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. 2001 Jul;89(3):287–293.

Health sciences libraries in Kuwait: a study of their resources, facilities, and services

Husain A Al-Ansari 1,3, Sana Al-Enezi 2,3
PMCID: PMC34562  PMID: 11465688

Abstract

The purpose of this study was to examine the current status of health sciences libraries in Kuwait in terms of their staff, collections, facilities, use of information technology, information services, and cooperation. Seventeen libraries participated in the study. Results show that the majority of health sciences libraries were established during the 1980s. Their collections are relatively small. The majority of their staff is nonprofessional. The majority of libraries provide only basic information services. Cooperation among libraries is limited. Survey results also indicate that a significant number of health sciences libraries are not automated. Some recommendations for the improvement of existing resources, facilities, and services are made.

INTRODUCTION

Kuwait, a small Arab country, is located in southwestern Asia, on the northwestern coast of the Arabian Gulf. It is bounded on the north and northwest by Iraq, on the east by the Arabian Gulf, and on the south by Saudi Arabia. Kuwait, under agreement, was a British protectorate from 1899 until it achieved its independence on June 19, 1961. It is a constitutional monarchy, headed by the amir. The country's total area is 6,880 square miles. The population of Kuwait is 2.1 million, out of which about 60% are expatriate workers. Kuwait's economy depends mainly on crude oil, petrochemical industries, overseas investments, and banking and financial services. Its per capita income is $23,500, one of the highest in the world. Arabic is the official language of the country, but English is widely understood and used. Education is free from elementary school to university. Education before the university level is divided into three levels of four years each: elementary, intermediate, and secondary.

Health care in Kuwait

The history of health care in Kuwait dates back to 1912, when its first medical clinic was opened. The improvement of the health sector in Kuwait has been phenomenal since the country's independence in 1961. The government has succeeded in providing an up-to-date health service system, available to every person living in Kuwait, citizen or non-citizen alike, free of charge. The Ministry of Public Health divides Kuwait into six health zones, each of which serves about 300,000 persons. The health system in each zone consists of a public hospital, health center, and health units including general and specialized clinics. If patients need special treatment, they are referred to the Sabah Public Health Center, which includes a number of hospitals and specialized centers. The Ministry of Public Health provides almost 90% of the health services. It has six general hospitals and sixteen specialty hospitals and clinics providing tertiary-level care, with a total of 6,139 hospital beds, 65 clinics providing primary-level care, and 157 dental clinics. In addition, the Ministry of Education has more than 600 school clinics. The Ministry of Public Health has a total of 31,338 employees. Of these 3,009 are medical doctors, 8,335 nurses, and 5,704 other professional and technical staff [1].

Libraries and information centers in Kuwait

Libraries and information centers in Kuwait can be divided into four types according to their functions: public, school, academic, and special. A majority of these libraries are administered and financed by the government. The first library in Kuwait, the Al-Maktabah Al-Ahlia, was established in 1923 by a group of eighteen citizens. In 1936, the Central Public Library was established, absorbing the collection of Al-Maktabah Al-Ahlia. Today, the public library system consists of twenty-four public libraries mainly located in the city of Kuwait and its suburbs. The combined holdings of all public libraries are approximately 429,292 volumes [2]. The public library service is supported by government funds to provide free library services to all members of the community. There are 543 libraries in public schools with a total collection of 2,446,313 volumes and 915 librarians serving in elementary, intermediate, secondary, vocational, and technical schools [3]. The Libraries Administration at the Ministry of Education manages the public and school libraries in Kuwait. It provides centralized acquisition, cataloging, and processing services and distributes ready-to-use materials to all school and public libraries. In addition, there are approximately fifty libraries in private schools.

The academic libraries in Kuwait are in higher education institutions, namely Kuwait University and the Public Authority for Applied Education and Training (PAAET). Kuwait University is the only university in the country. It has 12 faculties with 43 academic departments and 35 master's degree programs. It has about 19,000 students and 970 faculty members. Its library system, which is decentralized, consists of 10 faculty libraries containing about 290,000 volumes. PAAET also has a decentralized library system consisting of seventeen libraries with a total book collection of 95,000 volumes.

There are seventeen health sciences libraries located mostly in Kuwait City. Fifteen of these libraries serve government ministries and agencies. Two libraries are for nongovernmental organizations. One is maintained by the Kuwait Medical Association (KMA) while the other, the Arab Center for Medical Literature (AKMAL), provides services for a regional association. Ten of the seventeen health sciences libraries are located in hospitals throughout Kuwait City. Most of these health sciences libraries were established during the 1980s. The KMA library, begun in 1962, is the oldest. The latest is the Military Hospital Library at the Ministry of Defense, established in 1997. All of these libraries primarily serve health professionals consisting of physicians, dentists, pharmacists, veterinarians, faculty members, and students.

Library and information science professionals working in these libraries consist of both Kuwaitis and expatriates educated in Kuwait and abroad. PAAET offers a bachelor's degree in library and information science, which was begun in 1986. However, PAAET focuses on training manpower needed by school and public libraries. Kuwait University started a master's program in library and information science in 1996, catering to the needs of academic, research, and special libraries.

LITERATURE REVIEW

The literature on health sciences libraries in the Gulf Cooperation Council (GCC) countries that have similar conditions is very limited. In general, all the authors report similar findings: inadequate collections, poorly trained staff, lack of professional services available to users, and very little cooperation among libraries.

Saudi Arabia, because of the size of its health services, is covered best. Sutherland-Brown and Martin wrote articles describing the King Khalid Eye Hospital Library in Saudi Arabia focusing on collection development, technical services, and staff training [4, 5]. Brown described the interlibrary loan cooperation among the six libraries of the Saudi Ministry of Defense and Aviation [6]. Sliney listed the advantages, barriers, and requirements of medical library cooperation and the document delivery system in Saudi Arabia and at a regional level [7]. Among other important studies in the region, Al-Olga examined the status of hospital libraries in Riyadh, Saudi Arabia, in terms of their sponsoring organizations, staff, collections, facilities, and services. The study stressed the need to establish a library in each hospital, to develop greater international cooperation to improve library services, to shift the focus from ownership to access, and to hire professional librarians to improve information services for users [8].

Jaffer reported on the status of medical libraries in the United Arab Emirates (UAE). He emphasized the need for strong medical information systems to be able to manage the rapid growth of medical information effectively. In addition, he recognized the need to develop indexing and abstracting services for UAE medical journals. He also identified the necessity of resource sharing and coordination between medical libraries [9]. Alian conducted a study of medical libraries in the state of Bahrain. Insufficient budgets, poor collections, absence of qualified staff, poor physical locations, and lack of cooperation were the major problems facing these libraries in Bahrain [10].

Only two articles have been published about medical libraries in Kuwait. The first by Sullivan and Brennen published in 1984 included a description of Kuwait University's medical library in terms of organizational structure, staff, services, and new library facilities. The authors concluded that too much bureaucracy, lack of trained librarians, and little perception of the importance of libraries in the educational system are the major problems facing medical libraries in Kuwait [11]. The second article, by Hague, described a four-week medical librarianship course conducted in Kuwait at the Ministry of Public Health [12].

PURPOSE AND METHODOLOGY

The purpose of this study was to survey and assess the current status of health sciences libraries in Kuwait in terms of staff, information resources, facilities, use of information technology, user services, and cooperation. It also aimed to suggest, on the basis of findings, recommendations for future development.

Survey methodology was employed in this study. A list of twenty medical libraries in Kuwait was developed through the Directory of Libraries and Information Centers in Kuwait, Kuwait Telephone Directory, and consultation with personnel in key medical libraries. Included among the twenty were three academic libraries: the Health Science Library at Kuwait University, the College of Medical Sciences Library (women) at PAAET, and the College of Medical Sciences library (men) at PAAET. These twenty libraries served health sciences professionals in hospitals as well as the faculty and students at the institutions where they were located. During personal contact, three hospital libraries were found to have very small collections and no full-time staff. These were excluded from the study.

The researchers developed a questionnaire consisting of nineteen items to gather data about staff, collections, facilities, services, and cooperation. Health sciences libraries in Kuwait did not provide service to patients. This aspect, therefore, was not covered in this study. The questionnaire was mailed to the seventeen health sciences libraries. The mailing was augmented by follow-up telephone calls for clarification and to ensure better response.

All seventeen participating libraries returned the questionnaire. Additionally, the authors visited most of the libraries to observe their facilities firsthand, seek clarifications, and collect any data that were missing from the returned questionnaires.

RESULTS

Staff

The seventeen responding libraries employ a total of fifty-four staff members, with an average of 3.2 persons per library. Nine libraries have only one staff member. Of the fifty-four employees, twenty-eight are Kuwaitis (51.9%) and twenty-six are expatriates (48.1 %). The majority of the current workforce (74.1%) is nonprofessional (technicians, clerks, secretaries), while fourteen (25.9%) are professionals. Of these fourteen, only three (21.4%) have a master's degree in library and information science (MLIS), whereas eleven (78.6%) have a bachelor of arts degree in library science. Among the nonprofessional staff, only four hold college degrees. The rest have high school or associate diplomas. The Health Sciences Library at Kuwait University has the largest staff, numbering sixteen. The three professionals who have MLIS degrees work in this library.

Table 1 provides information about the professional status of staff as reported by respondents. Eleven of the seventeen head librarians (64.7%) are nonprofessionals. Seven of these eleven have no college degree or library training. Only six head librarians (35.3%) are professionals. Of these six, only one, the director of the Health Sciences Library at Kuwait University, has an MLIS, and five have bachelor's degrees in library science.

Table 1 Health sciences libraries staff (N = 17)

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Information resources

Table 2 shows that the total collections of all medical libraries in Kuwait come to 56,072 volumes and 2,783 periodical titles. The analysis of resources in individual libraries reveals great differences. Only two significant collections are reported. The first of these, in the Health Sciences Center Library at Kuwait University, is the largest, with 15,836 volumes and 1,320 periodical subscriptions. The second, in the College of Medical Sciences Library (women) at PAAET, has a collection of 6,577 volumes. The smallest collection was found in the Psychological Hospital Library, with only 280 books and four periodical subscriptions. Overall, more than half of the libraries (53%) have collections of less than 2,000 volumes.

Table 2 Monographic holdings and periodical subscriptions

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The number of current subscriptions varies from 4 to 1,320 titles. More than half of the libraries (58.8%) have fewer than 100 subscriptions. Seven libraries (41.2%) offer literature searches by using CD-ROM databases. The Health Sciences Center Library at Kuwait University is the only library that has 15 CD-ROM databases available to users.

Access and facilities

Most libraries follow the government work schedule, opening at 7:30 a.m. and closing at 2:00 p.m. The Health Sciences Center Library at Kuwait University remains open from 7:30 a.m. to midnight. Two libraries, the Kuwait Medical Association Library and the Arab Center for Medical Literature, remain open from 7:30 a.m. to 2:00 p.m. and from 4:30 p.m. to 8:00 p.m.

A large majority of these libraries (88.2%) classify their library materials according to the National Library of Medicine (NLM) classification. Five of these libraries use two classification systems, the NLM for English materials and the Dewey Decimal Classification (DDC) system for Arabic materials. Only two libraries (11.8%) use the Library of Congress classification system.

Although twelve (70.6%) libraries have planned library buildings, only ten (58.8%) have sufficient space for their collections and activities. Space in the remaining seven is inadequate for their collections and services. Some hospital libraries do not have a reading room. The largest library in terms of space is the Health Sciences Center Library at Kuwait University, with 8,000 square feet. Most of the libraries range in size between 1,500 and 3,000 square feet. Some hospital libraries, such as Al-Razi Hospital Library and Al-Sabah Hospital Library, occupy single rooms with an area of about 270 square feet.

Information services

Health sciences libraries in Kuwait cater to the needs of their users, practitioners, educators, scientists, and students, working to provide good health services by offering them a variety of information services. Almost all libraries (94.1%) provide two basic services: circulation and reference (Table 3). Fourteen libraries (82.4%) provide photocopying services. Online services are provided by nine libraries (52.9%), whereas, CD-ROM searching and interlibrary loan service is provided by seven libraries (41.2%). Five of the libraries (29.4%) provide bibliographic instruction to users. Translation service is provided by only one library, the Arab Center for Medical Literature Library. Only four libraries (23.5%) provide Internet access. None of the hospital libraries has Internet facilities for users.

Table 3 Indication of service offering by type (N = 17)

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Use of information technology

Information technology has a very significant role in the storage, retrieval, and delivery of health sciences information and services. Respondents were asked specifically whether the library had CD-ROMs, an automated library system, Internet, or any other communication equipment such as telephones and faxes. Table 4 shows the extent of information technology available in health sciences libraries in Kuwait. Data in this table show that seven of the responding libraries (41.2%) use CD-ROM databases. Hospital libraries of the Ministry of Public Health are connected through modems to its Central Library CD-ROM databases. Only three of the libraries (17.6%) have an automated library system. The only fully automated library is the Health Sciences Library at Kuwait University, which uses the Horizon integrated library system. It provides an online public access catalog to its users through the Internet.

Table 4 Information technology in Kuwaiti libraries by type

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Fifteen of the libraries (88.2%) own microcomputers for word processing and other library applications, but only four (23.5%) have access to the Internet. Fifteen of the libraries (88.2%) have fax machines, and all have telephone lines. None of the health sciences libraries in Kuwait have access to major bibliographic utilities such as Online Computer Library Center, Inc. (OCLC), and Research Libraries Information Network (RLIN).

Cooperation

Ten libraries (58.8%) report that they participate in local cooperative activities, mainly the exchange of copies of articles. Of these ten, seven have a formal interlibrary loan agreement. The Central Medical Library at the Kuwait Institute for Medical Specialties provides interlibrary loan to all hospital libraries of the Ministry of Public Health. It acts as a coordinating agency for hospital libraries.

Five libraries (29.4%) have interlibrary loan cooperation with medical libraries in the GCC countries. Only two have cooperative agreements with libraries at the international level. These are the Health Sciences Center Library at Kuwait University and the Kuwaiti Medical Association Library. These libraries mainly use the British Library Document Supply Center (BLDSC) and World Health Organization (WHO) Eastern Mediterranean Region Organization (EMRO) for document delivery.

DISCUSSION

The seventeen participating libraries have fifty-four staff members. A majority of these (74.1%) are nonprofessionals. Only three staff members have MLIS degrees, and all work at the Health Sciences Library at Kuwait University. Lack of well-trained librarians is one of the critical problems facing libraries and information centers in Kuwait and the GCC region. Low status, low salaries, lack of incentives, and unattractive work environments and conditions have not drawn staff with professional degrees [13]. Until these conditions change, the staff crisis will continue.

Some encouraging trends are evident. Opportunities for professional training through short courses, seminars, and workshops are increasing. For example, Kuwait University, the National Scientific and Technical Information Center (NSTIC), and the Arabian Gulf Chapter of the Special Libraries Association (SLA) organize frequent continuing-education programs covering important topics such as online searching, management, and use of the Internet and information technology. Also, in 1996, the College of Graduate Studies at Kuwait University established a graduate library and information science program, which allows medical librarians to continue their professional education, either by studying part time for the degree or taking courses as nondegree students.

The study shows that most health sciences library collections consist mainly of printed materials, with less emphasis on multimedia, microforms, and electronic databases. Also, according to some hospital librarians who were interviewed, the available printed materials—books and journals—are inadequate. Most of the responding libraries reported collections that are quite small. There may be several explanations for the small size: (1) lack of financial support from the parent institution; (2) recency of establishment of the library; (3) the very specialized nature of the library, because the collections of most hospital libraries are intended to support the work of physicians in different specialties; and (4) the loss of some collections, during the Iraqi occupation in 1991, that have not been returned or replaced.

The only two libraries with sizable and well-developed collections are the Health Sciences Center Library at Kuwait University and the Central Medical Library at Kuwait Institute for Medical Specialties. Both libraries have developed very good collections of printed and electronic resources along with dynamic interlibrary loan services. Because these libraries are attached to academic or research institutions, they need sizable collections to support the instructional and research needs of their faculty, physicians, and students.

Space is an acute problem for some libraries. Even with their small collections, many reported inadequate room for their collections, users, and services.

At least half of the responding libraries provide basic services such as circulation, reference, photocopying services, and online searching. However, bibliographic instruction and abstracting and indexing services are less frequently available. Furthermore, important services such as reference and interlibrary loan generally are not well developed in hospital libraries. This is due to the lack of professional librarians.

A sizable number of health sciences libraries (88.2%) indicate that they own microcomputers and fax machines, and a number (41.2%) use CD-ROM databases. This is a positive sign, indicating efforts to provide a greater level of assistance, especially in regard to reference, interlibrary loan, and current awareness services. These services are frequently available to users regardless of affiliation.

Even though individual libraries are attempting to improve their services, cooperation among libraries is lacking. Especially when resources are limited, as revealed in this study, libraries need to use interconnections to meet the information requirements of their patrons. Although library personnel are aware of this need, seven of the responding libraries (41.4%) have no form of cooperation. A major problem here is the absence of a forum or an agency that could initiate, integrate, and coordinate resources and services. Another reason is the absence of a union list of medical serials.

CONCLUSION

This study provides baseline data on the current status of the resources, facilities, and services of the health sciences libraries in Kuwait. Before this study was conducted, no comprehensive information existed regarding health sciences libraries in Kuwait. Although several libraries attached to educational institutions and professional associations have been found to have adequate collections, resources, and services, the results of this study show that the hospital libraries, in particular, face various problems and challenges such as lack of specialized professionals and trained staff, lack of cooperative programs, small collections, and limited resources. These problems need immediate attention from librarians and continuous support from administrators in their parent institutions, so that adequate library resources and services are made available to support the information needs of the health care community and to improve the quality of patient care in Kuwait.

RECOMMENDATIONS FOR IMPROVEMENTS

In order to improve the current situation of health sciences libraries in Kuwait, the following recommendations are made:

  1. Health sciences libraries need highly skilled and specialized librarians. Therefore, they should hire professional staff with MLIS degrees, particularly bilingual librarians (Arabic and English). All libraries should be headed by a professional librarian. In addition, attractive salary scales, appropriate incentives, and higher official status should be offered to attract qualified Kuwaiti professionals.

  2. The health sciences libraries must be supported with adequate budgets to improve their collections, services, equipment, and furniture.

  3. To avoid wasteful duplication of effort and resources, some small hospital libraries should be merged into one library. For example, the libraries of the hospitals in the Al-Sabah Health District should be combined into one central library serving the whole district.

  4. All health sciences libraries need a collection-development policy to guide the proper and systematic growth of the collections in all formats. The top priority for hospital libraries should be building a core collection. As an example, they could be guided by the “Brandon/Hill Selected List of Books and Journals for the Small Medical Library” by Hill [14].

  5. Intensive and comprehensive training programs for professional and support staff should be offered on an ongoing basis. Training should focus on providing information services and applying and using the latest information technology. In addition, professionals should be encouraged to attend conferences, workshops, seminars, and internships abroad to keep abreast of new developments.

  6. Health sciences libraries cannot continue to use traditional work methods. These libraries must automate their operations and services with currently available technology. All health sciences libraries in Kuwait should be connected to the Internet to provide eletronic access to remote and widely distributed electronic information.

  7. In addition to basic information services, health sciences libraries should provide bibliographic instruction, current awareness service, and access to full-text medical journals and MEDLINE, available freely over the Internet.

  8. To strengthen resource sharing, a cooperative national network of all health sciences libraries should be established. The Health Sciences Center Library at Kuwait University should act as a central library to coordinate all activities such as interlibrary loan and shared acquisition. Some encouraging trends have already appeared in this area. For example, the NSTIC, with the cooperation of Kuwait University libraries and PAAET libraries, has developed an online union list of serials containing about 4,664 titles. It is available on the Internet. All health sciences libraries should join this project by adding their periodical holdings.

  9. Based on the findings of the study, the following recommendations are made for further research:
    • an indepth analysis and evaluation of collection in each health sciences library
    • a study of information-seeking behavior of health care professionals
    • a study of potential cooperation between health sciences libraries in the GCC countries
    • a training needs analysis of employees of health sciences libraries

These suggested studies could provide a more comprehensive basis for future planning and the development of health sciences libraries in Kuwait.

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