Enhancing access to health information is a major gateway to effective healthcare delivery; especially in developing countries.
Morbidity and mortality rates can be reduced if access to health information within the health system is eased. Today, moving health information from the point of generation to where it is needed requires the Medical Librarians to be proactive.
Introduction
According to the WHO Constitution of 1948; health is defined as “a state of complete physical, social and mental well-being; and not merely the absence of disease or infirmity”. Again the Ottawa Charter for Health Promotion (WHO, Geneva, 1986) regards health as a fundamental human right and so a resource for everyday life, not the object of living.
It considers health less as an abstract state and more as a means to an end which can be expressed in functional terms as a resource which permits people to lead an individually, socially and economically productive life. Information is an invaluable tool necessary for the advancement of the individual and society. It is required for the attainment of personal goals and objectives.
Health information therefore is that knowledge, facts and news generated from various sources, necessary for good physical and mental conditions of human beings.
Importance of health information today:
Health information has been variously described as the “glue” holding the health system together, and the “oil” keeping the health system running (Lippeveld T, 2001).
The part that health information can play in improving healthcare has been recognized for a number of years. It is generally known that knowledge is the enemy disease.
the utilization of available health information can prevent and reduce seven healthcare problems observable in every system, namely; unknowing variations in policy and practice; waste; errors; poor quality clinical care; poor patient experience; the over enthusiastic adoption of interventions of low value and the failure to implement interventions of high value.
To tackle the above health problems, all three types of knowledge have to be mobilized and utilized namely;
- Knowledge derived from research sometimes called evidence;
- Knowledge derived from routinely collected or audit data, sometimes called statistics
- Knowledge derived from experience.
The emphasis here is on the utilization of generated information for health because the value of health information lies in its utilization at the point of need. Health information can also be demonstrated as a supply chain streching from its source of production to the point of use.
Using the health professionals as example here, the generation of the information that doctors need is first step in the chain. This is necessary but not sufficient because information has to reach the point where it is needed.
For doctors to save lives, it is imperative to ensure that their decisions are based on best current health information whenever and wherever those decisions are being made. This requires the supply chain to be organized from the producer to the consumer, ensuring that:
- The information that is needed is generated
- The information that is generated is organized
- The information that is organized is delivered to where decision makers need it before and during the process of decision making.
- The organizations and individual within the healthcare systems have the skills and resources to find, appraise and use the knowledge.
The access to health information by patients remain the overall most important need of health information for a healthy society. The patient/consumer is the epicenter of the health information structure.
According to world medical and health experts the world will get it right only when tens of thousands of people are stopped from dying daily by improving their direct access to health information. Patients, their care givers (domestic and professional) from the last level of care to the tertiary must be routinely equipped with adequate health information for everyday need.
Sources of Enhancing Access to Health Information
Health information is derived mainly from research. It can be generated from routinely collected or audit data sometimes called statistics and from knowledge derived from experience.
The World Health Organization identifies the various sources, tools and methods through which health information can be generated to include:
- National health accounts
- Clinical based data
- Academic and research institution
- Communities and advocacy groups
- Administrative data
- Vital registration and census system
- Household and facility surveys
- Disease surveillance systems
Users of Health Information
At every level of healthcare system, users of health information need it in varying ways to meet their needs. The health information users include-
- Service providers
- Funders
- Consumers/patients
- Government/non-governmental organizations.
- Caregivers/communities
- Researchers
- Program managers
- Global agencies
- Policy makers
All these sectors from service providers to policy makers need health information on a range of health measurement areas. This may include mortality and morbidity rates; disease outbreaks; determinants of health (such as nutrition, environment, and socioeconomic status); access, coverage and quality of services; costs and expenditure; and equity (World Health Organization).
Factors Impending Access to Health Information
According to World Health Organization supply and demand in the health information field are not currently in equilibrium, with an oversupply of data coexisting with large unmet needs for information.
In many countries information on adult mortality and cause of death is not generally available. Morbidity is too poorly measured, while the coverage and costs of many interventions are not measured properly, and the information needed to monitor equity is inadequate.
In addition, the quality of health information is often highly variable with little standardization across definitions and methodologies, and considerable overlap and duplication.
Furthermore, information dissemination is inconsistent, and the use of information to inform decision-making is weak at all levels of healthcare system. However, different groups within the health system have peculiar impediments as listed below:
- Health professionals including doctors, nurses,and allied health professionals in Nigeria may have their access to health information compromised by the following barriers;
- Non availability of current and relevant sources of information.
- Non conducive library environment.
- High cost of acquiring materials.
- Lack of time and incentive to read and browse.
- Incompetent computer and internet skills.
- Low motivation associated with poor working condition.
- Poor internet connectivity.
2. Patients/consumers of health information services in both cities and rural Nigeria may have their access limited by these constraints:
- Ignorance of available health information and services.
- Low basic literacy rate.
- Poor internet access.
- Low health literacy levels.
- Preference for crude traditional medical practices.
- Proximity to health facilities and services.
- Superstitious beliefs and practices.
3. Researchers who are the major generators of health information for clinical practices especially in this era of evidence-based care may encounter these barriers:
- Inadequate provision of research facilities.
- Poor government funding/commitment.
- Poor feedback from medical facilities in the country.
- Lack of coordination from Ministries of health.
- Unreliable survey reports from the academia and other sources.
- Weak channel of communication within health systems in the country.
Ways to Enhancing Access to Health Information
Stakeholders should:
- Understand the health information needs of all sectors.
- Develop appropriate health literacy programmes.
- Embrace service delivery innovations using ICT and multimedia.
- Undertake clinical outreach programmes.
- Develop easy to read patient education materials.
- Collaborate with other health professionals to accelerate health promotion, education and communication activities.
Conclusion
The custodians (Medical Librarians) of this invaluable health care information should track and repackage health information from library collection in appropriate formats and make this readily accessible to both healthcare providers and health service consumers. Therefore enhancing access to health information cannot be over emphasized.
