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Dear LIS-medical colleagues,

From the postings I have read on LIS-medical over the past 2 years, I am
aware that many on this list are interested in issues of information for
health professionals in developing countries. 

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 access to the
information they need to learn, to diagnose, and to save lives.

I would like to invite you to take part in the first 'HIF-net at WHO'
consultation of users and providers of health information. 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 particular, 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 information
for health professionals, publishers and librarians in developing and
transitional countries <www.inasp.info/links/health>.

Please send your contributions to <[log in to unmask]>. 

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
<[log in to unmask]>.
 
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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 creation 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 <[log in to unmask]>.

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 available for one or more project
representatives to present their project at the workshop in Tanzania.

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At the end of the process, summaries of the discussion and descriptions 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
<[log in to unmask]>.
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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 something
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 colleagues?
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 effectively to
end-users?
7. How can local producers share their information with others worldwide
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 improve
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?

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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 Information 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 experiences in health
for the developing world."

Despite its massive potential, the current global information explosion has
had surprisingly little impact on access to practical information for
frontline healthcare workers in developing countries, especially those
working in primary care and district hospital settings. Heathcare 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 healthcare
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 individual healthcare
workers in developing countries: relevant to their level of training,
relevant to available diagnostic and treatment resources, 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 experience.

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 factors that affect healthcare interactions,
levels of available resources (eg 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
resource-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' interpretations,
beliefs,
and (in research articles) new data thrown in. In other words, generation
of
new content *plus* access to source content, 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, visual 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 international
organizations in fact spend more time trying to understand 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 organizations, 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 publications, email, CD-ROM,
internet? How can they be enhanced to facilitate 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

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About IICD: IICD's mission is to assist developing countries to utilise the
opportunities 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 ownership. The best practices
and lessons learned are documented and disseminated internationally through
a Knowledge Sharing programme. Contact: Peter Ballantyne
<[log in to unmask]>

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 publication 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 <[log in to unmask]>