HEALTH INFORMATION FORUM PROCEEDINGS
THEME: Donation and distribution of physical health information materials: books, journals, newsletters, CD-ROMs...
THEME: Donation and distribution of physical health information materials:
books, journals, newsletters, CD-ROMs...
CHAIR: Anthony Costello, Professor of International Child Health at the
Institute for Child Health, London
PARTICIPANTS: Representatives of: British Medical Association, BMJ
Publishing Group, Book Aid International, Commonwealth Secretariat, Health
Information for Develpment, Health Communications Exchange, Healthlink
Worldwide, INASP, International Centre for Eye Health, International Health
Exchange, John Smith & Son, Nature, Nigerian Medical Forum, Nigerian Medical
Forum, Partnerships in Health Information, Pharmabridge, Healthnet Kenya,
Strategies for Hope, Teaching-Aids at Low Cost, University College London,
Wellcome Trust, WHO.
Email contributions to the meeting:
1. Graham Icke (Principal Scientist, Royal Perth Hospital, Australia)
free CD-ROMs (malaria education project). Postal expenses are often more
than production costs. As many as 25 per cent of CD-ROMs are 'lost in the
post'.
2. Lenny Rhine (Medical Librarian, University of Florida)
and/or developing country libraries about the resources of potential donors;
(2) How can we tie individual parnterships into larger projects?; (3) Is
there a means of co-ordinating the activities of donor groups?
3. Matko Marusik (Editor, Croatian Medical Journal)
Offers free subscription of CMJ to developing countries; (2) offers
possibility of publishing HIF proceedings in CMJ.
SPEAKERS
1A: Carolyn Sharples, Book Aid International [email protected]
1B: Rob Sarjant, Book Aid International - delivered on behalf of Nelly
Williams, [email protected]
2: Sallie Nicholas, BMA [email protected]
The following presentations are summaries. Please contact the individual
speakers if you need further details.
1A: OVERVIEW OF PARTNERSHIPS, CRITERIA AND MODELS OF DISTRIBUTION
What do we mean by partnership?
Book Aid International believes that partnership is based on mutual respect,
common objectives and a long term commitment to delivering successful
programmes
Providing health information is a key objective, therefore we actively seek
partnerships which will help to deliver health information to a large number
of people:
We have three main types of partner:
1. Ongoing large distributing partners who have a role in the local context
to target information to a range of organisations.
2. Ongoing partners, such as health colleges which have a pivotal role in
providing health training or care, and need a continuos supply of specific
information.
3. We also receive a number of requests from organisations which have highly
specialised needs.
So how do we decide where we work and who with?
Book Aid International's work must fit with local development objectives, no
matter how valuable we see our work we will only work where we are invited
to work, either by government or by recognised marginalised groups. We try
to work with the existing infrastructure and why many of our partners are
national bodies.
There are a large number of organisations in countries throughout the world
who ask us to provide books. We cannot possibly work with all of them, nor
would it be appropriate to do so. Our criteria policy, currently under
review, uses indicators such as low HDI, low income countries, language and
local infrastructure.
Our partners need to be committed to the programme. They are responsible for
local decisions and together we work to raise funds and develop the
programme. Partners have to be able to provide information on needs,
monitoring information and evaluation as part of the relationship.
Distribution models
A basic organisational belief which guides the development of our programmes
is the desire to reach the greatest number of people with the information we
send. So whilst we recognise that individuals have specific needs we also
recognise that it is not always practical to meet these needs directly. The
only example where we send books which will be used by individual doctors
and pharmacists is the PHARMAID scheme to send British National Formularies.
In Ghana and Nigeria we have distribution committees. These bring together
key information providers who oversee the distribution of books, monitor and
evaluate the programmes and direct the future development of the programme.
Direct support
In some countries it is not possible, nor practical to develop a
distribution committee approach. In Palestine there are political and
logistical constraints, such as the barriers to travel and specialist needs
which make it impossible to have a the same approach as we do in Ghana. So
in Palestine we send specific cases of books via the British Council, to
specific organisations such as the Medical Relief Society.
I think what all this illustrates is the need to fit with the local context
and not to fit a generic model to all situations.
1B GETTING THE RIGHT BOOK TO THE RIGHT PLACE
BAI is a small organisation and we ship over 700,000 good quality books and
journals a year. About 45,000 of these are medical.
1. Acquiring the right books
Firstly, we need to acquire the right stock. To help achieve this, we have
developed criteria for book donations. Books for donation must be in good
condition, relevant to our partners' needs, and within 10 years of
publication date - and for medical donations, to ensure the information is
up-to-date, we are a little stricter, and reduce this to 5 years. We only
accept journals from the last 2 years. We have an Acquisitions team which,
each year, develops a strategy based on partners' needs so as to target
publishers and other organisations in key subject areas.
Medical books and journals come from a variety of sources including
publishers such as Lipincott, Cambridge University Press and
Heinemann-Butterworth.
Book Buying - we raise money for book purchase in gap areas - especially in
areas such as basic health material where we get very little in the form of
donations. Recently, we have bought titles such as Where there is no Doctor
(one of our most requested books), Where Women have no Doctor, Helping
Health Workers Learn, the Oxford Handbook of Tropical Medicine, The Aids Handbook, A Book for Midwives, and Community
Health Care published by AMREF in Kenya.
2. Selecting the Right Books
The main selection tool that we use is a subject based requirements form
which BAI's own librarians use to select appropriate books. The form is
detailed to make sure subjects and levels are right, and the medical section
was designed with help from Neil Pakenham-Walsh. Partners also provide
background information on an application form.
3. Making Sure the Right Books were sent
Evaluation forms are sent annually to ongoing partners. Generally, feedback
is very encouraging.. Recent examples include:
Mrs Edna Adan Ismail - Director, Edna Adan Maternity Teaching Hospital,
Hargeisa, Somaliland
'These books have made our teaching programme distinguished because it has
enabled our organisation to become the only organisation that has a
specialised and up-to-date medical library in Somaliland ...... the books
also opened up a whole new world to our
students who had never seen a library in their lives before' She added 'We
have also been able to benefit from your books for the development of
Somaliland curriculum for training nurses and midwives. This will enable us
to carry out training in other locations in Somaliland.'
Whilst the situation in Somaliland may be worse than in many other
countries, as it tries to rebuild itself, the feedback is not untypical. For
example, the College of Health Sciences at the University of Nairobi is
going through difficult times:
'During the 1990's the library has not managed to buy as many titles as it
would have liked. Most of the books supplied by BAI were recent publications
and as such helped us to update our collection'. They added 'The Journals
are extremely useful since we still have not yet managed to revive our
annual journal subscription list. Please keep
this subscription support scheme active'.
Questions
Q: Do you have difficulties with Customs?
A: This is not as difficult as might be expected. Local partners help with
customs issues.
Q: Can students from developing countries while in London go and pick out
books at Book Aid? A: Yes - this sometimes is possible but in general people
need to work specifically with partners of Book Aid.
Q: Do you have opposition from publishers in Developing countries?
A: The issue is seen as important. Support from the South is good and it is
not seen as competition to local market.
THE BMA/BMJ INFORMATION FUND
Both the BMA and BMJ receive many requests from organisations and
individuals in developing countries and other areas of need. Until
recently, both had responded to these on an "ad hoc" basis, but had had no
formal mechanism for doing so, nor any specific funding. There was a clear
need for a more coherent system and support from BMA members for
establishing one. In April 2000, the BMA's Finance and General Purposes
Committee had approved a recommendation from the Journal Committee that a
small sum of money be set aside to provide material for developing countries
and other areas of need. The funds were drawn from the profits of the BMJ
Publishing Group and the BMA International Committee had political
responsibility for the administration of the fund.
The fund was administered on a day-to-day basis by a small steering group,
including Sallie Nicholas and John Hudson of the BMJ Publishing Group. It
had drawn up the following mission statement:
"To provide access to health-related information to appropriate institutions
in developing countries and other regions in need. Information should be
relevant, current and of high quality."
Appropriate institutions might include medical libraries, professional
bodies and healthcare institutions, the aim being to maximise limited
resources by ensuring availability to as wide an audience as possible. For
this reason, it was not possible to respond to requests from individuals.
In feeling its way forward, the group had faced a number of dilemmas -
including how to establish the bona fides of applicants, how to involve
recipients in the choice of materials to ensure their appropriateness and
how to ensure feedback. It had not advertised the fund, but responded to
requests from various quarters. So far it had arranged donations to a
number of Iraqi medical schools, the Nigerian Medical Forum, Hargeisa
University (Somaliland) and a London-based Refugee Doctor Postgraduate
Centre - this last donation being consistent with the BMA's work to help
refugee doctors in re-establishing their careers in the UK. It had also
arranged a special print run of the ABC of AIDS and Sexual Health for
distribution by Book Aid International.
The future approach was likely to be a "two-pronged" one, working with Book
Aid International with its established networks and expertise, but also
allowing scope to respond to individual requests.
SMALL GROUPS: 'IMPROVING THE COST-EFFECTIVENESS OF DONATION-DISTRIBUTION
PROGRAMMES'
Group A: Building partnerships and identifying needs
1. Interactions between donors, distributors and institutions are important
2. Personal communications are a priority
3. Need to register individual organizational needs
4. Health library partnerships are essential
5. Need to acknowledge gap between what is available and what is needed
6. Use of IT for communication
Group B: Working with donors (eg publishers) to get what is needed
1. Importance of working with donors directly
2. Consider donor brokerage so requests don't 'have to make rounds'
3. Might publishers pay for distribution?
4. Should Northern publishers be encouraged to sponsor over-runs in
publication for developing countries?
Group C: Coordinating distribution (N-N, N-S, S-S)
1. Coordination of distribution needs to be improved and requires a
conceptual shift
2. When material is in the South, how do we know it gets to where it needs
to be?
3. Need to strengthen infrastructure for the 'last mile'
4. More knowledge is needed about what works locally.
FINAL DISCUSSION
Donated CD-ROMs often get 'lost in the post'.
If the government is the local distributor for publications, then the
materials are very unlikely to get to where they are needed. There is a
need to mix private and public distributors locally.
Perhaps a common database of available materials should be established among
donor-distributors to make it easier for Southern institutions to identify
what is available.
Perhaps the Millennium Dome in Greenwich could be converted to serve as a
donation-distribution warehouse!
The HEALTH INFORMATION FORUM is run as an activity of the INASP-Health Programme.
Contact Dr Neil Pakenham-Walsh Email: [email protected] Web: www.inasp.org.uk
The WORLD HEALTH ORGANIZATION headquarters is based in Geneva,
Switzerland. Email: [email protected] Web: www.who.int