____________________________________
Inaugural Commonwealth Nurses Conference
Our health: our common wealth 10-11 March 2012 London UK
In collaboration with the 9th CNF Europe Region Conference
Supported by the Royal College of Nursing UK
Dr NEIL PAKENHAM-WALSH
Meeting the information needs of nurses and midwives in low- and middle-income countries
Meeting the information needs
of nurses and midwives across
the Commonwealth
Dr Neil Pakenham-Walsh
Coordinator
Healthcare Information For All by 2015
Global Healthcare Information Network, UK
www.hifa2015.org [email protected] Twitter @hifa2015
Inaugural Conference, Commonwealth Nurses
Federation, London, 10 March 2012
High income
countries
India
Pakistan +
Bangladesh +
Nigeria
40 other LMICs
Commonwealth: 2.1 billion people
94% in LMICs
Outline
1. Empowering Nurses and Midwives to
save lives and reduce suffering
2. Healthcare Information For All by 2015
3. The HIFA Challenge 2009-15: Meeting
the information needs of Nurses and
Midwives
4. Ways forward: Strengthening the Global
Healthcare Knowledge System for N&M
1.1 Empowering Nurses and
Midwives to save lives and
reduce suffering
“The only route to reaching the health MDGs
is through the health worker; there are no
short-cuts”
Lincoln Chen, Human Resources for Health:
Overcoming the crisis 2004
Empowering Nurses and Midwives is
fundamental to reduce unnecessary
death and suffering and thereby achieve
the health MDGs
1.2 Empowering Nurses and
Midwives
– Poor health care in LMICs is seldom due to
individual nurses and midwives
– The problem is usually due to health systems
failing to (1) provide sufficient numbers of
nurses and midwives and (2) meeting the
needs of existing nurses and midwives
– Nurses and midwives are not the problem, they
are the solution
Meeting the needs of existing nurses and midwives…
1. Skills
2. Equipment
3. Information
4. Supporting infrastructure
5. Medicines
6. Incentives (including a decent salary)
7. Communication facilities
SEISMIC
1.3 Empowering Nurses and
Midwives
1.4 Empowering Nurses and
Midwives
ICN: Positive Practice Environments
campaign (PPE)
ICN/HIFA2015 Fact Sheet: Meeting the
information needs of healthcare providers
2.1 Healthcare Information For
All by 2015
People are
dying for
lack of basic
healthcare
knowledge
400 children and 20 young women will die in the next half hour due to lack of simple,
inexpensive life-saving interventions
Slide 2.2
People are dying for
lack of basic healthcare
knowledge
Many of these deaths would have been
avoided if citizens and health workers
– including nurses and midwives –
had access to appropriate, reliable
healthcare information
Slide 2.3
2.4 HIFA2015
How can we improve the availability and use of healthcare knowledge?
Lancet article: Fiona Godlee, Neil Pakenham-Walsh et al 2004: Can we achieve health information for all by 2015?
Strengthen links between health professionals, researchers, publishers, librarians, policymakers and others
2.5 HIFA2015
Launched in Mombasa, Kenya 2006
5 global email forums
>7,500 members from >2000 organisations
in 163 countries
2.6 HIFA2015
HIFA2015 Goal:
“By 2015, every person worldwide will have access to an informed healthcare provider – availability of basic healthcare knowledge will no longer be a major contributor to avoidable death and suffering”
Dr Tikki Pang, Director, Research, WHO:
“The HIFA2015 goal is ambitious but is achievable if all stakeholders work together”
2.7 Professional status of
HIFA2015 members
Health workers
Information
delivery
Development
Health systems
Researchers
Donors
Slide 2.9
2.8 HIFA2015
Officially supported by 132 health
and development organisations
worldwide, including the
Commonwealth Nursing
Federation, ICM, ICN, RCM,
RCN…
132 HIFA2015 Supporting Organisations
2.9 HIFA2015 Email Forum
“HIFA2015 has many incredibly
important and informative
discussions - it is a tremendous,
flourishing community and a valuable
service to health workers and others
around the world.”
Dr Eric Friedman, Physicians for Human Rights, USA
2.10 CHILD2015
2.11 Invitation to join HIFA2015
and CHILD2015 today
2.12 HIFA-Zambia
2.13 Collaboration with WHO
2.14 External Evaluation of
HIFA2015
“HIFA2015 achieves an
extraordinary level of activity
on minimal resources from
which many people around the
world benefit.” External Evaluation of HIFA2015, funded by
Rockefeller Foundation, 2011
“As I travel around the world and visit health centres and schools of health professionals, I am outraged by the lack of current books and journals in a number of countries… That is why I decided to join the HIFA2015 campaign. HIFA2015 provides a forum for pooling of our resources, experiences and best practices. Together we can improve access to health information and ‘walk the talk’ toward evidence based care for all.” Tesfamicael Ghebrehiwet, International Council of Nurses, Geneva, Switzerland
3.1 HIFA 2009-15 Challenge:
Meeting the information needs
of Nurses and Midwives
“I am from Ethiopia, Nurse Lecturer at Jigjiga University.. we have lack of essential reference books to refer and internet access is also limited. I also observe that nurses working at hospitals and health centers face the same problem. Therefore a coordinated effort of many stakeholders as well as nurses is needed to solve these problems…Who, how and when to start this effort?”
HIFA2015 profile: Beyene Meressa is a lecturer at Jijiga University, Ethiopia. Professional interests: research in priority health problems and project design and implementation improve public health. beyenemeressa AT yahoo.com
6th March 2012
3.2 HIFA 2009-15 Challenge:
Meeting the information needs
of Nurses and Midwives
3.3 HIFA 2009-15 Challenge:
Meeting info needs of N & M
How?
1. HIFA Challenge Working Group
BMA, ICM, ICN, RCM, RCN
2. Agree a specific goal with HIFA members:
“By 2015, every nurse and midwife will have access to the information they need to learn, to diagnose, to provide appropriate care and treatment, and to save lives.”
3. Increase number of N&M on HIFA – >800
3.4 HIFA 2009-15 Challenge:
Meeting info needs of N & M
How? (cont’d)
4. Promote discussion on the information
needs of N&M and how to meet them
5. Literature review of information needs of
N&M
3.5 HIFA 2009-15 Challenge:
Meeting info needs of N & M
General lit review: only 35 studies identified in past 10 years (Medline)
“The studies suggest a gross lack of knowledge about the basics on how to diagnose and manage common diseases, going right across the health workforce and often associated with suboptimal, ineffective and dangerous health care practices.”
Pakenham-Walsh N & Bukachi F. Information needs of health care workers in developing countries: a literature review with a focus on Africa. Human Resources for Health 2009, 7:30
3.6 HIFA 2009-15 Challenge:
Meeting info needs of N & M
3 in 4 doctors and nurses caring for sick
children in district hospitals in low-income
countries had poor basic knowledge of
how to provide care for children with
common, life-threatening diseases. Nolan T et al. Quality of hospital care for seriously ill children in less-developed
countries. Lancet 2001;357(9250):106-10
3.7 HIFA 2009-15 Challenge:
Meeting info needs of N & M
“The ones needing the information most are the nurses and the Community health workers in the rural health settings including the “Urban Poor areas.” HIFA2015 member Mary Roroi, MoH, Papua New Guinea
The language barrier to evidence-based health care: Translators without Borders (HIFA Supporting Organisation) – Local capacity
3.8 HIFA 2009-15 Challenge:
Meeting info needs of N & M
3.9 HIFA 2009-15 Challenge:
Midwives
A study of a 250-bed government hospital in
Uganda found a lack of standard treatment
guidelines associated with lack of basic
knowledge of obstetric emergencies such as
haemorrhage, obstructed labour, sepsis, and
eclampsia… and poor quality care. Kaye D. Quality of midwifery care in Soroti district, Uganda. East African
Medical Journal 2000;77:558-561
4.1 Strengthening the global
healthcare knowledge system for
nurses and midwives
4.2 Understanding information
needs
To be useful, information must be
relevant and reliable
Information needs are Diverse and
Dynamic
Perceived needs are not the same as
Actual needs
4.3 Strengthening the global
healthcare knowledge system for
N & M
4.4 Undertaking and publishing
health research on nursing and
midwifery Lack of research relevant to LICs – ‘10/90 gap’
Low research capacity in LICs
Lack of research on how to improve nursing and
midwifery care in low-resource settings
4.5 Strengthening the global
healthcare knowledge system for
N & M
4.6 Producing systematic
reviews and guidelines
4.7 Strengthening the global
healthcare knowledge system for
N&M
4.8
4.9
4.10 Strengthening the global
healthcare knowledge system for
N & M
4.11 Strengthening the global
healthcare knowledge system for
N & M
4.12 Making information available
3 organisations working together
Information Training & Outreach Centre for
Africa (ITOCA) We envision an improved quality of life and sustainable
development in Africa through enhanced research and
education
Association of Health Information & Libraries
in Africa (AHILA) Lead in promoting access and use of health information in Africa
Partnerships in Health Information (Phi) Saving lives through reliable health information
CONTACT: Chipo Msengezi [email protected]
4.13 Making information available
• 5.9 billion mobile phone subscriptions worldwide
• 79% are in developing world
• Wide-spread use in both urban and rural areas
• Highest rate of mobile market growth is in developing
countries
• Worldwide, 200,000 text messages are sent every second
L'Engle K et al. Reaching Young People with FP Information via Mobile Phone
Mobile phones
4.14 Making information available:
mobile phones
• Every nurse and midwife should have a means of communication by which they can reliably and immediately speak to other health professionals for advice and referral
• Every nurse and midwife should eventually have access to essential reference information, on their mobile phone, when and where they need it
• Information for mothers (eg MAMA), citizens, families: HIFA 2012 Challenge
Summary
1. All efforts should be directed to liberate
and empower Nurses and Midwives to
save lives and reduce suffering.
2. It is not acceptable that people are
dying for lack of healthcare knowledge
3. Join HIFA2015 – Let’s work together to
achieve our common goal:
“By 2015, every nurse and midwife will have access to the information they need to learn, to diagnose, to provide appropriate care and treatment, and to save lives.”