Regional publication in African Emergency Care - where should you publish?

We are often asked id AfJEM is a good place to publish.  The best answer is that it depends on your target audience.  In fact, identifying your target audience and then aiming to publish in a journal with the best impact in that group should be a key consideration for any publication. This is a vital consideration to ensure that your paper reaches the audience that will benefit most from the content.  

African emergency care is a regional endeavour and as such must be considered regionally.  Much of the research conducted here, only have relevance here and no where else. Oddly there is no way to measure regional impact of journals. A work-around is to calculate the regional impact of a journal by considering its regional five-year h-index; by including only the citations of papers published in the last five years the regional h-index can provide a reasonable consideration of regional impact.  
So how do the rankings look for African emergency care AfJEM is ranked fourth out of 38 emergency medicine journals that cited published African emergency care related research between 2012 and 2016.  The World Journal of Emergency Surgery, Burns and Injury are in joint first place.  Resuscitation is joint fourth with AfJEM.  See the graphic below for the full ranking by h-index