Existing Status of Private Health Libraries (PHLs) in Bangladesh: A Survey

Mohammad Raju, Sk. Mamun Mostofa^*

Department of Information Science and Library Management, University of Dhaka, Dhaka, Bangladesh

Abstract

The principal aim of this study is to explore the existing information systems and services of private health libraries (PHLs) of Dhaka city, in Bangladesh. The more specific objectives of the study are to determine the adequacy of the health libraries resources and services, to find out the health professionals (HPs) information needs, technique of searching information, identify the challenges and provide some recommendations for improvement of health libraries in Bangladesh. The study showed that information systems implemented are not fully utilized; users are not satisfied with current information and communication technology (ICT) and services of the health libraries. There are difficulties in accessing electronic information resources and limitation in the printed collections. Finally the study proposed a roadmap for adoption the better services of PHLs in Bangladesh.

Keywords

Health, Private Health Libraries, Health Professionals, Health Information, Dhaka City, Bangladesh

Received: March 1, 2015
Accepted: March 20, 2015
Published online: March 24, 2015

@ 2015 The Authors. Published by American Institute of Science. This Open Access article is under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/

1. Introduction and Background of the Study

Bangladesh is one of the oldest civilizations with a kaleidoscopic variety and rich cultural heritage. It has achieved multifaceted socio-economic progress during the last 43 years of its independence. As the seventh largest country in the world (by population), Bangladesh is well marked off from the rest of Asia by mountains and the sea, which gives the country a distinct geographical entity (Raju, 2014). Bangladesh has made commendable progress in the technological, engineering and communication fields. Modern technologies are applied to information handling. Production of hardware and software technology is domestic. Dhaka is the capital and one of the biggest cities of Bangladesh. National resources are augmented by establishing links with the international systems. There are many medical colleges, and dental colleges in Dhaka city. Besides this, there are nursing colleges, pharmacy colleges and other institutions. Each college/institution has a library of its own attached to it. The libraries can be classified into Medical, Research, Ayurvedic, Homeopathic, Dental, Unani and Pharmaceutical libraries. People in poor countries like Bangladesh tend to have less access to health services than those in better-off countries, and within countries, the poor have less access to health services. Although a lack of financial resources or information can create barriers to accessing services, the causal relationship between access to health services and poverty also runs in the other direction. When health care is needed but is delayed or not obtained, people's health worsens, which in turn leads to lost income and higher health care costs, both of which contribute to poverty. Deprivations that lead to ill health are common in developing countries, and the poor in developing countries are particularly at risk. The relationship between poverty and access to health care can be seen as part of a larger cycle, where poverty leads to ill health and ill health maintains poverty. Health libraries in Dhaka city were founded concurrently with the foundation of medical teaching programs and modern hospitals in major localities. The number of health libraries is increasing with the establishment of new hospitals and universities around the entire city. In recent years many health libraries in Dhaka city improving their condition in ICT sites, but there are also some problems in other sectors. The role of health information cannot be overemphasized in this century. To achieve the goals of a healthy nation by these days, it is vital to stress the need for the supply of appropriate information to the right people at the right time. The health libraries can play a vital role about that which is possible by health libraries. Improvements in health information can come about only through information and education to the public to enable them to make healthy choices. The private hospitals strategy in Dhaka city, for example, focuses on health information promotion through provision of timely information at the community level. The aim of community based health care is that the community must be informed, motivated and involved. Through community-based health information schemes the standard top-down approach of conventional health care delivery would be replaced by an approach in which the organization and activities for health care information within the community are determined by local needs and conditions. Health concerns have, consequently, been brought into the mainstream of village activities. Health committees have been formed and village health workers (VHWs) have been appointed. These personnel help create a heightened community understanding of how people can organize themselves to prevent disease and improve their health. This way individuals gradually develop a positive attitude towards their own health information services as well as the community’s well-being, and the ability to become development conscious (Kaane, 1997).Health information reform efforts in the Dhaka city have focused on resolving some of the fundamental irrationalities of the system whereby costs and services utilization are often not linked to improved doctors and students outcomes. Consensus about health reform requires trust. The traditional trust patients have in physicians provides an important base on which to build.

2. Research Objectives

The prime aim of this study was to explore the existing information systems and services of PHLs in Dhaka city. The more specific objectives of the study were to:

a.  To reveal the adequacy of the PHLs resources and services in Dhaka city.

b.  To find out the HPs information needs, the information sources used by them and the adequacy of those sources.

c.   To show the frequency of library use and the satisfaction level of the users.

d.  To proposed roadmap for adoption.

e.   To identify the challenges and provide some recommendations for improvement of health libraries in Bangladesh.

3. Literature Review

Kaane (1997) reported that the promotion of health through community participation and by acceptable means is a big challenge to the library and information profession. He also suggested that libraries and information centres have to work in joint venture with health professionals.

Davarpanah (2003) in his study on university libraries in Iran reported that due to language barriers, an overwhelming number of these libraries had utilized commercial library-oriented packages developed in the country. The study reported that university libraries associated with the Ministry of Health. Treatment and medical education relied on either Nosa or Pars Azarakhsh software packages. The findings also indicated that largest number of libraries had computerized cataloguing systems.

Halkar and Gupta (2005) they observed that user is the supreme leader of any kind of information system. The benefits of information revolution are entering on the user and their convenience. The third and fourth laws of library science viz. lay emphasis on the importance of the user's research and his or her time.

Rathinasabapathy (2005) observed that the Internet gives access to a huge collection of health information to patients and professionals. Further, the training required for Librarians and Medical Professionals for evaluation of online healthcare information resources.

Khudair and Bawden (2007) carried out a study to gain a detailed understanding of the current health library environment in Saudi Arabia, to identify problems, issues, and areas for improvement, etc. They found that the healthcare libraries are well-used, and appreciated by their users, and the staffs are generally satisfied with their work. The study also identified some problems like use of information communication technologies and digital resources; lack of proactive information services etc. Finally they provide some recommendations for improvements of medical libraries.

Hayati and Jowkar (2008) found that the most problematic factors which slow down the adoption of electronic reference materials stem from unfamiliarity of academic librarians and users with computers and searching databases. They point out that the implementation of computers and information technology does not mean final acceptance and work productiveness.

A study was carried out by Farahi and Gandhi (2011) to investigate and compare the current state of information technology in medical libraries in Karnataka, India and Iran. They showed that though medical libraries in both countries have hardware, software, and communication facilities to some extent, they should strive to achieve excellent IT levels. They also identified that a good number of libraries had library management software and only few medical libraries in both countries are fully automated.

Bhatt (2012) reported that IT infrastructure in the medical college libraries of Gujarat is still in different stage of development, the status of library automation in these libraries is not encouraging. He also revealed that there is a clear lack of e-resources in self financed colleges due to non availability of financial aid, more stress need to be given on human resource management. He suggested that there is an urgent to plan, implement and develop ICT infrastructure to be fit in facing the challenges ahead of them.

Literature done above has made the researcher easy to have superb findings along with a good model of health library and solve the problems and the future prospects of health libraries in Dhaka city.

4. Methodology and Sample Design

The study used four separate data gathering methods: like; literature reviews, profiling of libraries and library staff, questionnaire analysis of library users and interviews with library staff. The questionnaire designed for this research was for HPs working in some PHLs in Dhaka city. Its main purpose was to gather both quantitative and qualitative data, and to gain an accurate knowledge of present activities of PHLs in Dhaka city. In addition, the questionnaire focused on the level of user satisfaction as it related to library services. One hundred and fifty sample library users were selected from different PHLs users, such as medical students, doctors, and researcher. Authors collected information equally from the selected health libraries, which are 30 from each library. Librarian has been also interviewed through a semi-structured questionnaire. The name of the libraries are Bangladesh Institute of Research and rehabilitation for diabetes, Endocrine and Metabolic disorders (BIRDEM), Bangladesh Medical College (BMC), Holy Family Red Crescent Hospital (HFRCH), Green Life General Hospital (GLGH), Anwar Khan Medical College and Hospital (AKMCH).

5. Information Services of Participating Health Libraries in Dhaka City

5.1. BIRDEM Library

BIRDEM library is a well established medical and health science library of the country. It is started in 1975 at Segun Bagicha and shifted to Shahbagh in 1981 and re-shifted to present premises in 1985. A short description of the library is given below (see table 1):

Table 1. BIRDEM Library at a Glance (Source: Annual report 2014-2015, BIRDEM Library)

5.2. BMC Library

The library started with the establishment of the Bangladesh medical college. This library is situated in the part of the main building of the college academy. Recently the library introduced networking system in it.  The collection of the library is enough enrich. This is a modern medical library. This library has open access system for the users and the teachers and researchers. The library provides various library services to the users like: Library use instruction, reference service, CAS service, Photocopy service etc. A short description of the library and library staffs is given below (see table 2):

Table 2. BMC Library at a glance (Source: Librarian, BMC Library)

5.3. HFRCMC Library

HFRCMC library is one of the famous hospital libraries. There are two parts of the library. Both are situated in the part of the main building. Library also provides internet service for the students. A short description of the library and library staffs is given below (see table 3):

Table 3. HFRCMC Library (Source: Librarian, HFRCMC Library)

5.4. GLMCL Library

GLMCL library is one of the most well furnished libraries among the medical college libraries in Dhaka city. The library is situated with the part of the main building in 13th floor. The library is fully central AC system. A short description of the library and library staffs is given below (see table 4):

Table 4. GLMCL Library at a Glance (Source: Librarian, GLMC Library)

5.5. AKMMC Library

The college library is spacious, well furnished with comfortable sitting arrangement, located at the academic building. It has a good collection of medical textbooks, references, monographs and journals on various subjects which can provide up to date information to the students and teachers. The library is also equipped with computers. It has user friendly access system, the library is provided with separate reading area for students as well as teachers. It has access to all medical related websites like HINARI, PubMED, Wikipedia and other online and also WiFi coverage. A short description of the library and library staffs is given below (see table 5):

Table 5. AKMMC Library at a glance (Source: Librarian, AKMMC Library)

This is the overall condition of health science libraries in Dhaka city. There are also many definitions of access to health services, with most researchers recognizing that access is related to the timely use of services according to need. Although some researchers distinguish between the supply and opportunity for use of services and the actual using of health services, most view access to health services as including realized need. Here we use a conceptual framework that builds on longstanding descriptions of access to health services that includes actual use.

6. Findings and Discussion

The authenticity and cogency of the research depends upon the validity of research data. This section gives a good indication of what is expected to get out of research. The investigator has attempted the data analysis and possible outcomes to the theory and questions that the users have raised. The researcher has tried to find out the existing information systems and services of PHLs in Dhaka city, available infrastructural facilities, modern library facilities, library professionals ability, some of the basic and general information of the libraries and the details about materials processing etc. The study shows that all libraries operate within the official hours, which is 09.00 a.m. to 05.00 p.m. Only BMC library and BIRDEM library close at 04.00 p.m. On the other hand, HFRCMC library is used generally two shifts. One starts at 08.00 a.m. and close at 02.00 p.m. and the second shift is starts at 02.00 p.m. and close at 08.00 p.m. All sample libraries have communication facilities like telephone, fax and e-mail. All the participating health libraries have their individual websites.

6.1. Frequency of Library Use

Figure 1 represents the frequency of library use by the respondents of PHLs in Dhaka city. It showed that 31% of the respondents use libraries occasionally and 30% use the libraries twice in a week. Other side, 24% and 15% of respondents use the library daily and occasionally.

6.2. Opinion about the Collections of Books in the Libraries

Figure 2 represent the opinion of the respondents of PHLs about the collections of books for research work in percentage. 37% respondents reported that the collections of the libraries are inadequate while 28% said that the collections are adequate. Rest 35% said that it is fairly adequate.

6.3. Number of Books in PHLs of Dhaka City

Figure 3 shows that BIRDEM library has the highest number of books i.e. 7413 books while AKMMC library, GLMC library and HFRCM College library have the lowest number of books i.e. less than 4000.

6.4. Average Ratings of the Sufficiency of the Information Materials

Figure 4 represent the average ratings of the sufficiency of the information materials in all the selected libraries of AKMMC library in Dhaka city. Among all the libraries the on average insufficiency is 58% and sufficiency is 30%.

Figure 1. Frequencies of Library Use

Figure 2. Opinion about the collections of books in the libraries

Figure 3. Number of Books in PHLs of Dhaka City libraries

Figure 4. Average Ratings of the Sufficiency of the Information Materials

Figure 5. Sources of information

Figure 6. Library Satisfaction Level

6.5. Sources of Information

Figure 5 represents that the user of the health library finds their information mostly through the text book, i.e. 40%. Rest20%, 15%, 10% finds their information through, journals, conference proceedings and unpublished sources.

6.6. Library Satisfaction Level

Figure 6 reveals satisfaction level of the library user. Largest number of users i.e. 50% is satisfied with overall library service. Remaining 30% users are satisfied with only library service and 20% are satisfied with the collection of the library materials of the respective libraries.

7. Challenges of PHLs in Dhaka City

Urban communities like Dhaka city receive information on various aspects of health. They are provided with information about family planning, nutrition, communicable diseases, immunization, anti-smoking, traditional birth attendants (TBA) delivery, environmental health, and others. The information is presented to them in many formats. This allows for greater individualization because those who are unable to process the information in one format are presented with an alternative. This poses a challenge to librarians and other information workers. Should they sit back and leave the information transfer process to professionals such as community health educators, social workers, communicators and others? The challenge and task are great in the developing world where librarians are faced with very many problems. These problems range from poor library infrastructure, lack of adequate trained manpower, lack of managerial skills among the existing trained manpower, lack of goodwill within the institutions that the libraries serve, to financial constraints and many others. Developing world librarians and other information workers must face the situation and use their professional skills and will to deal with this challenge.

8. Proposed Roadmap for Adoption

The foundation for the roadmap is a business case developed by e-health information researchers that will lower the risk of adoption for health care information providers. A strong foundation will enable three targeted efforts by the e-health information community to partner with providers, payers, and policymakers. First, the roadmap will help the e-health information community disseminate the business case and make available implementation best practices to providers seeking information.

Figure 7. Proposed roadmap for adoption (Raju, 2014)

Second, it will guide the nation to develop a workforce capable of implementing and utilizing e-health technologies information in clinical settings. Finally, the roadmap will outline methods to ensure sustainability of e-health’s role in health care information delivery. The roadmap was designed not as a prescriptive model for any one particular technology, but rather a framework to help the e-health information community to demonstrate real value to providers, integrate IT into clinical practice, and disseminate best practices to providers in the many settings that currently define the Bangladeshi health care information landscape.

9. Recommendations

HPs are expecting faster access to health information and to be able to share such information with other professional bodies and individuals, but this is clearly not possible in the absence of a health information network. Health libraries would benefit from such a network by providing more convenient, accurate, and up-to-date information to all users. On the other hand, health librarians are not satisfied with the current condition of their libraries and services. They expect development related to various issues concerning health sciences libraries in Dhaka (i.e. co-operation, policy, access to electronic sources, development of information services and information networks). Information networks could create and improve co-operation among health libraries in Bangladesh and with other health libraries elsewhere. Based on the study the following specific recommendations could be made for HPs.

9.1. Recommendations for HPs

1.  The electronic information services delivered to HPs should be developed and improved to enable them to make more efficient use of their time.

2.  During formal education, HPs should be provided with opportunities to acquire basic information handling skills.

3.  HPs should be provided with continuing educational programs which cover their information competencies and keep up with technological advances to maintain their information management skills.

4.  Advice and training programs should be conducted using various methodologies, for example: one-to-one, within group, online consultation, live training courses (either on site or e-learning).

5.  Policy makers for the healthcare system in the country should develop and implement policies and strategies to make certain that all health professionals have appropriate access to all forms of health and medical information.

6.  Be more proactive and assertive in demanding improvement in and development of the current situation of few available resources and inadequate access to needed information.

7.  Give more consideration to improving ICT skills in order for them to use various types of resources and not be limited to traditional printed materials.

9.2. Recommendations for Health Library

1.  To improve their technical and technological skills to deliver effective information services.

2.  To develop their professional attitudes and their practice paradigm from a reactive to a proactive stance.

3.  LIS educational programs should develop their curriculum to match the demands and challenges of the health information profession.

4.  Staff members should be developed through a continuous training facility (continuous professional development).

5.  Hospital management should work together with health information specialists to create and develop an information society in the healthcare environment.

6.  Should participate in national and international conferences and meetings to discuss various issues related to their profession.

7.  To establish a national association like, Association of Health Information Professionals.

8.  Training program evaluation should be considered in order for hospitals and health sciences libraries to develop their training services.

9.  A professional qualification in Library and Information Science (LIS) must be considered as a condition of employment for specialized positions in health libraries.

It is to be hoped that the results of the study reported here (more detail in Khudair, 2005) may be of attention in countries other than Bangladesh, as many of the issues and challenges will be the same.

10. Conclusion

HPs are expecting faster access to health information and to be able to share such information with other professional bodies and individuals, but this is clearly not possible in the absence of a health information network. Health libraries would benefit from such a network by providing more convenient, accurate, and up-to-date information to all users. The present study showed that that the user of the health library found their information mostly through the text book and lowest number of the user found their information through, journals, Conference proceedings and unpublished sources. Largest number of users is satisfied with overall library service. On the other hand, health librarians are not satisfied with the current condition of their libraries and services. They expect development related to various issues concerning health libraries in Dhaka city (i.e. co-operation, policy, access to electronic sources, development of information services and information networks). Information networks could create and improve co-operation among health libraries in Bangladesh and with other health libraries elsewhere.

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