AFRO-NETS> Local capacities to create and adapt health information

["Dr N.M.Pakenham-Walsh" <INASP_Health@CompuServe.COM>]

Local capacities to create and adapt health information
-------------------------------------------------------
International consultation

Dear colleagues on AFRO-NETS,

Local 'health information providers' - whether ministries of health, 
NGOs, training colleges, publishers, or libraries - are best placed 
to create and adapt information for local healthcare workers. Despite 
information technology, however, health workers continue to lack ac-
cess to the information they need to learn, to diagnose, and to save 
lives.

You are warmly invited to take part in the first 'HIF-net at WHO' in-
ternational consultation of users and providers of health informa-
tion. The theme is: 

'LOCAL CAPACITIES TO CREATE AND ADAPT INFORMATION FOR HEALTHCARE 
WORKERS IN DEVELOPING COUNTRIES'

This 4-week consultation has been commissioned by the International 
Institute for Communication and Development, in the Netherlands. 
Working with the UK Department for International Development and the 
DOT Force, the IICD have asked us to help identify ways to strengthen 
local capacities to create and adapt health information. In particu-
lar, we are keen to identify innovative ways of using information and 
communication technologies.

Below are some QUESTIONS FOR DISCUSSION and a brief DISCUSSION PAPER 
to introduce the subject. Contributions are welcome from all 'HIF-net 
at WHO' participants, whether you are based in the North or South, 
publisher or librarian, researcher or community health worker.

All contributions posted on 'HIF-net at WHO' will receive a free copy 
of the new printed publication 'INASP Health Links', a gateway to in-
formation for health professionals, publishers and librarians in de-
veloping and transitional countries <www.inasp.info/links/health>.

Please send your contributions to <hif-net@who.int>

If you would like to follow the debate, join 'HIF-net at WHO' - email 
your name, organization, and brief description of your professional 
interests to <health@inasp.info>.

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IN ADDITION, we would like to hear about PROJECTS in Africa, South 
Asia and other parts of the developing world which involve the crea-
tion and adaptation of information for healthcare workers. We are 
particularly interested in practical experience and lessons learned 
in the use of information and communication technologies. We are also 
interested to hear about your ideas for future projects.

If you would be interested to promote your project or idea, or to 
recommend a project that we might profile, please write about it on 
'HIF-net at WHO' or send an email to <health@inasp.info>.

Four projects will be selected for presentation to DFID and other 
funding agencies on 11-13 March at an international workshop in Dar 
es Salaam, Tanzania, as models for future funding. A small honorarium 
of up to 200 US dollars (or sterling equivalent) will be paid to each 
of the four selected projects in recognition of the time required to 
complete the profile. In addition, travel sponsorship may be avail-
able for one or more project representatives to present their project 
at the workshop in Tanzania.

********************************************************************

At the end of the process, summaries of the discussion and descrip-
tions of selected projects will be posted on 'HIF-net at WHO'.

With thanks,
Neil

Neil Pakenham-Walsh
Programme Manager, INASP-Health
Moderator, HIF-net at WHO
mailto:health@inasp.info

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QUESTIONS FOR DISCUSSION

1. Why is it important to strengthen local capacities to create and
   adapt health information?
2. How can local producers assess whether a product is actually
   needed?
3. If a product is needed, how can local producers find out if some-
   thing similar already exists nationally or internationally, which
   might minimize or avoid duplication of effort?
4. How can local producers access existing source information on the
   subject? From international sources, from local sources, from col-
   leagues? 
5. How can local producers transform content from a 'caterpillar' to 
   a 'butterfly' - from awkward pieces of 'source information' into 
   an attractive product that is easy to use, reliable, and relevant
   in form and content to the needs of end-users? 
6. How can local producers distribute their information more effec-
   tively to end-users? 
7. How can local producers share their information with others world-
   wide for further reproduction, adaptation, and distribution? 
8. How can local producers know if their products make a difference 
   to the quality of healthcare delivery? How can they learn from the 
   feedback of their end-users? 
9. How can information technology and access to the Internet make a 
   difference to the above processes? 
10. What can be done by international organizations and others to im-
    prove access to essential 'source information' - existing local 
    and international publications? 
11. What can be done to increase the visibility and distribution of 
    new local health information materials? 
12. What are the potential benefits of South-South communication and 
    sharing of experience among 'health information providers'? How 
    can this be facilitated?

*******************************************************************

DISCUSSION PAPER:

LOCAL CAPACITIES TO CREATE AND ADAPT INFORMATION FOR HEALTHCARE 
WORKERS IN DEVELOPING COUNTRIES

In his message to 'HIF-net at WHO' today (30 January 2002), Ibrahima 
Bob (Secretary-General of AHILA, the Association for Health Informa-
tion and Libraries in Africa) said:

"I am really worried about this policy of giving priority to the 
availability of top technology rather than reinforcing essential 
means of communication and the trickling up of local relevant experi-
ences in health for the developing world."

Despite its massive potential, the current global information explo-
sion has had surprisingly little impact on access to practical infor-
mation for frontline healthcare workers in developing countries, es-
pecially those working in primary care and district hospital set-
tings. Healthcare workers in developing countries continue to lack 
access to the basic information they need to learn, to diagnose, and 
to save lives.

RELIABILITY AND RELEVANCE 
Improving access to *reliable* and *relevant* information for health-
care workers is potentially the most cost-effective way to enhance 
the delivery of healthcare and reduce the burden of disease and death 
in developing countries.

It is relatively easy to find *reliable* health information - there 
are hundreds of 'reliable' resources on the Internet. But it is hard 
to find information in a form that is directly *relevant* to individ-
ual healthcare workers in developing countries: relevant to their 
level of training, relevant to available diagnostic and treatment re-
sources, relevant in terms of language and vocabulary, relevant to 
local disease patterns and health priorities, relevant to local 
healthcare infrastructure . . . the list goes on.

Many observers have noted the need to promote 'a reading culture', 
and governments in developing countries are increasingly concerned to 
enhance continued professional development of healthcare workers. But 
this can only be achieved if readers have access to materials that 
are easy to use, rewarding, useful and relevant to their everyday ex-
perience.

LOCAL CREATION AND ADAPTATION FOR LOCAL RELEVANCE 
Local 'health information providers' - whether ministries of health, 
NGOs, training colleges, publishers, or libraries - are best placed 
to create and adapt health information for local healthcare workers. 
They are best placed to understand their information needs, use of 
language, and educational level. They are best placed to understand 
the context of how the information will be used: socio-economic fac-
tors that affect healthcare interactions, levels of available re-
sources (e.g. drugs, diagnostic equipment), health system logistics, 
cultural factors, and local disease profiles.

A recognized priority area for action is to "Strengthen the local 
production, translation, adaptation, and dissemination process in re-
source-poor countries. National and local players - ministries of 
health and education, local publishers, NGOs - are best placed to 
produce many types of materials. Their capacity needs to be supported 
as part of any long-term strategy to improve information access." [1]

THE CONVERGENCE OF RELIABILITY AND RELEVANCE 
Healthcare is too important to be influenced by untested, potentially 
harmful information. In practice, collection and dissemination of 
'local knowledge' is not enough. There is plenty of overlap between 
'creation' and 'adaptation' of content. Generation and dissemination 
of new content in and by developing countries is relatively weak and 
requires much greater support.

Any piece of 'new content' is in practice generally a synthesis of 
adapted content from other sources (formal and informal publications, 
own experience, others' experience), plus the authors' interpreta-
tions, beliefs, and (in research articles) new data thrown in. In 
other words, generation of new content *plus* access to source con-
tent, including international or 'Northern' sources, are part of the 
same.

HOW TO STRENGTHEN LOCAL CAPACITIES TO CREATE AND ADAPT CONTENT? 
How can the processes of local content creation and sharing can be 
best supported? Possibilities include [ref 1]:

* training and technical support (writing, editing, adaptation,
  evaluation); 
* access to and application of information technology, including
  Internet connectivity; 
* joint initiatives that involve local producers and end-users
  throughout the publication cycle, from initial needs assessment and
  planning through to evaluation of use and impact assessment.

Information technology has the potential to increase dramatically the 
ability of local 'health information providers' to produce locally 
relevant content, whether this is in electronic or printed form, vis-
ual or audio.

But information technology is of limited value on its own. What is of 
enormous potential value is the opportunity to link with partners 
around the world, to access 'source' information, and to disseminate 
locally created or adapted resources for the benefit of others. There 
is a huge opportunity for local people and organisations to generate 
and share their own knowledge and ideas, appropriating and adapting 
information and communication tools as necessary.

International organizations have spent an increasing amount of time 
to try to understand the needs of end users, and tailoring their own 
publications accordingly. But is this the best approach? Should in-
ternational organizations in fact spend more time trying to under-
stand the needs of local 'health information providers'. If local 
'health information providers' are best placed to create and adapt 
locally relevant information, surely the priority for international 
organizations should be to strengthen their capacities to meet the 
needs of their end users.

ICTs are increasingly available to creators and adaptors of local 
content, and (less so) to end-users. How can international organiza-
tions, local creators and adaptors and others work more effectively 
together to meet the needs of end users? What channels are available 
for sharing of local content, whether locally, with other southern 
end-user groups, or internationally? Formal and informal printed pub-
lications, email, CD-ROM, internet? How can they be enhanced to fa-
cilitate the sharing of local content? What are the training, IT and 
other requirements of local repackagers of information? What new 
channels can be used?

With the increasing availability of ICTs to access, adapt, and share 
materials, 'health information providers' worldwide can work together 
to ensure that future healthcare workers have access to information 
that is reliable and relevant.

Reference: 
[1] WHO-HIF Cooperation Group, INASP Newsletter, February 2001.
http://www.inasp.info/newslet/feb01.html#6

*********************************************************************

About IICD: 
IICD's mission is to assist developing countries to utilise the op-
portunities offered by Information and Communication Technologies 
(ICTs) towards realising sustainable development. In developing its 
services, IICD is guided primarily by the needs as articulated by the 
developing countries themselves, based on the principle of local own-
ership. The best practices and lessons learned are documented and 
disseminated internationally through a Knowledge Sharing programme. 
Contact: 
Peter Ballantyne <PBallantyne@iicd.org>

About INASP: 
INASP is a co-operative network of partners whose aim is to improve 
world-wide access to information and knowledge. In particular its 
mission is to improve the flow of information within and between 
countries, especially those with less developed systems of publica-
tion and dissemination. The INASP-Health programme is specifically 
concerned with improving access to reliable, relevant information for 
health professionals in developing and emerging countries. INASP was 
established in 1992 by the International Council for Science (ICSU), 
as a programme of the Committee for the Dissemination of Scientific 
Information (CDSI), previously known as ICSU Press. 
Contact: 
Neil Pakenham-Walsh <health@inasp.info>

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