July 13 - August 8 2008

This 9-page document, prepared for the Making the eHealth Connection: Global Partnerships, Local Solutions conference of 2008 in Bellagio, Italy, describes barriers in developing countries to access to quality health information. It discusses 8 main barriers to equitable access: connectivity, medical writing skills, language, copyright, information technology (IT) skills, economic support, national/regional resources, cultural issues, and government policies. Internet connectivity is generally limited to urban centres, lacking rural penetration. A barrier to free distribution of health-related information is the copyright barrier, as well as the high cost of journals, linguistic and/or cultural barriers, the limited availability of regional and national information resources, restrictive government policies, and lack of medical writing and IT skill training.

However, there is a trend toward internet growth. Advances in internet-enabled mobile devices are opening possibilities of remote patient monitoring applications and patient information retrieval. In India, medical consultation in remote areas is increasing through mobile consultation. Medical education programmes for doctors and tele-referrals are being provided also. The National Library of Medicine's (NLM’s) Medical Subject Headings (an online resource from the United States National Institutes of Health) are being made available in languages other than English, and NLM has also made consumer health information available in more than 40 languages. Though the cost of medical journals is reported here to be spiralling, there is a trend towards open access technology for journal publishing and free access to health literature. As stated here, "[a]n open journal system is being used by several publishers that enable online publishing of journals free of copyright restraints."

Recommendations include the following:

• Ensure reliable connectivity and internet access to the last mile.
• Provide effective training in IT skills and information retrieval techniques.
• Strengthen medical libraries.
• Build consortium at global, national, and regional levels.
• Promote open access publishing and building of institutional repositories.
• Ensure availability of online and web versions of journals and information sources.
• Disseminate national and regional level information in a proper and effective mode.
• Align government policies.

Making the eHealth Connection website.