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Research in the Developing World

Health Hubs in Kenyan libraries

How donated medical books and librarian training are helping Kenyan health providers

 Health Hub, KNLS Buruburu library, Nairobi (Photos courtesy of Book AID International)Across sub-Saharan Africa, there is an enormous demand for health and medical books and for training to make resources accessible. A 2011 report by EIFL titled Perceptions of Public libraries in Africa surveyed  library users and non-users, librarians and officials in Tanzania, Ethiopia, Ghana, Kenya, Zimbabwe and Uganda and revealed overwhelming support for the role that libraries can play in development.

Only one out of five people surveyed said they would expect to find health information in a local library.

The report recommended that "libraries need to engage with the community at a more tangible level that goes beyond passively providing books information only, e.g., facilitating community interaction with service providers of health, agriculture and culture."

To this end, Book Aid International has spent three years working with Kenya National Library Service (KNLS) on a project to establish Health Hubs in 15 branch libraries, with funding from the Elsevier Foundation's Innovative Libraries in Developing Countries Program.

Our project was a direct response to findings such as these; it targeted KNLS  librarians so they could identify health information needs in their own communities and provide  primary healthcare providers access to relevant, trustworthy and up-to-date information in public libraries.

Health Hub at Murang'a Library"KNLS recognized the urgent need to improve healthcare information for health workers in order to meet some of the challenges of providing book public health services in Kenya," said KNLS Project Coordinator Caroline Kayoro. She said that through providing Health Hubs in 15 public libraries, training librarians and health workers, increasing book stock and providing access to health information online, they have seen library visits and book issuing increase by 10 percent.

KNLS selected 15 of their 60 libraries based on their geographical spread, proximity to hospitals, clinics and medical training colleges and available space for a dedicated health section. Healthcare staff in the vicinity of these libraries access information regularly, and usage statistics show high demand for medical books. In total, we trained 30 KNLS branch librarians (two from each library) and equipped seven KNLS staff with additional skills to serve as master trainers. Ten local health providers also took part in the annual training workshops. Over 7,000 high quality donated health and medical books were provided by Book Aid, with additional and relevant primary healthcare titles purchased locally by KNLS.

Workshop participants engage in active learning, which encourages discussion and problem solving. This includes sharing their own experiences using activities such as simulations, making training enjoyable as well as informative.

Book Aid International and KNLS facilitated four-day training workshops in Nairobi.A team from Book Aid International and KNLS facilitated four-day training workshops in a residential center in Nairobi. Workshops were highly participatory. In one activity, participants were divided into small groups and given a task and present to the rest of the group in a plenary session. Buzz groupswere also used, pairing people so they could discuss an issue or task in depth and agree on a common response to present to the rest of the group. Individual thinking was also a feature, allowing each participant time to reflect, make notes and share their responses to particular ideas or issues.

Topics they discussed included:

  • Why librarians and health workers need to work together
  • How to set up a health hub for healthcare providers
  • How to conduct an information needs assessment (INA)
  • The role of electronic information resources
  • Promotion and marketing of the health hub
  • Creating links between libraries and health organizations
  • Collaboration and health information referrals
  • Documentation and reporting of the project
  • Monitoring and evaluation of a health information service
  • Action planning

Musyoki Nzambu, a Clinical Officer at Mwingi District Hospital in Kenya, with the new donated books: "I am very impressed. I have not seen some of the titles even in my college library," he said. He added that he would introduce the library team to the Mwingi district hospital so that they could promote the information health resources in the library.Identifying librarians with the potential to train other librarians was also a key feature of the workshops. Starting in the second year, local health workers were involved in the workshops.

The training was an important part of the project. We asked librarians to prepare for the workshops and to do a presentation based on their experience of meeting health information needs. That gave us the basis for a discussion on who they were already reaching, how much more could be done to set up health partnerships in their locality, and common diseases where improved information could make a major difference to healthcare in their areas. Setting initial goals for each library meant that each librarian produced an action plan at the workshop.

Given the rapidly expanding availability of computers and broadband in Kenya, the workshops also trained on accessing online health information. Although the degree of access and speed varies among libraries, they are clearly becoming important centers for accessing the most up-to-date health information online and in print.

We also set up focus groups with local health organizations to assess their health information needs, using an information gathering tool designed by the project team. In some libraries, local committees were quickly formed. Local partnerships between the libraries and health providers include doctors, nurses, anesthetists, laboratory technicians, public health workers, representatives from local medical training colleges, district public health officers, hospitals health education officers, youth peer group counselors, local NGOs, public healthcare workers, and medical personnel from neighboring dispensaries, including prison dispensaries, which provide outpatient services for simple ailments.

Continual training and learning are an integral part of any project. When we made the first follow-up visits after the training workshop, we saw there were some big differences between libraries in their approach to needs assessments, target audiences (the primary users of the Health Hubs in their branch libraries) and collecting project monitoring and evaluation information. We decided to build in more on-site follow-up training and support to consolidate the learnings from the workshops and needs assessments to decide how the project would be taken forward.[divider]

Partnering with Book Aid

Since 2004, Elsevier has donated about 260,000 scientific, technical and medical books to 211 partner institutions in developing countries — including 20,000 books to Book Aid in 2013. Elsevier is Book Aid's largest donor of medical books, with 90,000 donated to date. Donating print books through Book Aid complements Elsevier's involvement of Research4Life, a  free and low-cost online research access program for developing countries. Book Aid's high-priority areas include agricultural and biological sciences, chemistry, dentistry, energy and power, engineering and technology, environmental sciences, health professions, immunology, life sciences, mathematics, medicine, nursing, pharmaceutical sciences, pharmacology and physics.

To learn more about Elsevier's involvement, contact Ylann Schemm (@ylannschemm), Elsevier Foundation Program Director, at y.schemm@elsevier.com.[divider]

In 2012, I interviewed five KNLS librarians based at three of the libraries, and they identified many positive outcomes, including increased skills, improved health information, job satisfaction, development of local partnerships, and more effective promotion of the service. Bernard Lugah, a medic working with the Ministry of Health, based in Nakuru in Rift Valley Province, shared his insights with us:

The Health Hub has been of great importance to me as an individual, and to the vast number of health workers in Nakuru. I know of colleagues who have also travelled from Naivasha, Eldama Ravine and Molo Districts to use the facility. … It has long been a dream for the universities and colleges offering medical training in Nakuru.

Learn more

More information about the e-health corners project at Eldoret and Kisumu, supported by Electronic Information for Libraries (EIFL), can be found here.[divider]

The Kenyan Public Library Service

KNLS has a network of more than 60 public libraries across the country, and health and medical texts have for many years formed part of library collections. Many are provided through Book Aid International, which has worked with partner library services in Kenya since the 1960s. These include new books donated by publishers, including substantial donations from Elsevier. Other donors include the Ministry of Health in-country NGOs, such as HIV/AIDS consortia, and USAID. KNLS is keen to improve its health information service and has, for example, set up HIV and AIDS information corners in many libraries. Access to e-resources on health is also available.

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Elsevier Connect Contributor

James KimaniJames Kimani is Book Aid International's East Africa representative, based in Nairobi, Kenya. He is a librarian, a health information specialist and trainer with over 15 years' experience working across Africa. From 2010 to 2013, he worked with the with the Kenya National Library Service (KNLS) team to manage the Health Hubs project, train the librarians and health workers monitor and evaluate the project's outcomes.



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1 Archived Comment

Easter Achieng February 21, 2014 at 3:16 am

This is quite interesting. This has worked to aid the processes of devolving information to this the lowest unit inturn giving access to information as is Envisioned in the Constitution of Kenya 2010. How do we use this as a best practice to ensure that Human Resources for Health in Kenya can also be devolved?

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