International Network for the Availability of Scientific Publications
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Health Information Forum: Working together to improve access to reliable information for healthcare workers in developing and transitional countries

HIF15: Donation and distribution of physical health information materials: books, journals, newsletters, CD-ROMs...

Venue: British Medical Association, Tavistock Square, London, WC1H 9JR Date: Tuesday 16 January 2001 Contact: Neil Pakenham-Walsh Telephone: 01865 249909 E-mail: [email protected] 

Chair: Anthony Costello, Professor of International Child Health at the Institute for Child Health, London

Participants: 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: 1. Graham Icke <[email protected] > Has produced and distributed thousands of 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'.

Presentation 1A: Carolyn Sharples, Book Aid International Presentation 1B: Rob Sarjant, Book Aid International Presentation 3: Sallie Nicholas, BMA Small group rapporteurs and discussion

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

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 INASP-Health, a cooperative network for organizations and individuals working timprove access treliable information for healthcare workers in developing and transitional countries. Participation is free of charge and without obligation. INASP-Health is supported by the BMA, Danida, ICSU-Press, and WHO. INASP is a programme of the International Council for Science (ICSU).