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					                                  Proceed Nat Semi Hlth Sci Libraries in India 1982, 29/2, 75-82




Health science libraries as information dissemination and
health education centres

SUDHA S. MURTHY
Librarian, National T.B. Institute, Bangalore 560 003

Abstract
Library is an establishment having the responsibility to organise and preserve the recorded human
thoughts to achieve its basic objective of dissemination of information. Interpreting the collection to the
readers and bringing the right material to the right reader are the important components of the
dissemination system. The dissemination of information in a health science library achieves special
importance because of its impact on the medical care to the community. This paper discusses the role of
a specialized, health science library at the National Tuberculosis Institute, Bangalore, in the dissemination
of information to the various category of users. It defines and describes a) the organization of information
b) nature of information to be disseminated and c) the beneficiaries of such information. Model of the
dissemination system is presented, the working of the system, its maintenance and cost are also
mentioned. The paper highlights the importance of information dissemination in promoting health
education to the community.

Introduction

Library is a community agency charged with the responsibility to organise the
preservation of the recorded human thought to achieve its basic objective of the
dissemination of such thought. A library should not be a static stock of information but
be a dynamic centre providing for an exchange of information to promote the knowledge
available. As said by the National Research Professor Late Dr. S. R. Ranganathan
“Libraries should become multi-purpose social institutions to assemble, organize,
preserve, socialise, and serve all the expressed thoughts embodied in manuscripts,
books and periodicals.…” The dissemination of information of specialised as well as
general nature to health workers and for the education of the lay persons in a language
understandable to them, is thus a much needed service required to be rendered by the
health science libraries.

Object

This paper discusses the role of a specialized health science library (HSL) at the
National Tuberculosis Institute (NTI) in the dissemination of information. It also
describes the network of a system for the communication of information on the health
research, teaching and training aspects. Steps involved in the process are mentioned
and defined.

The case of the National Tuberculosis Institute (NTI) Bangalore is cited as
76                                                           HEALTH SCIENCE INFORMATION SERVICES

illustrative of a specialized library in public health. An introduction of the Institute, its
objectives and functions is necessary for appreciation of the services rendered by the
library.

Public health is that branch of medical science which systematically attempts to reduce
and finally remove the suffering of the community at large. Mentioned below is the place
of the disease tuberculosis in the overall context of public health problem.

                                                   CHART 1
                                           PUBLIC HEALTH PROBLEMS

                Infectious          Mental              Nutritional                      etc.
                diseases            health              diseases



TUBERCULOSIS Malaria                Plague      etc.
Tuberculosis is considered as a major public health problem for the reasons given in
Table 1. The Institute’s objectives and functions in fighting against tuberculosis are
given below.

TABLE 1
Tuberculosis

                               Objectives of public
 TB as a public health                                     Objectives of the
                              health programme in                                   Objectives of the library
       problem                                                 institute
                                 controlling T.B.
             1                          2                            3                          4
a) Studies have pointed     a) To quantity the          a) The aim of the           a)      To        provide
out that 4 persons out      problem to be tackled in    institute is to bring out   information     to    the
of every thousand will      the    community       by   reduction     of   T    B   research workers on
be      suffering    from   carrying out community      problem.                    public health, sociology,
infectious tuberculosis     surveys. This is needed     b) The objective of the     management of health
(TB) and another 16 per     to      develop        an   institute is to evolve      programmes,
thousand from non-          appropriate programme.      through research a          bacteriology,         TB,
infective active TB.        b) To find out the          nationally applicable TB    radiology, epidemiology
b) 10% of all deaths in     people suffering from       control programme.          & statiscal aspects of
the general population      TB who are mostly in        c) Its tasks then are to    TB.
aged 5 years and over       the villages and treat      simplify the diagnostic
is due to TB and thus it    them.                       methods        and    the   b)To               provide
is the largest single       c) Preventing further       treatment.                  information to the in-
cause of death in the       development of the          d) To train the in-         service       candidates
community.                  disease by immunising       service personnel to        while on training.
c) This is obvious to       the             remaining   carry out simple tasks in   c)       To        provide
show that TB is an          population.                 the periphery.              information to the senior
important public health                                                             workers of TB and to
problem           causing                                                           similar health research
considerable suffering &                                                            institutes.
death in the community.
HEALTH SCIENCE LIBRARIES AS INFORMATION DISSEMINATION AND HEALTH EDUCATION CENTRES         77


The aims, objectives and tasks of the library and information services of the Institute will
naturally be guided and determined by those of the Institute as outlined in the table. In a
similar manner, any other health science library also has to define its objectives and
functions to be in step with the defined objectives and functions of the institution which it
serves.

Organization of the information available in special libraries

Specialized HSLs are the ‘Information Centres’ on a particular branch of medical
science. For e.g. it may be tuberculosis, malaria, plague, nutrition, mental health, drug
research etc. The collection of documents is on that particular branch and on other
related branches of sciences. For e.g. a tuberculosis institute has got to have
documents on tuberculosis and respiratory diseases and some basic documents on
supportive and participating interdisciplinary fields such as social science, management
science, public health, general medicine, statistics, X-ray and biomedical engineering,
bacteriology and microbiology. Microdocuments such as periodicals, information series
issued by WHO, such as Technical Report Series, Reprints, Offprints, Public Health
Papers, proceedings of national and international conferences as special materials, are
of immense value in a specialised library. As there is a tremendous increase in the
publication of articles in microdocuments at the national and international level in a
particular field, it is very difficult for the clientele—scientists, research workers,
programme supervisors, teachers and professors, students and health team workers—
to keep abreast with all the published information. The articles published therefore
should either be maintained on a card system or may be computerised according to a
thesarus on the subject prepared by the librarian/information specialist using Medical
Subject Headings (MESH) to meet the information needs of the users. The information
thus organised can become a source index on a particular field.

Nature of the information to be disseminated from a specialised library

All the information thus indexed needs to be made available to different categories of
workers according to their needs. The types of information to be communicated are as
follows:
(a) Information on the general aspects of the disease, history, pathology, epidemiology,
    clinical aspects like diagnosis, treatment and public health implications, including
    control methodology.

(b) In-depth information on the subject.

(c) Information on the latest trend of research on the disease including unpublished
    documents for use by the research workers only e.g. provisional assignment reports
    by WHO consulting scientists.

(d) Information produced on the research work carried out at the institute/organization.

(e) General information on research methodology such as lay out plan of research
    studies and mode of application of the results.
78                                                 HEALTH SCIENCE INFORMATION SERVICES

Beneficiaries of the disseminated information

To give the maximum service to the beneficiaries, the librarian/information specialist
besides having technical qualification, should have an aptitude or liking for the job and
should have the habit of methodical study. He should himself be a retrieval tool as well
as information bureau. Reading is therefore a must for the librarian. A proper grasp of
the essential problems of the speciality, its research and training needs is a must.
Hence, responsibility of the information specialist in a specialised library is such that it
calls for a dynamic person who has welded into himself the twin specialities of
information and the particular branch of health sciences.

The ways in which an information specialist/librarian tries to fulfil the needs of
the workers
(a) Information on the latest trend of work at the national and international level can be
    circulated among the research workers, and scientists by “Current Awareness
    Services” or by issuing periodical “Abstract Bulletin” without any loss of time. Slides
    of such illustrative materials on important research findings can be prepared and
    kept ready for the needs of research workers. At the NTI, periodical abstract bulletin
    is brought out quarterly and circulated to research scientists of the Institute. On an
    average 50 titles are listed every quarter, classified under broad subject headings.

                                        CHART 2

          Model of the dissemination system of the information produced at the
                             National Tuberculosis Institute


Programs supervisors       State TB         Similar health   Senior workers       Academic
for e.g., Asst. Director   Demonstration    research         in the field (All    institutions
of Health Services         & Trg. centres   institutions     types of articles)
(TB), Director General     (conceptual,     (research and
of Health Services,        research type    conceptual)
Adviser in TB, Govt. of    & program
India (conceptual &        information)
pro gram information)


  Functioning health                        Under             Post graduates        Nursing
    centres (various                        graduates                             institutions
  district tuberculosis
centres) (brief reports,                             (Elementary type of articles)
   field reports and
 program information)
HEALTH SCIENCE LIBRARIES AS INFORMATION DISSEMINATION AND HEALTH EDUCATION CENTRES           79


(b) Information produced by an Institute like the NTI at the national or international level,
    can be disseminated by issuing a communicative bulletin or newsletter for a wider
    coverage and circulation or by bringing out summaries of its publications from time
    to time. The NTI has brought out two volumes of such summaries so far. Articles in
    newsletters can be published under the different categories such as research
    standard (for res. workers), conceptual standard, elementary standard (for teaching
    and learning community) and health programme information for the promotion of
    better health service. Abstracts of the Institute’s papers published in journals can be
    brought out in the newsletter. A separate section of the newsletter can be devoted to
    the reader’s forum in which the readers’ queries are replied to. Given below is an
    illustrative chart of the NTI Newsletter.


                                          CHART 3


                                    International level



 TB research, teaching, &          Undergraduate &           Interested senior workers
   training institutions         postgraduate medical
                                      institutions
Reprints can also become a source of exchange of information for which a mailing list
can be maintained. The distribution chart maintained at the NTI to serve as an example
is as follows:
                                       CHART 4

                              National & international level


TB research & training       Allied postgraduate teaching and            Interested senior
      institutes               research medical institutions                  workers


In-depth information or bibliography on the subject can either be prepared in anticipation
or on demand to meet the needs of a research worker or postgraduate student.
General information on the plan of research studies and operational aspects will be
useful for the fellow health institutions or individual research workers.
Information on the general aspects of the disease and its treatment will be helpful for
the general practitioners, undergraduate medical students and health team workers.

Preparation of the mailing list

Mailing list of an institute at the national level can be prepared with the utmost objective
of disseminating the information to the health planners, administrators, supervisors,
programme workers etc.
80                                                HEALTH SCIENCE INFORMATION SERVICES

The addresses can be obtained from the state health authorities such as Directorate of
Health Services and its subordinate, the Indian Medical Association and by consulting
the available directories. To maintain the proper continuity of supply, it is better to
address the designations than individual names.

For people at the international level addresses can be obtained either during their visits
to the institute/library, by correspondence or by regular review of the articles appearing
in technical periodicals.

Updating the mailing list


Mailing list thus prepared need updating at least once in three years to ensure proper
receipt of the bulletin and to ascertain the addressee’s interest in receiving the
publications. Updating will also be beneficial to monitor their varied interests, so as to
incorporate new topics in the future publications. Updating can be done by inserting a
“Call Attention Slip” in the bulletin sent out from the library. Revision can then be made
on the basis of response received from the readers.

An opinion poll can be conducted in this manner to ascertain the users’ needs, Opinion
poll conducted in 1970 amongst those who receive the NTI Newsletter reveals the
following interesting facts. 54% out of the 410 persons residing in India and 35% of the
overseas recipients had given a positive response that they looked forward to receive
the Newsletter. Considering all the 219 who responded to the questionnaire, 54 (25%)
had even given suggestions to improve the services while 131 (66%) had offered to
contribute.

In another survey conducted in 1978, the following response was obtained. 36% of the
155 medical colleges and 82.4% of 17 state units had shown their keen interest in
receiving. But a total average i.e., 25% (out of 852 slips enclosed) only had shown their
sustained interest in receiving the Newsletter. Mailing addresses were deleted in
respect of those who failed to respond. Even though the response is poor with respect
to medical colleges, the information specialist cannot and did not ignore them as they
are the institutions from which the medical graduates come out to occupy responsible
positions in the field. One cannot afford to let them stay as academic ivory towers only.
It is our experience that a newsletter helps to forge a link between an institution and the
alumni, as well as motivates scholars working in the respective speciality and allied
fields to come for consultations with the faculty.


Cost of dissemination of information

Expenditure on the dissemination system can be negligible when compared to the
benefits of the system. Cost of reprints to be mailed and of postage form additional
expenditure. Publication of a newsletter can be made with the active participation of the
faculty members. It is estimated that material cost of a cyclostyled copy of a newsletter
of 12 pages may cost only a rupee including the expenditure on post and for the
overseas mailing another 80 paise more. Hence at the current prices the total
expenditure to be incurred annually to bring out a newsletter on a quarterly basis for a
HEALTH SCIENCE LIBRARIES AS INFORMATION DISSEMINATION AND HEALTH EDUCATION CENTRES         81


mailing list of 300 will only be Rs. 1,200/-. The NTI Newsletter with such humble
beginning, of course, has developed today into a 30-35 page unpriced quarterly
publication of a nearly full fledged journal, through the dedicated efforts of the faculty as
well as the information specialists at the Institute. Though resources not permitting, a
newsletter may still serve its purpose without necessarily expanding its scope as the
NTI has done.

Results of the information disseminated in improving the health services

Information produced and preserved in a health science library is ultimately for
improvement of the health services which aims at the improvement of health status of
the people. The information sent out should reach, the workers at the grass-root level
who are in contact with the community. They are the intermediaries between the
research workers and the community, bringing the benefits of knowledge to the people.
The technical problems faced by them need to be solved. The information system in
health science library should therefore provide a two way traffic, and the information
specialist/librarian, should strive to gather the information from field workers and to
release the appropriate information.

                             CHART 5

                 Network of information system

                     NTI health science library
                                 ••

    State Health          District Health         District TB Officers                ?
     Authorities          Officers/District                                    (In
                         Medical Officers/                                     collaboration
                         District Surgeons                                     with DAVP,
                                  ••                                           State
                                                                               bureaus,
                                                                               publication
    paramedical               General             Medical Officers at          Medical     in
      workers               practitioners               PHI                    news-papers)



                             Community                     •


Health science libraries as health education centres

One aspect of the health science libraries is to communicate information to the health
workers. But what about the general community ? May be separate health education
offices/bureaus can meet this need; but as an information centre and a community
82                                                HEALTH SCIENCE INFORMATION SERVICES

agency, the health science library should cater to such requirements also. This can be
achieved by bringing out models and educative posters on health programmes about
the various diseases, their cure, prevention and control in a layman’s language. As we
are aware, our country has 71% illiterates who can only be best educated by posters,
audiovisual aids. Health science libraries can be information centres to cater to their
needs also. They should also organize the publication of more popular articles in daily
newspapers for the benefit of lay public. Serious thought needs to be given to this
aspect. At present the health education materials are brought out by the Division of
Audio-visual Publications (DAVP). The librarians of the specialized institutions and
DAVP can associate themselves. At the NTI, however, the method of reaching the
community for their education is attempted through the district centres whose personnel
are trained at the NTI and who are continually kept informed on different aspects of the
disease by NTI information system. It is expected of the district centres in turn to
educate the PHI doctors and the community at large.

It is finally proposed that similar health science libraries should develop a
communication net work for the information dissemination system. The health science
library has a major responsibility in promoting and disseminating health information. It is
quite possible that with the availability of better technological communication system,
this can be achieved effectively and efficiently.