Advancing an African medical library into the digital age

A team from George Washington University helps the University of Malawi College of Medicine update its information infrastructure


Michael Driscoll and Anne Linton of George Washington University with Diston Chiweza, Director of the Library at the University of Malawi College of Medicine.Over the last decade, there have been critical changes in the library landscape. The emergence of digital technologies has pushed the physical book into the margins of the library building, while the use of electronic resources has become widespread. It is especially difficult for libraries in developing countries to guarantee access to these digital resources to their patrons.

In August 2013, a team of the George Washington University (GW) School of Medicine visited the University of Malawi College of Medicine in Blantyre, Malawi, to assess the needs of the college's library and share their expertise on library information infrastructures and the changing function of the library building. The Elsevier Foundation Innovative Libraries program provided a grant for the medical library needs assessment.

The team consisted of Anne Linton, Director of the Himmelfarb Health Sciences Library at George Washington University, Alexandra Gomes, Associate Director of Himmelfarb, and Michael Driscoll, Director of Computer Applications and Support Services. They had been invited by Dr. Mwapatsa Mipando, Dean of the Faculty of Biomedical Sciences and Health Professions of the University of Malawi.

"We received a warm reception and had the opportunity to experience the warm heart of Africa first hand," Linton said.

Here, Linton and Gomes write about that trip and the steps the library is taking to modernize its information infrastructure. – The Editor

Assessing challenges and opportunities

The library of the University of Malawi College of Medicine The main goal of our trip was to create a needs assessment to improve the health care library and information infrastructure of the College of Medicine, in order to support education, research and patient care. In 2009, a site visit report by the Sub-Saharan African Medical School Study noted the need for extended Internet access, stating that there were not enough computers and textbooks to meet students' needs. This inspired our team to focus heavily on the library's infrastructure and access to electronic resources during its visit. We conducted five in-depth interviews with college administrators, students and the Information and communications technology department, and paid a visit to the university library.

The interviews confirmed the 2009 findings. There are still not enough computers and textbooks, and even though there is a strong intranet and widespread HINARI access, Internet access is expensive and not always available.

Off-campus access to information is strongly limited, which is particularly debilitating for students at a satellite campus at about four hours from Blantyre. More positively, however, we noticed that there was a strong intention to build an evidence-based, research-intensive and community-focused curriculum, with an infrastructure which would support this. The interviews also showed that university staff and students consider the library to be a key supporter of the curriculum, and have a very positive image of the library staff and director.

Coping with the changing function of the library building

Inside the library of the University of Malawi College of MedicineIn addition to the interviews, we also visited the library, which had recently moved to a new and spacious building at the center of the campus. During the visit, the library staff was preparing to move to its new headquarters. Our team reviewed the building plans to improve ICT services in the building and across the campus.

Between the initial design for the library and its final construction, the role and position of academic libraries have been subjected to continuous changes. Many resources are now electronic, and it has become a key priority for libraries to help their patrons in navigating the electronic information environment. Furthermore, students are demanding more dedicated study and collaborative space. Since it is impossible to tell what the future might hold regarding technological innovations, our GWU team noted that future library services and programs should be designed with the possibility to adapt to such changes in mind.

As for the College of Medicine library, we found a number of important questions to consider, which address both the issue of access to electronic resources, and the facilities and services that should be offered in the library building:

  • What is the nature of the collection going forward? HINARI provides much-used and highly-valued access to the world's biomedical journal literature. How can similar and sustainable access be provided to educational material such as electronic textbooks, clinical and drug resources, and multimedia materials for anatomy, pathology, and patient interviewing skills?

The HINARI Access to Research in Health Programme is a part of Research4Life (R4L), a public-private partnership of over 200 academic publishers, four UN agencies, Yale and Cornell Universities and the International Association of Scientific, Technical & Medical Publishers (STM). The program provides free or low-cost online access to nearly 30,000 peer-reviewed journals, books and databases to over 7,000 institutions in more than 100 developing countries and territories.

  • Can the new building be turned into a dynamic and central learning center for the entire College of Medicine? Can it become a venue to collaborate on data and research projects, to hear invited speakers, and to celebrate the breadth of the Malawian research enterprise? What furniture and infrastructure will be needed to create these gathering, collaborative and learning spaces?

These questions resulted in a list of immediate steps to be taken, which will help update the library for the digital age:

  • Invite faculty, students, and library staff  to participate in a discussion about a vision for library collections, services and programs that will drive decisions about space in particular.
  • Create a plan to select electronic medical textbooks crucial to the curriculum and identify funding sources and partners.
  • Explore the reconfiguration of the central areas of the library as an information/learning commons.
  • Identify funding sources and partners to install WiFi access throughout the building and wiring for the college's intranet and additional electrical outlets.
  • Study the feasibility of creating a dedicated computer teaching space in the library.
  • Expand the training program in literature reviews to include new instruction in evidence-based medicine, systematic reviews, and software programs to handle references, format papers and other tasks related to scholarly output.
  • Review the feasibility of using the space designated for special collections as a place to highlight the breadth of Malawian research and its research partnerships. Faculty publications, reports to conferences and poster presentations could all be highlighted.

Diston Chiweza, the library director, has already committed to developing an electronic collection and expanding library services in the new building. He aims to extend access to resources and librarian support both to clinical sites and to the new satellite campus in Lilongwe. The College of Medicine already uses the Moodle system as its learning management system.

Several avenues for delivering resources to students at a distance are being explored, as research project sites are scattered throughout the country.  Librarians work closely with medical students as they design and complete their projects during the third and fourth years.

On site, Chiweza is working also closely with ICT staff and medical faculty to design a space that serves the whole campus as a hub for learning, study, collaborative work, and conferencing — both in-person and from a distance. The GWU team hopes to continue the collaboration with the College of Medicine, exploring future directions for the library and its information infrastructure, so that students will be able to easily access all the latest information in the medical world.


Video: Assessing Medical Library Needs for an Eritrean Future

Ann Linton and Alexandra Gomes talk about a library assessment they conducted in Eritrea, funded by the same Innovative Libraries grant of the Elsevier Foundation.


Elsevier Foundation Innovative Libraries Grants

Grant funding comes through the ElsevierFoundation Innovative Libraries in Developing Countries program, whichoffers one, two and three year grants up to $50,000. The library programsupports the efforts of libraries to enhance the quality of life in developingcountries through infrastructure building, information literacy training,preservation of unique material and more. The 2014 call for grants will beissued in early May.

For more information, contact Elsevier Foundation Program Director Ylann Schemm ([divider]

Elsevier Connect Contributors

Anne Linton, MS, AHIPAnne Linton is Director of the Himmelfarb Health Sciences Library at George Washington University in Washington, DC. She has served in that position since January 1998 and in various other positions at Himmelfarb since 1984.  Linton is an adjunct associate professor in the Department of Medicine and a distinguished member of the Academy of Health Information Professionals. She is a graduate of Georgetown and Drexel Universities. Her main areas of interest include access to electronic resources, health informatics, and information literacy. She is the recipient of an Elsevier Foundation Innovation Libraries in Developing Countries grant.

Alexandra Gomes, MSLS, MT, AHIPAlexandra Gomes is the Associate Director for Education, Information and Technology Services forf Himmelfarb Health Sciences Library. In this role, she oversees the librarians and staff in the reference, technology and web services divisions. She also teaches medical and nursing students, helps staff the reference desk, and works on projects that can range from helping a faculty member with a systematic review to tracking annual library statistics. She has been an academic medical librarian since 1995 and has been at Himmelfarb Library since 1999.

Gomes and Linton have traveled to Eritrea and Malawi to visit health sciences libraries in these countries.

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