Assessing Health Information Needs: Globally and Locally HIPNet Meeting June 17, 2009

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Assessing Health Information Needs:

Globally and Locally

HIPNet Meeting June 17, 2009

Tara SullivanSaori Ohkubo

Elizabeth FrazeeAdrienne Kols

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K4Health Project

• USAID-supported 5 year Associate Award

• Implemented by:– Johns Hopkins Bloomberg School of Public

Health Center for Communication Programs (JHU/CCP)

• In partnership with:– Family Health International (FHI) and

Management Sciences for Health (MSH)

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K4Health Mission

• Quality health information captured,

synthesized, and made easy to find and

easy to use for policy makers, program

managers, and service providers.

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K4Health KM Model

1. Engage Networks: work with existing networks and nurture communities of practice to collaborate on common topic of interest

2. Manage Content: train COPs to use collaborative publishing solutions (TPT, DIY, CPT) to capture, organize, adapt and create knowledge

3. Deliver Knowledge: use web based, mobile, face-to-face, digital and print channels to reach audiences

4. Exchange Knowledge: facilitate forums and

develop e-learning programs

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K4Health Needs Assessment

Purpose

To provide research and analysis of health information needs, networks, technology and tools, infrastructure, and key stakeholders, globally and in multiple regions and countries.

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Research Questions

(1) What are the health information needshealth information needs of USAID health officers, program managers, healthcare providers and community health workers?

(2) What infrastructureinfrastructure exists to support information and communication technologies (ICTs)?

(3) What are the most promising technologies and toolstechnologies and tools?

(4) What health information networkshealth information networks exist and how can they extend reach and use of health information?

(5) Who are the key health information stakeholdershealth information stakeholders?

(6)(6) What are the What are the challengeschallenges to accessing and using up-to- to accessing and using up-to-date health information? date health information?

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Methods

(1) Environment Scan

(2) Online survey

(3) Multi-country qualitative study

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Methods: Environment Scan

• March 2 – May 8, 2009• Search of published literature using PubMed

and online databases and bibliographies• Internet search for grey literature, relevant

projects, and health information networks• Interviews with knowledge managers at 17

organization that are active members of HIPNet

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Methods: Online Survey

• March 25 to April 24, 2009• 39 questions addressed demand for health topics,

resources and tools of interest, information delivery and sharing preferences

• Dissemination using a targeted e-mail announcement to:– USAID, WHO, UNFPA, CAs (headquarters and field

offices)– Relevant listservs/discussion groups (HIFA2015, IBP,

HIPNet)

• 808 responses: English=540 (67%), French=88 (11%), Spanish=180 (22%)

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Background Characteristics

Online Survey Respondents

By Job Function By Region

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Methods: Multi-Country Qualitative Study

• June – September 2009• Countries

Africa: Ethiopia, Malawi, South Africa, Uganda

Asia: India

LAC: Peru

• In-depth Interviews• Network stakeholder interviews• Focus group discussions

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Results: Needs

Providers need information that is:• Trustworthy• Up-to-date• Relevant to the local setting• Practical• Easy to digest• Convenient and accessible

Source: Environment Scan

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Results: Needs

For Information, Health Workers in Developing Countries Rely on:

– Workshops and meetings sponsored by the facility or health care system

– Official materials, such as guidelines, manuals, and hospital protocols

– Discussions with colleagues

– Textbooks

– Internet, if available


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Results: NeedsTop 4 Useful Information Resources by Job Function Function

Source: Online Survey


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Results: NeedsTop 4 Program Management Topics by Job Function



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Results: NeedsTop 4 FP/RH Topics by Job Function



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Results: NeedsTop 4 FP/RH Topics by Region

Sorce: Online Survey


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Results: InfrastructureMore and More People

Online


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Results: InfrastructureAfrica and Asia Lag in 2008

73.1

59.9

48.5

28.6

23.3

17.2

5.6

23.5

0 10 20 30 40 50 60 70 80 90 100

North America

Oceania & Australia

Europe

Latin America & Caribbean

Middle East

Asia

Af rica

World average

% of population that uses the Internet


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Results: InfrastructureObstacles to Internet Access in Developing Countries

• Poor infrastructure: lack of electricity, phone lines, ISPs, bandwidth

• High costs: of hardware, software, and connections

• Lack of human capacity: limited computer literacy and skilled IT professionals

• Inappropriate content: mostly in English, requires high literacy and Internet savvy, little content is created in and relevant to the South


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Results: Tools and TechnologyMobile Phones Growing Faster Than Other

ICTS


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Results: Tools and TechnologyMobile Phones Lead in Every

Region

0

20

40

60

80

100

120

Africa Americas Asia Europe Oceania World

Nu

mb

er

pe

r 1

00

inh

ab

ita

nts

Fixed telephone lines Mobile phone subscribers Internet users


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Results: Tools and Technology

Capabilities of Mobile Devices • SMS (texting): Inexpensive, low

bandwidth, but limited to brief messages• Voice: Slow but does not require

literacy; new technologies emerging• Wireless Internet connectivity: limited

availability, small screen size• Electronic storage: PDAs can function

as knowledge repository


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Results: Technology and Tools

E-mail Usage by Job Function



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E-mail Usage by Region



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Results: Technology and ToolsUseful Electronic Resources by Job Function



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Results: Technology and ToolsUseful Electronic Resources by Region



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• 90% Computer with a CD-ROM drive• Over 85%

– Computer with the Internet– Mobile phone– Printer

• 80% DVD player• 30% iPod/MP3 player• 15% PDA

Routine Access to IT Devices

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Results: NetworksSocial Networking Growing

Rapidly

Region

# of Unique Visitors

% changeJune 2007 June 2008

Asia-Pacific 163 million 201 million 23%

Europe 123 million 165 million 35%

N. America 121 million 131 million 9%

Latin America 40 million 53 million 33%

Middle East & Africa 18 million 30 million 66%

Worldwide 464 million 581 million 25%

Source: comScore World Metrix


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Results: NetworksProfessional Networks Mentioned by Survey Respondents


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Results: Barriers

Complaints about health information sources include:• Materials are out of date, inappropriate, irrelevant,

and/or costly• Internet access is unavailable or expensive

• Limited access to meetings, medical societies

• Providers are too busy

• Lack of a reading culture

• Information overload


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Results: BarriersBarriers mentioned by survey

respondents


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Key Findings from HIPNET Member Organizations

• Knowledge sharing activities rarely extend as far as frontline providers and managers

• Heavy reliance on informal feedback to assess information needs of audience and to judge success of products

• Most rely on email to communicate with staff and outsiders and on the web to disseminate materials

• Internal COPs have proven extremely useful


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HIPNET on new technologies

• Positive experiences with wikis and web-conferencing

• Great interest in mobile devices and new video technologies, but not clear how to exploit them

• Generational divide in opinions of and enthusiasm for Web 2.0 tools

• Recognize that social networking is young people’s preferred mode of communication, but struggling to figure out how to use Facebook effectively

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HIPNET on knowledge networks

• Tend to rely on a few trusted websites and listservs; prefer networks with narrow technical focus

• Few networks mentioned more than one person: IBP, Core Group, and HIPNET

• Staff at field offices promote knowledge sharing by joining local taskforces, working groups, and professional groups; local networking relies almost exclusively on face-to-face communication.

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Implications:Select Appropriate

Technologies• Do not migrate too quickly from “old” to “new”

technologies

• Anticipate and address bandwidth issues

• Explore mobile devices: consider voice, texting, and web-based applications

• Take advantage of new voice and video technologies

• Embrace social networking sites as a model, if not a platform


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Implications: Use Multiple Channels &

Technologies

• Use face-to-face and virtual interaction to reinforce one another

• Seek out and work with local intermediaries to extend the reach of the Internet, including radio and cybercafés

• Package the same content in multiple formats

• Collaborate with local partners to move information the last mile


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Implications: Meet the need for local

contentGoals• Translation into local languages• Solutions for low-literate audiences• Content tailored to local settings• Content repackaged for specific health cadres

Methods• Adapt global materials• Help local people create their own content• Promote knowledge sharing between countries• Recruit information specialists to help


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Implications: Conduct needs assessments and

M&E

• Rely on “pull” models that respond to the information needs of the audience

• Assess both perceived and real information needs of audiences

• Systematically evaluate the use of key information products


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Recommendations for K4Health:

Engage Networks

• Formalize feedback mechanism to/from audience members

• Create CoPs focused on specific technical and geographic areas

• Partner with in-country intermediaries who can serve as community access points

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Manage Content

• Collaborate with network members to gather materials and to review and field test knowledge toolkits

• Actively promote toolkits as authoritative, trustworthy, up-to-date, practical and easy-to-find and easy-to-use

• Train in-country partners to adapt materials in toolkits and create new materials

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Deliver Content

• Enable users to add content and participate in forums on the Website through email

• Use popular applications such as YouTube for hosting video content to make it more accessible

• Provide a link to CD-ROM version of toolkits to be downloaded and burned locally

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Exchange Knowledge

• Develop user forums centered around topic preferences and K4Health publishing toolkits

• Provide podcasts of e-learning courses

• Link e-Learning course and CoPs for continued training and discussion

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Next Steps

• Disseminate preliminary results widely

• Complete multi-country qualitative study– Disseminate results and develop

recommendations locally– Disseminate results and develop

recommendations globally

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For more information

• K4Health Environment Scan – Currently available– Contact: Tara Sullivan ([email protected])

• Results of online survey– Available mid-July– Contact: Saori Ohkubo ([email protected])

• Complete report– Available early November– Contact: Tara Sullivan ([email protected])

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Johns Hopkins Bloomberg School of Public Health

Center for Communication Programs111 Market Place, Suite 310

Baltimore, MD 21202Tel: 410-659-6300Fax: 410-659-6266

Contact: Earle Lawrence, Project Director([email protected])

Documents

Assessing Health Information Needs: Globally and Locally HIPNet Meeting June 17, 2009