WfjRKING GROUP OF FOCAL POINTS FOR THE REGIONAL {/ In OMEn 1 CAL I NFORMA nON PROGRAMME
Convened by the
REGIONAL OFFICE FOR THE WESTERN PACIFIC OF THE
WORLD HEALTH ORGANIZATION Manila, Philippines
14-18 December 1981
Not for resale Printed and distributed
by the
Regional Office for the Western Paicific of the World Health Organization
Manila, Philippines March 1982
The views expressed in this report are those of the participants of the Working Group and do not neccessarily reflect the policies ot the
Organization.
This report has been prepared by the Regional Office for the Western Pacific of the World Health Organization for governments of Member States in the Region and for those who participated in the Wotking Group of Focal Points for the Regional Biomedical Information Programme, which was held in Manila, Philippines, from 14 to 18 December 1981.
1.. INTRODUCTION .. ,. ... 10 " . . . ..
3.
4.
5.
OBJECTIVES ... .. 1
DURATION, SCHEDULE AND PARTIe! PANTS ••••••••••••••••••••••••• 2 STRATEGY ... ,. ... .. '1
PROCEEDINGS ... .. 2 5.1 Regional programme for research promotion
and deve 1 opmen t ... 3
5.2 5.3 5.4
Technical cooperation in the regional
hiomedical information lIystem •••.•••••.•••.•••••••••.•
WHO heal th litera t ure programme •••.••.•.•••••••••••••.
User requirements for health research
3 4 and cooperation... 4 5.5 Western Pacific regional biomedical
5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15
informs t ion pToJiZ;TBmme ... ..
Inter-library loan cooperation at regional level ••••••
Australia/WHO Agreement for Supply of
6 6 HEDLARS Services ... 7
National focal points for biomedical
literature in the Wel'ltern Pacific Region . . . . Information retrieval and document delivery •••••••••••
Network development: Planning, promotion
and procedures ... . Strengthening of national biomedical
infort1lation networks ... ..
Education and training nf medical lihrarians ••••••••••
National and regional network developments ••••••••••••
Bibliographic control of the regional
biomedical and health literature .••.••••••••••••••••••
Regional health literature and its control ••••••••••••
7 8 9 10 10 11 12 13 6. OONCLUSIONS. .. .. . . . .. . . .. . .. . . . .. .. . .. . .. .. .. .. . .. • • • .. .. . . .. • . • • . .. ••• .. • • • •• 15
7. REOOMMENDATIONS. . . • • • • . . . • . • . . . • • • • • . • • • • • • • • • • • • •• • • • • • • • • • 15 LIST OF ANNEXES
ANNEX I - PROVISIONAL AGENDA... 19 ANNEX 2 - LIST OF MEMBERS, TEMPORARY ADVISER
AND SECRETARIAT ... 21 ANNEX 3 - OPENING ADDRESS BY DR S. 1'. HAN,
DIRECTOR, PROGRAMME HANAGEMENT, ON BEHALF OF THE REGIONAL DIRECTOR. WHO REGIONAL
OFFICE FOR THE WESTERN PACIFIC . . . 23
ANNEX 4 - CLOSING ADDRESS BY DR S.T. HAN,
DIRECTOR, PROGRAMME MANAGEMENT, ON BEHALF OF THE REGIONAL DIRECTOR, WHO REGIONAL
OFFICE FOR THE WESTERN PACIFIC ••••••••••••••••.•.••••••• 2S ANNEX S - BIOMEDICAL INFORMATION SYSTEM DEVELOPMENT
...
27ANNEX 6 - PROPOSAL FOR THE DEVELOPMENT OF A WESTERN PACIFIC
REGIONAL BIOMEDICAL INFORMATION NETWORK ••••••••••.•.••.. 37 ANNEX 7 - IMPLEMENTATION OF THE AUSTRALIA/WHO MEMORANDUM
OF UNDERSTANDING FOR THE SUPPLY OF MEDLARS SERVICES TO THE DEVELOPING COUNTRIES IN
THE WESTERN PACIFIC OF WHO •••.•••••••••••••••••••..••••. 45 ANNEX 8 - MEDLARS SERVICES IN AUSTRALIA •••••••••••••••.••...•.•. Sl ANNEX 9 - BIOMEDICAL LIBRARIES AND INFORMATION
SERVICES IN CHINA •••••••••••••••••••••••••.•••••••.•••.• 57
In the context of "Heal th for All by the Year 2000", countriefl and .rea.
in th .. Western Pacific Region of WHO have been formulating Itrategies and developing snd implementing procedures and mechanisms to achieve the
Health/2000 goal within the ~iven time-frame. Development and provision of information support have been considered hy the Mpmber States as a priority art'a for programme development and management in relation to Health/2000 strategy. Since its inception, the Western Pacific Advisory Committee on Medical Research has emphusized the need to establish and facilitate
procedures for effective biomedical information exchange to permit the conduct of appropriate research to devplop health systems based on primary health care.
The WHO Regional Office for the Western Pacific organized a meeting of a regional Working Group of Librarians in Manila from
13 to 16 November 1978, which identified certain priority activities to be undertaken in the context of the WPACMR recommendations. During the period 11-29 August 1980, a study was carried out to formulate a biomedical
information programme that was practical and effective in satisfying the
biomedical informstion requirements of health managers, educators. reflearchers and service delivE'ry pprsonnel. Thill was immediately followed by an offer
from the Government of AUlltralis to provide the developing countries of the Western Pacific Region, through WHO, with bibliographic computer searches
(MEDLARS) and photocopies.
In response to the request by the Regional Director of WHO/WPRO, the developing Member States in the Region designated national focal point. to
facilitate the implementation of the Australia/WHO Memorandum of Understanding for the supply of MEDLARS services. The current meeting of the Working Group of Focal Points for the Regional Biomedical Information Programme was intended to bring together the users lind providers of health literature and inforaation services with the objective of formulating recommendations on the development of a user-oriented regional hiomedical information programme.
2. OBJECTIVES
The overall objective of the Working Group was to make recommendations on the direction WHO collaboration with Member States should take in the
development and establishment of a regional hiomt'dical information programme in the Western Pacific Region snd on priority activities to be undertaken in this respect at national and regional levels.
The specific objectives were as follows:
(1) to discuss the development of the Western Pacific biomedical health information network, to draft a regionsl network development plan for 1982-1983, and to explore further areas of regional cooperation;
(2) to determine which potential user groups will be served and to plan the promotion of network activities,
(3) to establish the administrative structure of the network,
especially the procedures for liaison between the national focal points, the Regional Office and the resource libraries;
(4) to review the possibilities for the monitoring, statistical recording and evaluation of network activities:
(5) with regard to the Australia/WHO Memorandum of Understanding for the Supply of MEDLARS Services to the Developing Countries of the Western Pacific Region, to agree on uniform work procedures and
forms, and to determine the preferred channels of request transmission.
3. DURATION, SCHEDULE AND PARTICIPANTS
The meeting of the Working Group was held from 14 to 18 Decemher 1981.
Annex 1 givea the agenda of the meeting. There were 14 participants in all at this Working Group meeting who are listed in Annex 2.
4. STRATEGY
The Working Group strategy consisted of plenary sessions on specific aspects followed by group sessions to discuss in-depth relevant issues so that the outcome of these sessions would provide an appropriate hasis for the formulation of concrete recommendations with regard to the direction the WHO regional biomedical information programme should take. It would specify
activitie~ to be undertaken and identify priorities at the national and regional levels and on a short-, medium- and long-term ba.is.
5. PROCEEDINGS
The meeting was opened by Dr S.T. Han, Director, Programme Management, on behalf of Dr Hiroshi Nakajima, Regional Director, WHO Regional Office for the Western Pacific. The full text of the opening address is given in
Annex 3.
Dr Fu Lai was elected Chairman, Dr Chin Thack Soh Vice-Chairman and Mr H.V. Pribac Rapporteur for the plenary sessions. The members weTe divided into two groups, each with its own chairman and rapporteur for the group sesaions. The meeting was closed on 18 December 1981 by Dr S.T. Han, on behalf of the Regional Director. The full text of the closing address is given as Annex 4. The following section deals with the presentations,
discussion. and outcome of the different ses.ions of the Working Group.
).1 Regional programme for rese.rch promotion and development
At the plenary session, the presentation and discu •• ionl can be summarized as under:
Library and bibliographic services conltitute .n e'lential lupport to relearch.
An
in-depth Itudy of the literature i. required before. rele.rch project can be launched and bibliographic servicel play an important role in the dissemination of research relult.. In view of this, the Weltern Pacific Advisory Committee on Medical Research at its Sixth sellion atated the need for a regional biomedical information programme.Research supported by WHO is viewed mainly as an accelerator of the health for all strategy. It includes the three major research sectors, namely: biomedical and health technology research, health services research and health behaviour research.
In the developing countries, resourcee in terma of manpower, equipment and funds available for research are very limited. It ie therefore
important to avoid duplication and to focus rese.rch efforts on need-based research simed at the solving of specific priority health problems. This rel.tes specifically to health services research, which is a fairly new, still embryonic research field. Its results are usually not diesemin.ted through the scientific journal literature but are documented in a variety of document categories such as rese.rch reports, working papers, memoranda, etc., which escape conventional bibliographical control. It ia ese.ntial to create new bibliographical services for the dissemination of theae research documents, otherwise their findings will not be communicated to a wider interested public.
In order to incorporate information aspects more closely into the work of the Western Pacific Advisory Committee on Medical Research, consideration should be given to co-opting one member of the biomedical information
community to the Committee's membership.
5.2. Technical cooperation in regional biomedical information ay.tem At the plenary session, the preaentation and discus.iona can he 'UEmari&ed as under:
Technical cooperation among developing countriea (TCDC) is not • new concept but ita important role in promoting aocioeconomic development was agsin highlighted during the United N.tion. Conferenc~ on Technic.l
Cooperation Among Developing Countries, held in Bueno. Aires in 1978. Its ohjective is the attainment of greater self-reliance by the developing countries. Countries are urged to strengthen their scientific and
technological capabilities to suit their special needs and conditions, to establish scientific and technological data bases, to encoura,e indigenous research and development activities, and to link their national reaearch institutions with those of others. In the information lector, the creation of a heslth development network is recommended at the n.tional, regional and global levels. Information to be transferred through this network would consist of health services research results, practical experiences in health
system plsnning and operation, information on training programmea, etc.
Exchange of information between developing countries on all aspects of
primsry health care will be a particularly important support in implementing the health for all strategy. Regrettably few health workers in the
developing countries can at present record th~ir experiences in writing. A promotional effort appears necessary to encourage more active information exchange in this area in the interest of TCDC.
5.3. WHO health literature programme
At the plenary session, the presentation and discusaions can he summsrized as under:
The development of a Western Pacific regional biomedical information network is not an isolated effort but part of a global WHO programme. All regions have now launched activities in the health literature sector. Their common objective is to improve access to the international resources of biomedical and health information for the health personnel in the developing countries. However, different priorities have been set in the various
regions and different approaches chosen.
In the African Region, a looaely organized consortium of medical
libraries has started to organize resource sharing. A union list of medical periodicals held in some major medical libraries is approaching completion.
The American Re~ion founded a Regional Medical Library for Latin America in 1966 and 18 now developing a network based on national centres.
Since 1979, an index to the medical periodical literature has been published.
Resource sharing through inter-library loans and photocopy supply IS the major thrust of the programme in the Eastern Mediterranean Region. A union list of serials and a directory of medical libraries have been
compiled.
5.4 User requirements for health research and cooperation
At the Group Session I, the following points were brOulht out:
The ~roups were unable in the time available to do more than identify a small proportion of the differing requir ••• nte of the varioul cla •• ea of health information usere. Underlying the diecua.ionl wa. tbe QOD.enlUI that existing information lervice. are inadequate although the dearae to which
this varies considerably from country to country.
With some exceptions, the pattern of library servicee in the Region consists of a series of uncoordinated librariee deeilnedto aerve the basic and immediate needs of users affiliated with major health iaatitutions.
From this, it follows that those who actually have physical accels to
library facilities, whether researchers, educator. or practttioners, are the only users who can be considered to be even adequately a.~. At the other end of the scale there are great categories of users who are Dot reached by
library services at all: these include such people aa health workers engaged in primary health care, particularly in outlying ar.a., private practitioners, and health consumers.
Both groups highlighted the inadequacies of existina services for health programme managera. While the indigestible nature of much
bibliographic information preaenta difficulties for all u.er., it w.a felt that, of all user groups, it is the health planners and policy-maker. who have the moat pressing need for evaluated and precise data.
In both groups, discusaion about the types of inforaation inadequately provided by existing library and documentation aervicea was closely
intertwined with the diacusaion about the differing requirements of different users.
Significantly, members from countries with non-Roman scripta
immediately identified the problem of translation aa beiDl the major problem affecting their library services. Dr Fu Lsi described a Chineae Inatitute of Medical Information service, which provides abatracta of foreign
literature in the Chinese language and is regarded as beiDg eminently successful.
China has also recently eatabliahed two regiatera, one for ongoing research and the other for completed reaearch. It is too early to gauge their effectiveness but, in the discuaaion which followed, it waa generally agreed that a real need exists in all Member State. for information ayatema which enable health planners to order research prioritiea in the light of existing and completed reaearch and of overall national bealth goal.. In
some countries, this is made difficult by the widespread publication of domestic research results in overseas publications.
Members of both groups strongly reaffirmed the need for areater control at the national level of locally produced information and their deaire to have established an index of material produced in the Region aa a whole.
It was also noted that user satiafaction with library aervices dependa heavily on the user's perception of what is available from librariea. This applies at all stages of library development. In Australia's case, it waa noted that the further development of telecommunication networks and the growing use of personal computers by medical practitioners would not only increase the potentialities of information aervices but would also create a desire among users for new and more appropriate services.
The European Region is in the proceas of organizing health literature services (MEDLARS searches and photocopiea) for the developina countries in that region.
National medical library networks are the first priority in the South-Eaat Asian Region. At the regional level, the major pTolTamme components are the compilation of a South-East Asian Index to Health I.iterature and various educational activities.
The Office of Library and Health Literature Service. of WHO
Headquarters is coordinating these activities, assisting the regions with expert advice and, upon request, actively participating in .pecific
projects. Under medium-term programming, the objective is to integrste the health literature programme firmly into the health for all strategy.
5.5 Western pacific regional biomedical information programme
At the plenary lel8ion, the presentation and dileussions esn be summsrized a8 under:
The history, objectives, technicsl and organizational approaches, ongoing activities, and prospects for future development are summarized in the annexed paper on "Biomedical information system development" by
Mr M. Subramanian, Regional Adviser in Health Information (see Annex 5).
5.6 Inter-library loan cooperation at regional level
At the plenary ses8ion, the presentation and discussions can be summsrized as under:
The demand for docuaent delivery, in the form of loans or photocopies, has seen a heavy growth during the last decade. This increasing demand for
literature from a steadily broadening range of periodicals has forced the libraries to rely more heavily on resource-sharing through inter-library lending. It can be expected that, wherever possible, requests are satisfied within the country froa which they originate. However, no country, not even the developed ones, can boast self-sufficiency in document delivery and all have to rely on the procurement of library materials from outside sources.
I t should be noted that the term "lending" in the present context refers usually to the provision of photocopies which, for the periodical
literature, have nearly entirely replaced the physical loan of the original pub licat ions.
There are at present two main sources of photocopy supply in the Region:
the free services offered by Australia and Japan (SEAMIC) inter-library lending between Member States of the Western Pacific Region.
The latter service is very little developed and at this stage is not considered to offer an efficient solution to this problem. With improved telecommunication links, inter-library transactions between Member States of the Western Pacific Region could become an integrated component of resource sharing in the network.
The very positive experience. with large literature resource centres such as the Regional Library of Medicine and Health Service. (BIREME) at Sao Paulo, Brazil, luggest that the feasibility of eatablishing such a central library in the Region should be considered. The Centre would have to be equipped with a core collection of medieal periodical. carefully selected so as to be responsive to the specific needs of users in the Region. If based on an existing good library collection, this might require aubecribing to an additionsl 800-1000 periodicals. FUnding .hould be sought from lovernaental agencies and donors in the private sector in the developed countries but the developing countries should also contribute to meeting the co.t. Location of the regional resource centre in a developing country would help to keep manpower cost at an affordable level and place the resources where they are most urgently needed. A payment mechanism by coupons is proposed, which could be administered by the Biomedical Information Coordination Unit at th~
Regional Office.
5.7 Australia/WHO Agreement for Supply of HEDLARS Services
At the plenary sesaion, the presentation and diacus.ions can be summarized as under:
On 5 September 1980, the Director-General of Health, Government of Auatralia, wrote to the Regional Director to make a proposal for the free supply of substantial bibliographic and document delivery services to the developing countries in the Region. The Memorandum of Understanding on this offer was signed by the two parties in August 1981. It specifies the nature and volume of the services and the modalities for the implementation of the Agreement (see Annex 7). The Regional Director subsequently informed the governments of the countries concerned of the Australian offer and invited them to designate national focal points.
The service offer is initially limited to a period of two year.. It may be extended if, during the initisl phase, its usefulne •• is
demonstrated. In this case, consideration might also be ,iven to entering, in a second stage, a number of other areas of cooperatioa between Australia and the other Member States of the Region through WHO. Theae could include
the development of an on-line network for data baae aearching and meaaage switching, the setting up of a regional resource library, the proviaion of core collections of medical periodicals at the focal points in the
developing countries, the generation of data basea of the local biomedical literature and on major local health problems, and a programme of u.er
education. If the full support of Member States can be obtained and a modu.
of joint financing found, this second stage of the Australia/WHO Agreement could be implemented on a medium-term basis.
A paper providing background information on the HEDLARS services in Australia is given as Annex 8.
5.8 National focal points for biomedical literature in the Western Pacific Region
At the plenary session, the preaentation and discussion can be summarized as under:
The role which the focal points play in the context of the regional biomedical information programme need. to be better specified. Their
functions and responsibilities must be determined and criteria defined that will assist Member States in designating them.
Reasons or premises These were stated to be:
dependence of medical and health personnel on the provi.ion of health literature and unpublished health reports and aurvey.:
dependence of libraries on resources and sources outaide tbeir country. Except for Japan, Australia and China, not much ia published in the Region;
scarcity of resources in some parts of the Region;
established evidence that demand and resource. in the Region are growing; e.g. in 1957 there were only 21 medical .choo1s, which in 1979 there were 45 medical schools <excluding China, Japan,
Australia and New Zealand);
need to share and coordinate existing resource. in the Region and to concentrate scarce resources to provide an effective response to demand.
Functions and responsibilities
These, as delineated in document WPR/WG/HLT/81.5, were found to be satisfactory, except that more emphasis .hould be placed on document delivery and technical facilities.
It was advocated that a focal point should be the central resource point for a country and that particular attention should be given to
communication channels between focal points and other resource libraries in the country if the focal point itself is not a resource library. It was emphasized also that focal points should serve not only 8~ collecting organisms but also as filters in the collection .nd indexing of the
so-cslled fugitive literature.
Criteria for selection of focal points These were considered to be:
(1) Focal points should be selected on the basi. of existing resources and strengths, at existing centres of excellency, if po.sible.
(2) Other re.ources in the country should be brought into a network coordinated by the focal point, and such. network should have the .upport of national medical councils and health authorities.
(3) Focal points should have good communication links with other
relource centres in the country and abroad (telex, telephone, close mail handling facilities, computer terminals, if possible). Theae points should be able to lervice health workers on the periphery as well. They should have reliable photocopying and microform.
handling equipment.
(4) Focal points should by themselve, have a good core collection of between 400 and 800 journal, selected from the world scientific core and should collect the relevant national literature.
(5) Focal points should have properly trained library ,taff and be able to train medical librarians and technicians for otber literature information handling units in the country.
5.9 Information retrieval and document delivery
At the Group Session II, the following points were brought out:
It wa. generally agreed that the reference collectia •• of mOlt librari •• in the Region are quite inadequate and that, of the . . jor abstracting and indexing publication., only Index Medicua i. generally affordable. Even here, . . ny librariea rely OD the ou.ulssed Index Medicua and are unable to afford the .onthly indexea. Thi. meana tbat even ba.lc reference aervicea are not up-to-date.
In the developed countries, preSlure OD library budpt. ie relulting in widespread cancellation of soae of the .ore expenai.e rehrence worke,
particularly Excerpta Medica, with libraries relying inat •• d on occaaional access to on-line services. While such acceaa ia see.inaly expensive enough already, prices are generally predicted to riae further •• a reault of this trend and of general risea in the coat. of publiahina. It ia likely that many reference toola will ceaae publication altogether.
What little use there ha. been . . de in the developi . . countries of computerized literature aearching ba. generally been satlefactory with usera providing a generally po.itive feedback about the re.ulta of their
searches. WHO found at the tiae of its Geneva MEDLARS .ervice that clinically oriented searches were more .uccea.ful than those on public health though it is posaible that technic.l change. in
MlDLARS aDd
theavailability of the Health Planning Database will reault in a better service to health planners now.
Data on the effect of computerized information services on
inter-library lending is non-exi.tent in .ost countries. In Auatralia, there are conflicting opinions on the iaaue. While it i. undoubtedly the case that the volume of interlending is increasing, it i. increasing far less rapidly than computer searching and there are few caaea where an
Australian library needs to employ extra staff to handle extra interlending traffic.
Most respondents to the questionnaire for the directory of medical libraries reported that they have photocopy machines. Telex and microform equipment are generally in short supply.
It waB felt that microcomputers bave great potential in health literature services and that WHO sbould explore their apt1ication in the developing countries.
5.10 Network develop!ent: PlanniDS. pra.otion and pr!O!dur.a
At the plenary Be •• ion, the pre •• ntation and di.cuaeion. can be summarized as under:
The objectives, structure and activities of the network are outlined in a paper entitled "Propossl for the development of a W ••
tem
PacificBiomedical Information Network" (aee Annex 6). 'l1Ih .ulleat. an
evolutionary network development, with eaphaais on the .trengtbenina of basic health literature services in the developing countrie. in the Region.
It was recognized that alternatives to this concept are feasible. A more aggresaive approach is outlined in Annex 8 as a potential second stage of the Australia/WHO Agreement for Supply of HEDLARS Searches. Its main componeuta would be the application of advanced telecommunications
technololY and the setting up of a regional biomedical literature resource centre.
Whichever of the two alternatives ia Unplemented will depend on the commitments that Member States of the Region are able and willing to make.
and on the availability of funds. An in-depth atudy of the specific
re~ource. and facilities availahle in the Region. and of the actual needa of the countriea ahould be conducted to provide the background informacion required by the deciaion-mekera intbe countriea snd the Regional Office.
5.11 Strengthening of NatioDal Biomedical Inforaation Networks At the plenary se9aion. the presentation and discussions can he summarized as under:
An exemplary approach to developing a comprehensive national hiomedical information system is being implemented in China. This encompsases all hAsic aspects of health litereture services. Only aome more advanced types
0f activities such as on-line data base searching have been postponed until the conditions for the application of the required technology have been created in the country. The present status of the biomedical information situation in China is described in detail in Annex 9.
Tt will depend on the specific conditions prevailing in the countries of thp Region. on the available resources and on user needs whether they choose an integrated approach like that of China or whether certain components of the health literature services are given national priority
stAtu~ for strengthening at short and medium-term.
5.l? Education and training of medical librarians
At the plenary session, the preaentation and discussions can be
~lImmari2'ed as under:
It will depend on the competence of the staff working in the medical libr.'lrif's of the Region how successful they will be in meeting the health inf,'nnation needs of the countries. There can be no douht therefore that pducRtional and training activities should be a priority item of the
n~~i"nal biomedical information progrllmme.
At this time. there lire few trained medical librarians working in the developing countries in the Region. The national capacities of medical librarianship will therefore have to be upgraded for all staff levels.
Four educational alternatives for medical library training could be considered:
(1) Attending foreign medical library achoola.
(2) Establishing medical library progr ... in existinl national library schoole.
(3) Establishing programmes at the regional level.
(4) Creating educational packages.
Alternative 3 would appear to be beat auited for the need. of most countries in the Region, while in aome cas.s the developaent of
self-teaching devices snd media (Alternative 4) would appear preferable.
Two special alternativea are in-service training in forei,n countries, which should be reserved for a few .enior or chief librarians, and baaic library courses for library assistants, which could be organhed in the countries themselves. It is hoped that, with better educatiOll, the profeaaional status of medical librarians in the developine countries can be raised.
An educational activity that can be conducted with tbe existing
manpower resources at the national and local levela ia uaer training. Short courses or presentations on library ua., bibliographic s.arch technique., etc. can be organized locally by medical libraries for .el.cted user groups. Medical schools should be encouraged to eatabliah formal, short courses in library use for first year medical students.
5.13 National and regional network developments
At the Group Session III, the followinl points were broulht out:
Levels of cooperation between medical librarians within each country in the Region vary markedly, ranginl fro. countries lik. AuetraUa, New Zealand and Republic of Korea, which fOl'1lla11y constituted a . . oci_tiem, of medical librarians, to Singapore, which has only one medical lib~.TY aDd
consequently no need for such .n a.sociation. China ba • • aeneral library association but it may consider the poasibility of formine an ••• ociation of medical librarians and information personnel.
At the international level, the level of cooperadem ha. increa.ed in recent years. partly as a direct result of the 1978
Manil . . .
etina ofmedical librarian. but, in general, contacts at global ~vel, except between Singapore and Malaysia, are still unsystematic and accldeRtal.
An
exception to tbis general rule were the meetings between ASEAN . . dicel librarian.sponsored by SEAMIC. involving three
WPRO
countrie. (MalaYlia, Philippines, Singapore).The nation.a1 focal points of the regional bioaedical infonDation network are seen to have an important role to play ift thi, coat.xt .l~e
poor liaison and communication impede cooperation. The perlona reapooaible for the focal points should be given the posaibility of vilitins libraries within the national biomedical information network and of giving att.ntion to their needs.
The groups felt that all areas of med~cal libra~ianship.would be
improved by greater cooperation at the natlonal and lnternatlonal level and by improved education facilities for librari~ns in the Re~ion. It.was agreed that training courses should be organlzed on a reglonal basls for professional librarians and for library assistants at the national level.
It might also be effective to run training couraea for profeasioaals on how they in turn ahould train library aasistanta.
Whatever their views on this matter, the group members agreed that at the present stage of network development it is vital for all Member States in the Region to formulate common policies whenever possible and that the WHO Regional Office has a continuing important role to play in developing coordinating mechanisms.
5.14 Biblio ra hie control of re ional biomedical and hea th Ilterature
At the plenary a.ssion, the preaentstion and discussions can be summa riled as under:
(a> Periodical literature
There is a ,roving awarenea. in all WHO regiona of the potential value which medical periodicals published in the developing countries may have in tbe information transfer process and of the impact which
their wide disaemination could make, especially in the field. of
clinicsl and experimental medicine. However, the existing abstracting and indexing journals and the related data bases cover only a very small percentage of this literature.
The first effort to close this gap has been the publication, since 1979, of the Index Medicus Latinoamericano by the Regional Library of Medicine and Health Services (BIREME) at Sao Paulo, Brazil. A similar project is being prepared by the IORO Regional Office for South-East Asia and the publication of the first issue of a South-East Asian Index to Health Literature is now imminent. Both the Eastern Mediterranean and African Regions are also considering the compilation of regional indexes and have undertaken SOme preparatory
work.
The project of compiling and publishing an index of the health and biomedical periodical literature in the Western Pacific aeaion was proposed
by
the 1978 working group of Librarians.At present, a number of national indexes are published in Member Statea of the Region, which may become the basis for a regional index provided they are produced uniformly in accordance with international bibliographic standards. It is felt, however, that the production of an index to the biomedical periodical literature published in the Western Pscific Region can only be undertaken by a strong regional
resource centre, which, for manpower cost and strategic reason., would have to be located in a developing country. This project will
therefore have to be postponed until such time as a regional facility has been set up.
(b) Fugitive literature
The term "fugitive" is applied to those documents which remain outside the normal distribution channels of the booktrade and escape
the traditionsl bibliographic control. lbeir dissemination is normally limited to a very restricted circle of recipients and not many find their way into libraries. If the value of these documents is uneven, there can be little doubt that among them is a sizeable number which contain information worthy of wider dissemination. It is felt that the developing countries in particular can no longer afford to neglect this part of the health literature but .hould make an effort to
collect, analyse, announce and dia.eminate the more .ubatantial items.
Such a project could become an important contribution to the information support for the health for all strate,y.
There is unanimity that the collection of fu,icive materials can only be undertaken at the .ouree, i.e. in the country where they originate. For the processing of the document •• however. their selection, subject analysis, storing in a data base or 1i.ting in an index, a central institution within the Region would appear to offer a more efficient and cost-effective solution.
Such regional processing would initially be limited to documents written or having abatracts in either Engli.h or 'reach and .elected
for their recognized value to a wider professional public.
5.15 Regional health literature .nd ita control
At the Group Session IV, the following points were brought out:
It is apparent that several developing countries in the aeaion have their own national medical indexes but that u.ually their t!aelinea., comprehensiveness or selectivity are in need of improv . . . nt.
Countries with established health literature retrieval services were identified. It was agreed that, while .maller countries in the Region do not have individual national medical indexes. sub-regional oraaDizations have undertaken this activity. The need for individual oational medical
indexes is not felt possibly because of the p.ucity of -aterial .nd lack of qualified indexers.
With regard to existing n.tioDal medical index •• , it-was recognized th.t their timeliness, ca.prehensivenell or .electivity
a ...
iD need of improvement. There is • need to .tandardize indexin, proe"ur.. at the national level 80 that indexed m.terial can later be . . . d into regional orsub-regional indexes.
Problem in relation to the collection. retrieval and di . . . . in.tion of fugitive literature were discussed. It was recognized that monitorin, procedures for fugitive literature at the national level have not been thoroughly effective.
The need waa expressed for a regional index of health literatllre, which would be useful for subjects that tranllcend national boundariell. It would create a forum among countries for the solution of health problem!! lind al"o prevent the duplication of work already undertaken in other countries.
Certain proposals were made for the production of a regional medical index as follows:
(1) A single index incorporating both journal and fugitive literature is to be preferred to two separate indexes.
(2) Index Medicus indexing procedures, with some variations to allow for nationai/regional requirements, should be adopted so that regional indexes and any of the resulting machine readabl~
offshoots would he compatible with Index Medicus and MEDLARS.
(3) Indexing of national literature should he done hy the national focal point inltead of I regional centre, 10 as to eliminate or minimize language problems.
(4) Only materials with English abstracts should be included in the index.
(5) Australia could be requested, through the WHO Regional Office for the Western Pacific, to undertake the publication of the index.
Means by which the Government of Australia could assist in the production of a regional medical index were identified as follows:
(1) Australia could prepare a set of draft guidelines on the use and modification of MESH headings.
(2) Australia could publish a regional medicsl index initially balled on contributions from the national centres upon receipt of a formal request from the WHO Regional Office for the Weatern Pacific and approval by the Director-General of Health of Aultralia.
The ways in which the WHO Regional Office for the Weltern Pacific could support the project were identified as followa:
(1) Request the governments to relax security elaasification of health documents whenever possible.
(2) Allow the use of WHO pouchea by the national centres to transmit indexed contributiona to Aultralia (if Australia agrees to compile the index).
(3) Provide funda for indexing at th. national level and for publiahing the index (Cost estimate: AS 70 000 to AS 100 000).
(4) Formally approach tbe Director-General of H.alth of Auatralia to undertake initially the publication of the ibdex.
The publication of the index could be undertaken by Australia on a 8hort-term baais until such time ss « regional resource centre would be established to engage in thi. activity fully.
I t was sgreed that the best method for the control of both the periodical and fugitive literature ultimately lie. in the creation of • regional resource library and that other mechani.m. for their control which may need to be introduced in the meantime are e.sentially temporary
solutions.
6. CONCLUSIONS
The Working Group concluded as follows:
(1) In most of the Member States of the Western Pacific Region of WHO, the existing health literature services have been developing primarily in response to biomedical research requirements and do not fully satisfy the requirements of all users of information and literature services in the context of the HFA/2000 .tratesy. There is a need to reorient, where neces.ary, the.e .ervlce. to become user-oriented and strengthen them considerably to provide timely and effective information support to programme development and management.
(2) Resources exist or can be mobilized to develop natioDal
capabilities and facilitate intercountry and regional cooperation.
Some of these resources are, however, short-term in nature and thus hsve to be used as an entry point to and as part of the long-term strategy in the development and establi.hment of regional and national biomedical information systems and service ••
(3) Technological developments in telecommunications and computers have been rapid in recent tLmes and have the potentiality to reduce storage, retrieval and communication cost conaiderably if judiciously applied in the health information area.
(4) It is necessary to undertake a comprehensive needs assessment study to identify apecific requirements for the development and
establishment of national and regional biomedical information centres and networks and related health literature services.
7. RECOMHBNDATIONS
The Working Group endorses the 1982-1983 plan of activities for the regional biOlledical information programme outlined in docUlllAlftt
(WPR/WG/HLT/8l.4).
In particular, it recommends to the Regional Director:
(I) to continue developing tht! regionlll biomerliclil infol1l1alion n,-(w"tk by invltlng all countries lind arE'ali in the Rt'gion to dt-signsl,-
focal points;
(2) to implement the Australia/WHO Agreement for Supply of MED1.ARS Searches in accordance wi th the Memorandum of Understand i ng I h.1t was signed by ooth parties;
(3) to request the national focal points to promote, implement and evalua te the services prov i ded under the Aus t ra Ii a/WHO Agreem"nt at country level to potential user groups;
(4) to approach the Government of Australia for negotiations on the prolongation of the present Agreement, and to jointly explore possibilities for an extension into a wider range of activities such as the development of on-line services to the Region;
(5) to set up at the Regional Office a small regional biomedical information coordination unit, charged with coordinatintl, the activities of the network. and to provide for liaison hetween its components; it should not function as a regional resource library
1n view of the higher cost implication.
(6) to develop a work plan for the training component of the programme that is responsive to the needs of the countries;
(7) to encourage the national focal points to collect systematically the published government documents and other categories of health literature originating from their countries;
(8) to invite He.ber Governments to reconsider their respective
policies regarding the public availability of governmental health documents and wherever possible to minimize restrictions;
(9) to seek support from Member States for the compilation, editin~
and publishing of an index to the Region's fugitive l health literature;
(10) to co-opt a prominent member of the Region's biomedical
information community into WPACMR in order to enaure a better incorporation of information components into research promotion and development;
(11) to study the feasibility for the Regionsl Office to develop and administer a aystem of payment to facilitate the reimbursement of document delivery cost among _dical libraries and information centres in the Region;
lIn this context. the term "fulitive" refers to doculllents which
remain outside the nonal distribution channels of the booktrade and ("scapI' traditional bibliographic control.
(12) to promote the appropriate use of international bibliographicsl standards for health and biomedical information activitiea in Member States of the Region;
(13) to seek support for the conduct of an in-depth technical .tudy to:
survey the status of existing biomedical information resources and facilities in the Region;
determine the present and future biomedical information needs, particularly in relation to the utilisation of research
findings in priority areas of Member States of the Region, including manpower training and developmentj
make preciae and detailed proposals for II comprehensive
regional hiomedical information network applying advsnced datn processing and telecommunications technology, and centered around a strong regional resource centre.
(14) to coordinate the activities of the programme with other agencies working in the field of biomedical information or related areas;
(15) to promote coordination between the biomedical information
programmes of the Western Pacific and neighbouring countries and regions;
(16) to provide for funding of the programme activities and to aeek extrabudgetary funding from governmentsl and private donors both within snd outside the Region.
The Working Group wishes to express its strongest support for the study recommended under item 13. It feels that all other activities recommended can only be regsrded as intermediary, pending the implementation of an optimal solution for the biomedical information network in the Region. The Working Group considera that, in view of the special geographical
characteristics of the Region, such an optimsl solution can only be achieved through the mobilization of considerable resources and the application of the late~t technology.
PROVISIONAL AGENDA
1 Opening ceremony 2
3 4
5 6 7 8 9
10
11 12 13
Regional programme for research promotion and development
Health literature programme
Technical cooperation in Regional Biomedical Information System Western Pacific Regional
Biomedical Information System Interlibrary loan cooperation at regional level
Australia/WHO Agreement for supply of MEDLARS services
Functions and responsibilities of national focal points
Network development - planning promotion and procedures
Strengthening of national medical library network Education and training of medical librarians
Bibliographic control of regional biomedical and health litersture Priority activities under Regional Biomedical Information Programme 14 Consideration of Working Group report 15 Closing ceremony
ANNEX I
(To be introduced by)
Dr Y.H. Paik, CRP Dr R. Weitzel, HLT/HQ Dr R.D. Mercado. nHP Mr M. Subramanian, HIN Mr R. Weitzel, HLT/HQ Mr P. Hodgson, Australia Mr H.V. Pribac, Australis Mr Y. Amano, Japan
Dr Fu Lai, China
Mrs J.L. Fernandez, Malaysia Mr R. Weitzel, HLT/HQ
Hiss R. Agoncillo, LIB/WPRO Mr M. Subramanian, HIN
ANNEX 2
LIST OF MEMBERS, TEMPORARY ADVISER AND SECRITARIAT
Australia
Peoplp's Republic of ClIina
Fiji
Malaysia
Papua New Guinea
Philippines
Republic of Korea
1.
MEMBERS
(1)
Mr Pau
1Hodgson Principal Librarian Life Sciences Section
National University of Australia Canberra
(2)
Mr Humbert
V.Pribac ClIief Libradan Central Library
( 3)
( 5)
Department of Health of Australia Canberra
Dr
PuLai Vice-Director
Institute of Medical Information Chinese Academy of Medical Sciences Beijing
Dr T.M. Biumaiwei
Permanent Secretary for Health Ministry of Health
Suva
Mrs Josephine LHy Ireland Librarian
Institute for Medical R.search Kuala Lumpur
(6)
.Dr J.D. lao Dean
Faculty of Medicine
University of Papua
NewGuines Bo rok
0(7)
Dr Andres Galvez Chief
Planning Service Ministry of Health San Lazaro Coapound Sta. Cruz
Manila
(8)
Dr ClIin Thack
SobD.an
Oollege of Medicine
Yon.ei University
Seoul
Annex 2
2. TEMPORARY ADVISER Mr Yoshio Amano Head
Operation Division International Medical Information Centre Tokyo
Japan
3. SECRETARIAT Mr R. We i t ze I Technical Officer
Office of Library and Health Literature Services
WHO Headquarters Geneva
Switzerland
Mr M. Subramanian
<Operational Officer) Regional Adviser in Health Information
WHO Regional Office for the Western Pacific P.O. Box 2932
Manila Philippines Dr R.D. Mercado Director
Heal th Service s
Development and Planning
WHO Regional Office for the Western Pac ific P.O. Box 2932
Manila Philippines Dr Y.H. Paik o,ief
Research Promotion and Development
WHO
Regional Office for the Western Pacific P.O. Box 2932Manila Phi 1 ippine s
M8 R.C. Agoncillo Librarian
WHO Regional Office for the Western Pacific P.O. Box 2932
Manila Philippines
OPENING ADDRESS BY BY
DR S. T. HAN, DIRECTOR, PROGRAMME MANAGEMENT,ON BEHALF OF THE REGIONAL DIRECTOR, WHO REGIONAL OFFICE FOR THE WESTERN PACIFIC
Ladies and Gentlemen,
ANNEX 3
On
behalf of the Re,ional Director of the World Health Organization Regional Office for the We.tem Pacific, Dr H. Nakajima, I wi.h to welcome you all to Hanila and to this Working Group meeting.'!bere can be little doubt tbat an effective worldwide transfer of scientific and tecbnological information would contribute significantly to achieving the
de . .
lo~nt goa1a of the 1 ••• indu.trialized and developing nationa. Moat countries, however, bave extremely limited capabilities and resourcea, ~th hu.an aod financial. to devote to the production andacquiaition of .ci.ntific and technical information. There is, thus, a grest need, and the po •• ibility exists. for the application of existing knowledge and information rather than tha generation of new knowledge.
Knowledge and information are readily available somewhere in the world; they must, however, be made accesaible to all kinds of decision-makers,
reaearchers and educators, and the . . ans for their communication and transfer mUlt be •• tabliahed. In many countries, it is the gap in
information acc ••• ibility and transfer, and therefore its utilization, which must be bridged
if
further progress is to he made.This meeting of users and providers of information comes at s time when Member States sre engaged in the implementation of activities related to their "health for all by the year 2000" strategy. Aa they develop
mechanisms and procedures for the purpose, information becomes the main ingredient for the organi.ation of a health syatem baaed on primary health care. As you know, .ccese to precise and reliable scientific, technologicsl and managerial information at the right time, by the right person in a form moat conveniently usable by him, can help to minimize the wastage of
resources due to the unnecessary and unintended reinvention, rediscovery, and redevelopment of techniques'and above all the making of unfruitful decisions about their application. Availability of the right type of information can trigger new directions in research, development and
mana~erial action. Any barriers to the access of information can only impede proper communication and information flow, causing problems for the user. It is the true infonaation profeeeional who haa the responsibility for overcoming or minimizing such barriera.
In 1978, a Working Group of Librarians was held in Hanila, which
~rouped varioue information profeslionala, and a start was made on bringing
to~ether different ad hoc activities in the Region in a programme
framework. The Government of Au.tralia then kindly offered to make the service. of the National Library of Auitrali. and of the Department of
Annex 3
Hpalth available to developin!1, Memher States in thp Region as their contribution to furthering the dissemination of health and hiomedical information in the Western Pacific Region. We are grateful to the
Government of Australia for this offer, which has enabled us to initiate developmental activities in this area. We have also been able to Ret most of the Member States to designate focal points as a first step in the development of a regional programme of collaboration with the countries.
The present meeting with users and providers of information will promote understanding of the information needs of individuals, the importance of getting such information, the facilities available for seeking it and knowledge about those facilities, the judgement of their value and the possibility of access to them; all these factors will facilitate the matching of needs and resources. This should also
contribute to the development of a user-oriented information service in support of researchers, pI ~nners and managers, and heal th workers and trainers hy facilitating the development, choice and u.e of appropriate health technology to achieve health for all by the year 2000.
I note that you have a heavy agenda ahead of you, and I am sure you will find this meeting a very useful and rewarding experience. I look
forward to your recommendation concerning the specific direction that WHO collaboration with Member States should take and your proposals for
priority activities" for the promotion, development snd establishment of a user-oriented biomedical information programme. I wish this Working Group every success and hope you all have a pleasant stay in Manila.
CLOSING ADDRESS BY BY DR S.T. HAN, DIRECTOR, PROGRAMME MANAGEMENT, ON BEHALF OF THE REGIONAL DIRECTOR, WHO REGIONAL OFFICE FOR THE WESTERN PACIFIC
Hr Chairman, Ladies and Gentlemen,
ANNEX 4
This Working Group is the first to have brought together health
managers, educators and librarians. I understand you have had an extremely useful meeting and I am gratified that it has contributed to a better
understanding of the expectations, opportunities and constraints in health information services from the point of view of users and providers at national and regional levels.
I note that you have been able to formulate activities to bridge the gap between what now exists and what is desirable on a short, medium and
long-term basis. I am also pleased to note that you have recommended a strategy to match information needs with resources available in the Relion, and thereby facilitate resource sharing in an efficient way.
Your conclusions and recommendations are of great importance to WHO in the context of the global goal of healtb for all by the year 2000 and with respect to the regional strategy for biomedical information system
development. As a first step, we shall be requesting the ministries and departments of health of developed Member States in the Western Pacific Region to nominate national focal points, and we expect that these will take the initiative, in collaboration with WHO where needed, to promote and
facilitate the implementation of relevant national and regional activities.
This is essential since the information system and services are country-dependent and must be developed in a country context.
Let me recall Benjamin Frsnklin's definition of human beings as
funnels, sponges and sifters. The funnel lets information go in one ear and out of the other; the sponge continues to soak it up, but does nothing about it; but the sifter sorts snd selects the fruits of basic and applied
research findings 10 that information can be transmitted and uled for the benefit of man. In order to provide for an ever-expanding fund of ba.ic knowledge in a wide spectrum, society requires an increasing number of gifted sifters. I see that your recommendations will enable WHO to collaborate with countries in developing a core group for the purpose.
I can assure you that we shall consider very favourably your recommendation no. 13 related to in depth technical study and initiate activities for early implementation.
I wish to thank the Chairman, Dr Fu Lai, the Vice-Chairman, Dr Soh, and the Rapporteur, Mr B. Pribac, for so ably conducting the meeting. I also wish to thank Mr Y. Amano and Mr R. Weitzel from WHO Headquarters for their
readiness to help us as consultants. I extend my best wishes to you all for the success of your work and a pleasant journey home.
ANNEX 5
BIOMEDICAL INFORMATION SYSTEM DEVELOPMENT by
Mr M. Subramanian 1
IRegional Adviser in Health Information, WHO Regional Office for the WPlltf'rn Pacific, Mani 18, Phi lippin ...
