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

1. Assessing Health Information Needs: Globally and Locally HIPNet Meeting June 17, 2009 Tara Sullivan Saori Ohkubo Elizabeth Frazee Adrienne Kols

2. 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)

3. K4Health Mission Quality health information captured, synthesized, and made easy to find and easy to use for policy makers, program managers, and service providers.

4. K4Health KM Model Engage Networks: work with existing networks and nurture communities of practice to collaborate on common topic of interest Manage Content: train COPs to use collaborative publishing solutions (TPT, DIY, CPT) to capture, organize, adapt and create knowledge Deliver Knowledge: use web based, mobile, face-to-face, digital and print channels to reach audiences Exchange Knowledge: facilitate forums and develop e-learning programs

5. 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.

6. Research Questions • What are the health information needs of USAID health officers, program managers, healthcare providers and community health workers? • What infrastructure exists to support information and communication technologies (ICTs)? • What are the most promising technologies and tools? • What health information networks exist and how can they extend reach and use of health information? • Who are the key health information stakeholders? • What are the challenges to accessing and using up-to-date health information?

7. Methods Environment Scan Online survey Multi-country qualitative study

8. 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

9. 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%)

10. Background Characteristics Online Survey Respondents By Job Function By Region

11. 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

12. 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

13. 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 Source: Environment Scan

14. Results: Needs Top 4 Useful Information Resources by Job Function Function Source: Online Survey Source: Online Survey

15. Results: Needs Top 4 Program Management Topics by Job Function Source: Online Survey Source: Online Survey

16. Results: Needs Top 4 FP/RH Topics by Job Function Source: Online Survey Source: Online Survey

17. Results: Needs Top 4 FP/RH Topics by Region Sorce: Online Survey Source: Online Survey

18. Results: InfrastructureMore and More People Online Source: Environment Scan

19. Results: InfrastructureAfrica and Asia Lag in 2008 Source: Environment Scan

20. 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 Source: Environment Scan

21. Results: Tools and TechnologyMobile Phones Growing Faster Than Other ICTS Source: Environment Scan

22. Results: Tools and TechnologyMobile Phones Lead in Every Region Source: Environment Scan

23. Results: Tools and TechnologyCapabilities 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 Source: Environment Scan

24. Results: Technology and Tools E-mail Usage by Job Function Source: Online Survey Source: Online Survey

25. Results: Technology and Tools E-mail Usage by Region Source: Online Survey Source: Online Survey

26. Results: Technology and Tools Useful Electronic Resources by Job Function Source: Online Survey Source: Online Survey

27. Results: Technology and Tools Useful Electronic Resources by Region Source: Online Survey Source: Online Survey

28. Results: Technology and Tools Routine Access to IT Devices • 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

29. Results: NetworksSocial Networking Growing Rapidly Source: Environment Scan

30. Results: Networks Professional Networks Mentioned by Survey Respondents Source: Online Survey

31. 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 Source: Environment Scan

32. Results: BarriersBarriers mentioned by survey respondents Source: Online Survey

33. 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 Source: Environment Scan

34. 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

35. 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.

36. 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 Source: Environment Scan

37. 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 Source: Environment Scan

38. Goals 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 Implications: Meet the need for local content Source: Environment Scan

39. 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 Source: Environment Scan

40. 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

41. Recommendations for K4Health: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

42. Recommendations for K4Health: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

43. Recommendations for K4Health: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

44. Next Steps • Disseminate preliminary results widely • Complete multi-country qualitative study • Disseminate results and develop recommendations locally • Disseminate results and develop recommendations globally

45. For more information • K4Health Environment Scan • Currently available • Contact: Tara Sullivan (tsulliva@jhsph.edu) • Results of online survey • Available mid-July • Contact: Saori Ohkubo (sohkubo@jhsph.edu) • Complete report • Available early November • Contact: Tara Sullivan (tsulliva@jhsph.edu)

46. Johns Hopkins Bloomberg School of Public Health Center for Communication Programs 111 Market Place, Suite 310 Baltimore, MD 21202 Tel: 410-659-6300 Fax: 410-659-6266 Contact: Earle Lawrence, Project Director (elawrenc@jhuccp.org)