Furthermore, many policy
makers and other key stakeholders
also read Wikipedia.
Wikipedia is particularly relevant for
LMICs, where internet access is often
slow and expensive. We have been
involved in developing mobile apps
for offline use which contain all of
Wikipedia’s anatomy, pharmacology,
medicine, and sanitation content in an
attempt to address this issue. We have
seen tens of thousands of downloads
of the apps, with the majority from
LMICs.7 There is clearly a huge unmet
need for health-related information,
to the extent that some mobile
network operators in LMICs do not
charge for data costs when users are
accessing Wikipedia (Wikipedia Zero8).
However, this generous practice has
been cautioned against because some
people feel it infringes upon internet
neutrality (the principle that internet
providers should treat all data equally).
In addition to the stillbirth article
there are many others on Wikipedia
associated with global health that
require further attention. Wikipedia
has the potential of being bolstered
as a key tool for global public health
promotion.9 However, Wikipedia
struggles to attract medical doctors
or other trained health professionals
as editors. We echo previous authors
in inviting the medical community—
and in particular medical journals—to
incentivise Wikipedia editing with
the goal of bringing about increased
access to reliable, understandable,
and up-to-date health information9
in multiple languages. PLoS
Computational Biology, for example,
encourages its authors to post topics
on Wikipedia.10 Promoting inclusive
and equitable learning opportunities
for all speaks to the aspirations of the
Sustainable Development Goals. We
suggest that medical journals actively
promote and incentivise Wikipedia
editing by the health-care community
so that the most commonly used
source of online health information is
as reliable as possible.
MRL reports a Research Foundation Flanders PhD
Fellowship grant, and personal fees from Flanders’
Agricultural Marketing Board, Alexion
Pharmaceuticals, and Novartis. All authors are
members of Wikimedia projects including Wikipedia
Copyright © The Author(s). Published by Elsevier Ltd.
This is an Open Access article under the CC BY license.
*Gwinyai Masukume, Lisa Kipersztok,
Diptanshu Das, Thomas M A Shafee,
Michaël R Laurent, James M Heilman