Agnes Chikonzo Librarian University of Zimbabwe Zimbabwe

Transcription

1 Date submitted: 08/07/2009 Access to Health Information: a Case Study of the University of Zimbabwe (UZ) College of Health Sciences (CHS) Digital Library Agnes Chikonzo Librarian University of Zimbabwe Zimbabwe achikonzo@uzlib.uz.ac.zw Meeting: 145. Health and Biosciences Libraries WORLD LIBRARY AND INFORMATION CONGRESS: 75TH IFLA GENERAL CONFERENCE AND COUNCIL August 2009, Milan, Italy Abstract: The paper focuses on the UZ- CHS Digital Library and how it has enhanced service delivery by having users have access to the vital health information available world wide. It first gives an outline of how the digital health information came to UZ-CHS Library when the CD-ROM MEDLINE service was introduced in The CD-ROM MEDLINE service revolutionized the pattern of library use in the CHS Library. The service was most welcome by the library users because it offered an ideal information technology for Africa. In 1984 UZ CHS Library became the national focal point for the provision of health information. As a result, the CHS Library was mandated to disseminate health information to health professionals through out Zimbabwe. To fulfill that mandate, in 1987, the UZ-CHS Library started producing the Current Health Information Zimbabwe (CHIZ), an in-house quarterly bulletin in which articles downloaded from relevant abstracts from MEDLINE were listed. The paper goes on to highlight how the CHS Library ensured that users had access to digital indigenous health information through this bulletin. The paper then outlines how user s health information needs were met through the digital health information document delivery service. In 2002 the Multilateral Initiative on Malaria (MIM) document delivery project between the UZ-CHS Library and National Library of Medicine was started. 1

2 The paper ends by focusing on how the UZ-CHS digital Library is making users have access to the current digital health information, through the Internet, HINARI database, PubMED, electronic journals the library is subscribing to, e-resources available through Open Access and the Free-For-All Document delivery service. From the above, it is possible to build a digital library on a shoestring budget and the UZ CHS Digital Library is a good example. BACKGROUND The University Of Zimbabwe College Of Health Sciences Library (formerly known as the University of Zimbabwe Medical Library) was established in The library was established to serve staff and students of the then Godfrey Huggins School of Medicine. The College of Health Sciences Library (CHS) is a branch of the University of Zimbabwe Main Library. Unlike other University of Zimbabwe branch libraries, CHS Library is situated in the Parirenyatwa Hospital complex which is six kilometres from the University of Zimbabwe campus, on the same campus as the other departments of the College of Health Sciences. The College of Health Sciences Library is historically, and by designation, the country's national focal point for health information and it is the only comprehensive source of biomedical and health information in Zimbabwe. The College of Health Sciences has 24 departments. It offers 20 postgraduate courses, of which 5 are diploma courses and 20 are degree courses. The student enrolment as of March 2006 is about There are 138 academic staff and 9 Senior Nonacademic staff, 52 Junior Non-Academic staff, 80 Technical staff and 42 Secretarial staff. The vision of the CHS Library is: To be the leading provider of health information in the region. The mission is: To effectively and efficiently support the teaching, learning and research functions of the College of Health Sciences, by providing ready access to relevant sources of appropriate and current information. As previously stated, the CHS Library was established to serve the staff and students of the then Godfrey Huggins School of Medicine. However in 1983, the CHS Library was designated the National focal point for the provision of health sciences information in Zimbabwe, which means, the CHS Library has an obligation to disseminate health information to registered health professionals registered with the CHS library and provincial hospitals in Zimbabwe. Collection and Users The collection in the CHS Library comprises of books; both print and electronic, journals; both print and online, CD-ROMs, theses and dissertations and video tapes. The loan period varies from one day for Reserve Books, three days for books on Short Term and two weeks for ordinary books. Theses and dissertations as well as video tapes do not go out of the library. 2

3 The following categories of users may be registered for access to the library s resources as borrowers or readers: - 1. Academic and non academic staff of the College of Health Sciences 2. University of Zimbabwe students and staff from other departments 3. Registered members of the Health Professions Council of Zimbabwe Approved readers and borrowers have to pay registration fees. These fees are regularly reviewed. Daily passes for users who do not want to become members are chargeable. Entry of users in the library is carefully controlled at all times. Membership identity cards must be shown on entry all the times. Services The CHS Library Reference Service provides assistance in finding and using printed and electronic materials for medicine, pharmacy and biomedical sciences. The Reference Librarian assists users in locating sources of information, selecting and using resources for reports, assignments, research, and learning to use library and information resources. Librarians at the reference desk also provide individual assistance to staff and students who want more detailed knowledge of information resources in a subject area. There are eighteen computers with Internet access in the reading room for the use of students and one machine that is dedicated to CD-ROM searches. There are also eleven computers, also connected to the Internet, for use by CHS staff. An outreach service aims at providing health professionals, wherever they are located in Zimbabwe, with information. Outreach services available are: Literature searches on any biomedical subject of interest Verification of references and other bibliographic services Electronic-mail services to institutions and individuals worldwide Provision of photocopies of journal articles on request Information Literacy Skills Training (ILS) While the CHS Library continues to enhance the quality of research and learning support through stock renewal, it also seeks to enhance the ability of users to access electronic resources in particular, and print resources in general. As a result, information literacy skills training was introduced to CHS Library users in Through this accessible component, students are taught information retrieval and storage and keyboarding skills. The information literacy skills is collaboration between Communication Skills Unit, the Library and the Computer Centre. The collaborative effort of the three units gives students skills that enable first year students to retrieve, use and store information. The CHS library staff is responsible for imparting information literacy skills to library users to enable them to become independent lifelong learners. Users are now in a position to effectively select, search and evaluate information sources. In 2003, 240 medical students were equipped with ICT skills that enable them to utilize information for learning, per year. It must be noted, however, that information literacy skills training is a continuous process. Duration and levels of training vary 3

4 depending on the need of different groups. The CHS library staff tailors its ILS products for each of these groups. EARLY DIGITAL LIBRARY Digital health information came to the University of Zimbabwe, CHS Library when the CD-ROM MEDLINE service was introduced in MEDLINE, the computerized version of the printed Index Medicus, then, indexed over six and a half million articles from 3400 biomedical journals dating back to The abstracts of these citations could be simultaneously retrieved and printed out from a second disc running on a second disc drive/player. The CD-ROM MEDLINE service revolutionized the pattern of library use in the CHS Library. The service was most welcome by the library users because it offered an ideal information technology for Africa. According to Diana Rosenberg (1997) writing about MEDLINE in the University of Zimbabwe Medical Library It is now not only used for access to journals but also for general browsing. A member of the academic staff said that she used it for patient care, management, teaching and research. A postgraduate student said she used it for general reviews of a subject as well as for specific subject searches. Many found that they did not need to go further than the abstract; this provided enough information. A survey carried out in 1995 found that 64% of users found abstracts useful, 20% found they usually provided all the required information and 53% said they sometimes provided all the required information (Rosenberg 1997, p.338). The MEDLINE CD-ROM databases proved to be user friendly and as a result it was most welcome by library users, library staff, physicians, researchers as well as health professionals because they were able to get good search results after very little training. By 1990, the CHS Library had two CD-ROM drives. The library was determined to acquire more PCs and from two CD-ROM drives in 1990, the CHS library had 27 by Use of electronic mail was introduced in 1992 with the introduction of Healthnet and was mainly used to make and receive requests and to transmit MEDLINE searches to users within Zimbabwe. CHS Library users therefore, had access to digital health information as far back as The ease of access to international medical literature through CD-ROM and caused a rocketing rate of interlibrary loans. By 2001 the following CD-ROM databases were available in the UZ CHS Library: 1. Africa Health Anthology : A collection of 12 bibliographic databases containing references relating to African health issues. 2. AIDSearch : Made up of three files, AIDSDRUGS, AIDSTRIALS and AIDSLINE, this database offers nearly records on Acquired Immunodeficiency Syndrome and related topics. References are derived from key files, abstracts of meetings, international conferences and symposia on AIDS. 4

5 3. Best Evidence : Included contents of American College of Physicians Journal Club and Evidence Based Medicine. Critical reviews of the contents of 90+ journals on internal medicine and other specialities. Citations and abstracts from 4300 main medical journals. 4. Cinahl : Citations and abstracts from 1200 English language journals. Covers nursing and allied health disciplines. 5. Cochrane Library of Systematic Reviews: The best single source of reliable evidence about the effects of health care. It also includes abstracts of reviews of effectiveness, Controlled Trials Register, etc. The figures and graphs in Cochrane Reviews display the Peto Odds Ratio and the Weighted Mean Difference by default. 6. Medline : The computerised version of the printed Index Medicus, indexes over six and a half million articles from biomedical journals. Medline is the United States National Library of Medicines database of the world s biomedical journal literature 7. Popline- 2000: A wide range of sources providing citations and abstracts on reproductive health and demographic topics. 8. Psyclit : Produced by the American Psychological Association; contains the best world s serial literature in psychology and related disciplines. Covered over journals. Also contains summaries of English language Chapters and books in psychology and related disciplines. 9. Rehabilitation and Physical Medicine : Citations and abstracts from sources specializing in all aspects of rehabilitation. DIGITAL INDIGENOUS HEALTH INFORMATION Current Health Information Zimbabwe (CHIZ) As already stated, the UZ CHS Library became the national focal point for the provision of health information in The CHS Library was mandated to disseminate health information to health professionals through out Zimbabwe. To fulfil that mandate, in 1987, the CHS Library started producing the Current Health Information Zimbabwe (CHIZ), an in-house quarterly bulletin in which articles downloaded from relevant abstracts from MEDLINE were listed. Users were requested to contact the Library if CHIZ was not available at their workplace. CHIZ was mailed to users. To receive CHIZ, users were asked to submit their name, designation and address to the library and were added to the mailing list. Photocopies of the abstracted articles were made available on request. According to Rosenberg (1997), the bulletin was very successful. It enhanced the recognition of the Medical Library services in the eyes of the Ministry of Health, the government of Zimbabwe and the World Health Organization. 5

6 Utano Database The Medical Library further digitized health information and in 1993, the UTANO database Volume 1(1), a bibliography of local unpublished health literature was published. This volume covered the period It was initially sponsored by IDRC. According to Rosenberg (1997), University of Zimbabwe Medical Library itself has placed quite a lot of emphasis on promoting local and African literature. The Utano bibliography (also a database) lists local and unpublished literature. The library contributes the Zimbabwe entries to the African Index Medicus. DIGITAL HEALTH INFORMATION DOCUMENT DELIVERY Digital document delivery has been used as an effective method of disseminating digital health information at the CHS Library. This has happened between the University of Zimbabwe, College of Health Sciences Library and the National Library of Medicine (NLM). In 2002 the Multilateral Initiative on Malaria (MIM) document delivery project was started between the National Library of Medicine, the MIMcom (Communications Working Group of MIM) and the University of Zimbabwe, College of Health Sciences Library (then Medical Library) to provide information on malaria. Eight countries namely Cameroon, Ghana, Kenya, Malawi, Nigeria, Tanzania, Uganda, Zambia and Zimbabwe were involved in the project. The National Library of Medicine heads up MIMcom for the United States and the NLM works with other partners who helped fund the telecommunications set up the satellite and other forms of telecommunication at malaria research sites in Africa. This enabled the research sites to have and Internet access. One of the main requests from the research centres was that they would have access to journal articles. The NLM then set up a pilot project to provide document delivery for malariarelated research to these research centres. The University of Zimbabwe CHS library was chosen to become a DOCLINE library serving the MIM research sites. The main reason Zimbabwe was chosen was because at that time the College of Health Sciences Library had current subscriptions to over two hundred journal titles and long runs from previous years. Requests were made through the MIMCom site and these were ed to College of Health Sciences Library, which filled the requests through their own collection first and only sent to NLM for those items that were not available in the library. The library satisfied requests from other MIM libraries and helped order from the National Library of Medicine those materials not available in its collections. CURRENT DIGITAL HEALTH INFORMATION Healthnet In Zimbabwe different forms of ICTs have been used to disseminate digital health information on several health issues. Healthnet was introduced in the CHS Library in In Zimbabwe; SatelLife s HealthNet network had a significant impact on institutional and national development in the health sector. The Health Net node in Harare provides low-cost and health information services to the health community. Raw data is sent electronically from the districts to the Provincial centres 6

7 for analysis and compilation into summaries and charts, forwarded onto the Health Ministry, and then resent to the districts via Health Net. Ministry of Health officials use HealthNet to collect and disseminate weekly surveillance reports on epidemiology and disease control to health centres around the country. Ministry personnel also use HealthNet for many other professional purposes including ordering drugs from central stores and distributing assignments to students on field attachments. In addition, other health professionals, including users in all major city health departments, blood transfusion services and several laboratories use Healthnet on a regular basis. Several of these work in the rural areas, and for them, HealthNet is their only viable connection. The University of Zimbabwe, College of Health Sciences Library uses the HealthNet to disseminate digital health information on various health issues to provincial hospitals. In turn health personnel in provincial hospitals also send their information requests to the Outreach Librarian. Responses to those requests are also sent through the HealthNet . The library also uses the Healthnet in a discussion group of malaria. To enhance access to malaria up-dates, these are posted for the benefit of medical students and staff on the notice board. PERI University libraries in developing countries are also benefiting from the Program for the Enhancement of Research of Information (PERI) under the sponsorship of the International Network for the Availability of Scientific Publications (INASP). Through PERI, donors have paid subscription on behalf of libraries in Africa to access web-based journals (Chifwepa 2003). INASP has played an important role in providing developing countries with vast digital information via the Internet. Through the PERI s health link, the CHS Library is able to access vast information on almost all health issues including HIV/AIDS. This information is made available to researchers, students, staff and health practitioners in different parts of the country and can also be repackaged to benefit the rural folk. There is also a facility of document delivery and users have access to full-text journal articles. As already stated, CHS Library has been training library users on accessing digital health information through the information literacy skills programme so that searching information on the Internet is not a nightmare. HINARI In 2000, the Health InterNetwork for the Availability of Research Initiative (HINARI) was launched by the Secretary General of the United Nations, led by the World Health Organization (WHO). The Health Internetwork was created to bridge the digital divide in health, ensuring that the relevant technologies to deliver it are widely available and effectively used by health personnel, which include professionals, researchers, scientists and policy makers. HINARI has brought together public and private partners under the principle of ensuring equitable access to health information. The core elements of the project are content, Internet connectivity and capacity building. 7

8 The HINARI enables developing countries to gain access to one of the largest collections of biomedical and health literature. Over journal titles are now available to health institutions in 113 developing countries, benefiting many thousands of health workers and researchers, and in turn, contributing to improved world health. When HINARI was introduced, University of Zimbabwe, College of Health Sciences Library welcomed this move and immediately registered for the service. CHS Library is able to access the HINARI database and make available information which was not available to its library users, including those in provincial hospitals through out Zimbabwe. The CHS ILL Librarian checks for articles requested by library users are available on HINARI, and if so advices the requestor, provided the requestor have access to HINARI. If not, the College of Health Sciences outreach librarian accesses the article and sends it through electronic mail to the user or the relevant library. PUBMED PubMed is the Internet version of MEDLINE. PubMed is a service of the U.S. National Library of Medicine that includes over 16 million citations from MEDLINE and other life science journals for biomedical articles back to the 1950s. PubMed includes links to full text articles and other related resources. Within PubMed the Loansome Document Ordering System allows users to order documents. Loansome Doc allows users to order full-text copies of articles from a medical library (local fees and delivery methods may vary). Users must register to use this service. To order documents using PubMed, users perform a search and select the desired citations. When they have finished marking their selections they can order the articles. The full-text of articles for some journals are available via a link to the publisher's Web site from the PubMed Abstract or Citation display. PubMed has proved to be a very useful database for health professionals in Zimbabwe. Free-For-All In August 2005, the Free-For-All document delivery was introduced to developing countries. Free-For-All is an international collaboration of libraries whose mission is to provide underserved nations with health science journal articles for free. The CHS Library has registered for this service and is able to get online full-text journal articles not available in the CHS Library for free. LESSONS LEARNT It is possible to build a digital library on a shoestring budget and the UZ CHS Library is a good example. The MEDLINE CD-ROM database and computer equipment was availed to CHS Library by Carnegie with further assistance for three years by International Development Research Centre (IDRC). The publication of the CHIZ Bulletin was initially funded by a grant from the J. F. Kapnek Charitable Trust and the MEDLINE services were supported by World Health Organization. The Utano database, which is a bibliography of local unpublished health literature, was initially 8

9 sponsored by IDRC, who wished to assist in the development of access to locally published literature. The University of Zimbabwe, CHS Library is a typical example of one library that has been able to digitize with no budget and managed to provide excellent services to staff, students and health professionals in Zimbabwe through establishing partnership with organizations willing to support. CHALLENGES CHS Library has, however, met with challenges in the provision of digital health information. The challenges include the following: 1. Limited computer equipment to expand access to digital information 2. Limited bandwidth, which results in slow down load times 3. Diminishing budgets These challenges have, however not stopped the CHS Library to harness ICTs in the provision of digital health information. CHS Library is making do with what is available at the moment, whilst finding means and ways of improving dissemination of digital health information. These efforts may be small but they have played a vital role before sufficient resources are in place. STRATEGIES FOR SUSTAINABILITY CHS Library however needs to ensure that users continue to have access to digital health information. The following should be done: 1. Continuation of partner support, especially from organizations such as WHO, UNESCO, which are concerned mainly with health issues in developing countries 2. Continuation of membership of the Zimbabwe University Libraries Consortium so that the library is able to negotiate for electronic resources through the group and get value for money 3. Building projects into the long-term budget. THE WAY FORWARD Below are some recommendations for CHS Library on how some of these challenges can be met: 1. Develop a well planned approach to digital library issues to capture funding from either internal or external sources 2. Ensure that trained staff are available to maintain the network if the connections go down, as this is critical in the adoption of a digital library. 3. Develop good strategies for advancing digital libraries and ensure that politicians and funders fully share these strategies 4. Establish co-operation and links with external partners and international organizations interested in funding digital libraries. 5. Seek to establish links with other medical universities outside Zimbabwe and share resources. 9

10 Conclusion Access to digital health information has enabled the CHS Library fulfil its mission. Library users have access to vast online health information and this does not benefit only CHS Library users but the whole of Zimbabwe. It is therefore important that everything that can be done is done to continue having access to digital health information. References: HINARI: access to research. [Online] available at [accessed on 22 May, 2006]. Lee, Rita and Balthazar, Luiza B., The evolution and installation of an in-house CD- ROM LAN, Bulletin of Medical Library Association, Vol. 79 no. 1. pp MAURICE, John. Poor countries get free online access to medical journals. Bull. World Health Organ. [Online]. 2001, vol.79, no.8 [cited 22 May 2006], p Available from World Wide Web: < ISSN [accessed 15 February, 2006]. Mutula, S. IT Diffussion in sub-saharan Africa: Implications for developing and managing digital libraries, New Library World (2004), 105 (7/8): Networks and CD-ROMs Aid Research, Development and Education in Zimbabwe [Online] available at [accessed on 20 March 2006]. Patrikios, Helga, 1990, MEDLINE on-line: an information service on CD-ROM, Central African Journal of Medicine, Vol 30 no.6. pp Patrikios, Helga, 1985, Zimbabwe s National Medical Library- 1. Its origins, The Central African Journal of Medicine, Vol. 31 no. 9. pp PubMed. [Online] available at Rosenberg, D. University libraries in Africa: a Review of Their Current State and Future Potential, London: International African Institute, 3 vols., 1997, 3: