MeTA - access to health information

There is widespread evidence of failure to implement health interventions that have been demonstrated to be cost-effective by high-quality research; this failure affects both high-income and low-income countries. Low-income countries face additional challenges to using research evidence including: the weakness of their health systems, the lack of professional regulation and a lack of access to evidence. There is a need to strengthen institutions and mechanisms that can more systematically promote interactions between researchers, policy-makers and other stakeholders who can influence the uptake of research findings. The concept of public engagement with health research requires a public that is both informed and active. Even when systematic reviews are available further work is needed to translate their findings into guidelines or messages that are understandable to patients and health professionals. Many of the commonly used approaches for keeping health professionals' knowledge up-to-date appear to have small or inconsistent effects. The evidence-base is more extensive for interventions directed towards professionals, such as education, reminders or feedback, than for those directed at organisations or patients. The effect of interventions varies according to the setting and the behaviour that is targeted. Case studies in low-income settings suggest that some strategies can result in increased coverage of evidence-based interventions, but there is a lack of evidence from systematic reviews of rigorous research. Given the potential for near-term improvements in health, finding more effective ways of promoting the uptake of evidence-based interventions should be a priority for researchers, practitioners and policy-makers

HINARI cannot reach everyone who might benefit. In many countries internet access is slow, expensive, and unreliable. Many poor institutions carrying out valuable research in countries with a GNP per capita of over $3000 per year are not eligible to use HINARI Information is often not available in electronic format - especially if it has been produced locally. The electronic format may be unsuitable for certain uses - for example, medical students in the developing world may benefit more from printed textbooks than from virtual textbooks that are only accessible from an unreliable internet connection at medical school. HINARI may also pose problems to researchers and health professionals working in the developing world. Allowing unrestricted access to much of the world's medical literature may produce an information overload and lead to valid and relevant information being difficult to find. This is particularly important for people who are not experienced in using information technology and reading primary research (but this problem occurs in the developed world too). Some valuable journals of specific relevance to the developing world (tropical medicine journals, for example) may not be available through HINARI as this may compromise publishers' commercial viability. Also, in a few countries, publishers withhold some journals because the sales of these journals are significant in these countries. However, institutions in these few countries are still able to access at least most of the key general medical and scientific journals without restrictions

A case study of the RESCUER project, in Iganga District, Eastern Uganda. The project was designed to link the traditional rural community health providers with the formal health delivery system in a cost-effective way. The increased number of deliveries under trained personnel, and increased referrals to health units, led to a reduction of about 50 percent in the maternal mortality rate (MMR) in three years

This article summarizes the attempts, since 1995, to utilize information and communication technology to bridge the health information gap between developing and industrialized countries. The authors note that the successes has been 'patchy' and that the potential has not been reached. Significant gaps continue between the north and south and also are seen between urban and rural areas especially for current clinical information. Stakeholders have not been involved sufficiently and there is considerable need for better telecommunications access and capacity building. The authors conclude that, without championing by a major player such as the WHO, the millennium goal of unviersal access to health information will not be reached despite some successes in the past 10 years

This manual focuses on selecting, testing, implementing and evaluating interventions to improve the use of medicines at community level. Two broad strategic areas are identified: communication strategies and strategies to create enabling environments. "What has become clear over the years is that there is no single model or approach that is the solution to all health communication challenges. Different techniques are appropriate in different contexts to deal with different priorities and problems. This manual will help you to build skills and experience to make that selection more effectively"

This guide provides a hands-on 12-step process to developing health communication campaigns. Each chapter is created according to the steps, with information on what the step is, why it is important and what is required to carry it out

This brief policy paper summarises the findings of a research project that focused on the information needs of the urban poor, and the information sources they access. The study found that the main sources of information were social networks, key informants, and infomediaries. It ends with six suggestions for development agencies seeking to share their knowledge and information with the urban poor