• Education, knowledge and technology

Education, knowledge and technology

This article highlights the lack of progress over the last 10 years in increasing levels of access by health professionals in developing countries to essential health care information. It goes on to outline what action should now be taken to improve this situation, and argues that universal access to health information is necessary if the Millennium Development Goals are to be achieved by 2015.

In 1994, a meeting to review global access to health information concluded that most health professionals in developing countries had inadequate access to information and that the information available to them was often unreliable or irrelevant. At that time there was optimism that the major developments about to take place in information technology would mean that by 2004 this situation would be transformed. However, despite some important progress made, there is little evidence that the majority of health professionals, especially those working in primary health care, are any better informed today than they were 10 years ago.

The article’s findings include the following:

• Less than 10 per cent of health research funding is targeted at the health problems that account for 90 per cent of illness globally (known as the "10/90 gap"). This situation is reflected in the type of information that is available, and is the major reason why health professionals in developing countries do not have relevant health information.
• There is a continuing tendency to push information out to health professionals in developing countries rather than responding to their information needs and engaging in an exchange of knowledge with them.
• Most health professionals rely on handbooks and drug formularies rather than journals. Most still prefer print, and the majority either cannot or will not pay for information themselves.
• There are local cycles of information, involving researchers, information providers and practitioners. The most sustainable way to increase access to health information is to fund and support local initiatives which strengthen these cycles.
• Many funding agencies are reluctant to fund projects in the area of health information provision, preferring to fund more "practical" projects.

The authors call on the World Health Organization (WHO) to champion the goal of "access to essential health information for all by 2015". They also call on the WHO to take a lead in setting up an international group, using the model of the Global Fund for AIDS, TB and Malaria, which would establish an overall strategy for achieving this goal and provide funding to local projects in line with this strategy. The article outlines four broad areas where action needs to be taken:

• Ensuring that the majority of health professionals who work in primary and district care have free access to essential information through strengthening local and regional libraries, publishers and information services
• Improving levels of connection to the internet
• Identifying the reasons why access to information does not necessarily lead to changes in practice, and providing solutions for this
• Improving the reliability, relevance and usefulness of healthcare information.

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