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Health Information Forum: Working together to improve access to reliable information for health professionals in developing and transitional countriesAnnual Open Forum: Proceedings Venue: British Medical Association, Tavistock Square, London, WC1H 9JR Date: Tuesday 30 May 2000, 3-6pm Contact: Neil Pakenham-Walsh Telephone: 01865 249909 E-mail: [email protected] Chair: Dr Richard Horton (Editor, The Lancet)
PRESENTATION 1: Barbara Crook (PATH - Program for Appropriate Technology in Health) Simple solutions, Global impact PATH's mission: `To improve health, especially the health of women and children in resource-poor settings.' About PATH:
PATH programme activities:
Examples of PATH programmes:
Diagnostic Technologies:
Appropriate Test Characteristics:
PATH Diagnostic Tests:
Ongoing Diagnostics Development:
Other global products: Malaria ICS; Syphilis ICS; Hepatitis B ICS; HCG (pregnancy) ICS; HIV Dipstick; TB Dipstick Sources of Support:
PRESENTATION 2: Eldryd Parry: The Work of THET, the Tropical Health and Education Trust. THET was started eleven years ago in response to the notable disadvantages of the schools which trained for health care in the tropics, whether in undergraduate or postgraduate medicine: nursing and midwifery: laboratory science: or a range of other essential health professions. We now work with the leaders of health care training institutions to enable them to reach their goals. We do not prescribe what should be done: instead we respond to the expressed goals and wishes of our partners overseas. There were a number of reasons for the relative neglect of such professional training: first, medical schools and teaching hospitals were thought to be irrelevant in their work and too costly to maintain. Second, primary health care and training for it effectively excluded support for clinical care, and appropriate training for its many disciplines. When new medical schools were established in tropical countries, which were almost uniformly committed to a community based training, it was almost impossible for them to attract any support. Because no organisation was able to remedy the disadvantages and fill the gaps in training, which were commonplace in training schools in the tropics, we started THET. Our activities are governed by simple principles.
Much of the work of THET is now accomplished through links between hospitals and training schools in the tropics and their counterparts in the United Kingdom. Such links start small but inevitably grow to cover a wide range of subjects and disciplines. Further Reading: Parry, Eldryd and Parry, Victoria. Training for health care in developing countries: the work of the Tropical Health and Education Trust Medical Education 1998: 32, 630-635 PRESENTATION 3: Michael Eddleston described how, as a medical student on a research project in Sri Lanka, he was struck by the lack of access to information among health professionals, particularly junior doctors working in isolation. This was partly due to poor distribution. WHO publications, for example, were plentiful in the WHO country office, but were not getting to the health professionals who needed them. Recognizing the usefulness to doctors in developed countries of pocket references such as the 'Oxford Handbook of Clinical Medicine', Michael decided to produce a similar publication on medicine in the developing world. Some years later, in 1999, collaborating with WHO and experts in the field, the 'Oxford Handbook of Tropical Medicine (OHTM)' was published by the Oxford University Press (OUP). The OHTM is designed to be used at the bedside, is well illustrated and fully cross-referenced. Locally relevant information is given wherever possible. The handbook is sold through local bookshops and commercial sales are seen as a key ingredient of sustainability. Michael described two hopes for the future: 1. That the handbook be available in developing countries at a price affordable to most healthcare professionals. OUP has indicated that they should be able to markedly reduce the price if demand is sufficient to warrant a cheap overrun. 2. That the whole book be made available free on the Web as an evolving publication, maintained by an editor and through user feedback, and with cross-references throughout the text to 'deeper' levels of information on other web sites. For a review of the OHTM, see http://www.cdc.gov/ncidod/eid/vol6no2/keystone_book_review.htm Thank you for the opportunity to speak with you today. I am the coordinator of the uk ngo aids consortium. The consortium is made up of over 50 of the leading international development ngos based in the UK. It was set up in 1986 at the suggestion of OXFAM in response to the growing impact of HIV\AIDS on development. We became a registered company in 1991. The main activities of the consortium are information exchange, networking, lobbying and to some degree campaigning. The consortium is funded by members contributions giving us a high degree of independence and - provided we continue to meet the needs of our members - a secure funding base. It is this last point, continuing to meet our members needs that I want to focus on today. The impact of HIV/AIDS can be described as a snowball rolling down a mountain. The further it rolls the faster it travels, the bigger it gets, the more damage it does, the further it rolls, the faster it travels and so on. The rapid escalation of the impact of the pandemic has meant that the response from development ngos has had to try and address a set of problems that are almost unique in their range and diversity. Such is the nature of the pandemic that our responses and approaches must be continually modified to match the ever changing paradigm of HIV/AIDS. This applies equally to the consortium. As the needs of our members change the consortium must change to ensure that those needs are met and that subscriptions are paid. The problem we have is:
The short term answer is to seek funding from trusts and foundations or negotiate with dfid for substantial core funding. Ultimately this will serve only to increase the pressure and create expectations that are not sustainable, weaken the sense of ownership that members currently have and create a consortium that is the secretariat rather than the sum of its members. The longer term solution might be to increase membership to a level that allows for development to take place. This requires time and energy and may take too long to reach the required level, by which time members could have become disillusioned and begin questioning the validity of remaining members and paying their subscriptions. What we have embarked upon is something in between. The key areas that need to change are:
These areas have been identified through discussion with a significant number of members, assessment of the direction of discussions at the consortium advocacy forum, observation and reading of the epidemic itself and a strategic review with the consortium steering committee. The first thing I have done is reducing the amount of administration I have to undertake. I am responsible for the co-ordination of all consortium meetings, production of papers and minute taker. Rather than the two or sometimes three notifications etc members now get one notification and where possible this is by email rather than hard copy. This has created some time for me to visit members and at the moment it is working well and I have managed to visit on average two members a month. The second thing is that I have agreed with DFID for a 50% increase in their annual subscription and a one off payment for new computer equipment. Thirdly I have submitted an international lottery application. The application, if successful, will provide breathing space. It would allow us to develop the areas identified and give me time to generate an increase in membership to sustain things once the lottery grant comes to an end. But that is all at the moment and I am not holding my breath on the success of our application. It seems to me that the emergence of electronic communication systems offers the best way for the consortium to develop its communication and dissemination of information work. For consortia in particular the advent of email and the internet offers the ideal opportunity for development of communication and networking. However, we like many other organisations receive in some ways too much information and it requires human resource to synthesise the information that comes in before it is sent out again. This at the moment we cannot do. As for primary policy analysis, I have committed us to it but quite how it is going to happen I don't yet know. So to sum up:
This is where you come in. I was keen for the consortium to be involved with the Health Information Forum for a number of reasons, not least because of the opportunity to pick the brains of others involved in the communication and information exchange. I would like to end by leaving the forum with a couple of brain picking questions:
I hope you are able to help me. Thank you. PRESENTATION 5: Bryan Pearson (Managing Director, FSG MediMedia Ltd) spoke on `Developing African-based Capabilities'. He presented an update on FSG MediMedia's plans for developing in-country services in Africa. He declared himself a healthy sceptic about electronic solutions being the panacea for solving Africa's HI shortfall, fearing that much of the big money currently being touted towards mending the pot holes and resurfacing the information superhighway would prove in time to have been 'the wrong kind of tar'. His company was therefore seeking to develop local operations in key countries (initially Ghana, Nigeria, Kenya, Zimbabwe) which would be commercially based for at least half of its activities (print and publishing, database development and datamining, conference and event management) in order to at least secure its overheads. Then through the activities of an Advisory Board it could act as a filter for health information projects, identifying in-country groups to undertake projects and facilitating any audit and evaluation that a donor might require. It would also work in the other direction, finding support internationally (financial and material) for identified needs within each country. It was critical that each entity should be locally led, locally managed, yet internationally responsible via a transparent commercial reporting structure. PRESENTATION 6: Mark Everard, Consultant Paediatrician. PIER – the Paediatric Information and Education Resource - is a free facility that has been developed to encourage communication and collaboration amongst paediatricians and others involved in the care and well being of children. PIER provides a venue through which high quality information can be shared with the aim of improving the health and quality of life of children everywhere. PIER aims to link resources with need. The resource is simple and intuitive to use, providing rapid access to quality peer-reviewed information. Background There is an enormous amount of quality information available:
but it is frequently difficult to access the right information at the right time. Meanwhile, the pace of change is very rapid, and re-invention of the wheel (or flat tyre) is common. Paediatricians comprise a valuable pool of highly committed health care professionals willing to work together to improve child health worldwide. How to access and use PIER www.pier.shef.ac.uk
Passwords The use of passwords has pros and cons. Pros: avoids unprofessional access to sensitive material; encourages robust debate; minimizes risk of partisan/abusive comments Cons: limits access To make the best use, a hybrid site is planned. How does it work?
The future
Funding Advice and suggestions most welcome. PRESENTATION 7: Trisha Greenhalgh, Director for the Open Learning Unit at the Department of Primary care and Population Sciences, University College London, described a new web-based Masters degree course in Primary Health Care which can be followed part time by health care workers from anywhere in the world. Dr Greenhalgh's team plans to develop the course further to meet the needs of academics and leaders in research, teaching and service development in developing and transitional countries. All study materials are available to students via the password-protected website. A key feature of the course is its interactive nature, allowing individuals in different countries to gain lateral support and share ideas and resources. Further details can be obtained from the course website < www.msc.phc.ucl.ac.uk > or by email < [email protected] >. Health Information Forum is run as an activity of the INASP-Health Programme, a cooperative network for organizations and individuals working to improve access to reliable information for health professionals in developing and transitional countries. Participation is free of charge and |
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