In the spirit of linking global health practice and evidence, I suggest a new structure for public health journal libraries, namely an alternative to PubMed. By organizing journal articles differently, users will more easily find the links between specific interventions and policies, their health impacts, and methods available to measure and evaluate these relationships.

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Virtually all major governmental and private funders require recipients to monitor and evaluate funded activities to justify and maximize donor investments. Periodic “little i” evaluations help implementers keep a pulse on program performance and report about their progress. Little i evaluations also provide critical information needed to improve or development new programs in (almost) real time. “Big I” impact evaluations are formal studies conducted over longer periods of time to gauge if and how programs or policies impact health outcomes. We tend to think of little i impact evaluation as less methodologically rigorous and destine for the “gray” matter of NGO annual reports and working papers. Big I impact evaluations, on the other hand, are more rigorous, but occur less frequently, and are described in short peer reviewed journal articles. In the real world, the distinction between little i and BIG I impact evaluation is not so clear cut.
The Google Scholar Effect
Since Google Scholar came online, I rarely do my initial literature searches in PubMed because the results I find in Google Scholar are more relevant to my search, more likely to reach across the many disciplines that comprise public health (environment, economics, sociology, medicine, etc), and importantly, helps me to identify important grey literature. Your best bet for searching in PubMed is to use MeSH terms – Medical Subject Headings. When a new article in published, someone official indexes it with several terms and subterms from a hierarchical tree of predefined terms. This is a great example of how the limits of the paper world have been applied to the digital world, and create arbitrary limits.
Search as Geography
There are a couple of fantastic ways to think of geography as a discipline. For example, geography is the study of everything at a particular time and place. Another favorite that applies here, geograpy is the study of interrelationships. Biology tells us about plants. Sociology tells us about people. But geography tells us about the interaction of people and their environments.
PubMed’s terminology hierarchy dissects and disconnects elements of public health. Public health practitioners are not only interested in policies, or average levels of health in a population, or statistics, or interviewing. They are interested in how policies and social structures act to impact health in populations, and how qualitative and quantitative techniques can be leveraged in non-lab environments (like how to design an ethical study that doesn’t withholding potentially life-saving services and treatment to a group of people in order to measure the impact of a new program). Public health is a discipline concerned with interrelationships, so why can’t our journal libraries facilitate this way of understanding?
little i, BIG I: a public health journal library with a new search flow
little i, BIG I contains all of the same journal articles as PubMed, but the users interactions are transformed. No longer to you browse MeSH terms looking for a sufficiently close fit words (community health worker) to the term you are actually looking for (accompagnateur). You also immediately get a sense of how the 3466 search results for “community health worker program” are related.
OLD search and results


NEW search and results
