McConnell Harry, Haile-Mariam Tenagne, Rangarajan S
Institute for Sustainable Health Education and Development.
World Hosp Health Serv. 2004;40(4):36-9.
The issues of the digital divide and of accessing health information in areas of greatest need has been addressed by many. It has been a key component of the discussion of the World Summit for the Information Society and also the focus of an important new initiative, the Global Review for Health Information. Only approximately 1 in 700 people in Africa have internet access compared to a rate worldwide of approximately 10%. Access to essential health information and knowledge management for health care has been deemed a priority for the development of health systems and for the care of patients in areas with limited resources, prompting recent efforts by international organisations and by both governmental and non-governmental agencies (see Godlee et al, 2004 and McConnell, 2004). Health care in developing countries can be limited by many different resources: lack of health care workers with sufficient training, lack of diagnostic equipment, lack of treatment facilities or essential pharmaceuticals; and lack of education or expertise in many relevant areas. Much of the health care done in developing countries is by local lay persons or practitioners or by volunteers working with a variety of NGOs. These volunteers are often very dedicated young people with a vision of health-for-all that is often frustrated in the limited time they are able to spend in these areas and further constrained by meager resources (including availability of appropriate information). The availability of medical expertise and consultation depends largely on the geographical location of the health practitioner and of the patient as well as the level of integration with local practitioners and extent of outside agency involvement. Futhermore, there are often many NGOs working simultaneously on similar projects in the same region without knowledge of each other's activities. Often this occurs simply because a lack of communication exists between organisations, resulting in unnecessary duplication of effort. The availability of medical expertise and consultation depends largely on the geographical location of the health practitioner and of the patient as well as the level of integration with local practitioners and extent of outside agency involvement. The health care worker in developing countries is frequently faced with a paucity of information appropriate to the clinical situations on hand as well as a lack of locally available expertise. The lack of access to health care and other vital resources is one factor in the much lower (by approximately 1/3) life expectancy in the least developed countries campared to industrialised nations. In many developing countries there is only one doctor for 5-10,00 people, compared to a ratio of 1:200 in many developed countries. Textbooks, if they exist, may be 10-20 years out of date and are often directed more at the needs of developed countries. There is thus a growing need for wider availability of training and information on health care in developing countries and support for health care workers. There is also a need for increased communication and collaboration between governmental and non-governmental organisations working in international health to share education, resources and to coordinate efforts in areas supporting improved health care delivery. In recognition of this, the Institute for Sustainable Health Education and Development (www.ished.org) is launching the World Health Channel (WHC) in the spring of 2005 in collaboration with WorldSpace. This will allow access to critical health information in developing countries and place the emphasis on issues important for clinical care for front line health workers in these areas.
数字鸿沟以及在最需要的地区获取健康信息的问题已被许多人提及。这一直是信息社会世界首脑会议讨论的关键组成部分,也是一项重要新倡议——全球健康信息审查的重点。相比全球约10%的互联网接入率,非洲每700人中只有约1人能使用互联网。获取基本健康信息以及医疗保健知识管理被视为卫生系统发展以及资源有限地区患者护理的优先事项,这促使国际组织以及政府和非政府机构近期做出了努力(见戈德利等人,2004年;麦康奈尔,2004年)。发展中国家的医疗保健可能受到多种不同资源的限制:缺乏受过充分培训的医护人员、缺乏诊断设备、缺乏治疗设施或基本药物;以及在许多相关领域缺乏教育或专业知识。发展中国家的许多医疗保健工作是由当地非专业人员或从业者,或者是与各种非政府组织合作的志愿者完成的。这些志愿者通常是非常敬业的年轻人,他们怀揣全民健康的愿景,但往往因在这些地区能够花费的时间有限而受挫,并且由于资源匮乏(包括缺乏适当信息)而受到进一步限制。医疗专业知识和咨询服务的可获得性在很大程度上取决于医护人员和患者的地理位置、与当地从业者的整合程度以及外部机构的参与程度。此外,在同一地区,往往有许多非政府组织同时开展类似项目,却互不了解彼此的活动。这种情况经常发生仅仅是因为各组织之间缺乏沟通,导致不必要的工作重复。医疗专业知识和咨询服务的可获得性在很大程度上取决于医护人员和患者的地理位置、与当地从业者的整合程度以及外部机构的参与程度。发展中国家的医护人员经常面临缺乏适合手头临床情况的信息以及当地缺乏专业知识的问题。无法获得医疗保健和其他重要资源是最不发达国家预期寿命比工业化国家低得多(约低三分之一)的一个因素。在许多发展中国家,每5000 - 10000人中只有一名医生,而在许多发达国家这一比例为1:200。教科书如果有的话,可能已经过时10 - 20年,而且往往更侧重于发达国家的需求。因此,发展中国家对更广泛提供医疗保健培训和信息以及对医护人员的支持的需求日益增加。在国际卫生领域开展工作的政府和非政府组织之间也需要加强沟通与合作,以分享教育、资源并协调在支持改善医疗保健服务领域的工作。认识到这一点,可持续健康教育与发展研究所(www.ished.org)将于2005年春季与世界空间公司合作推出世界健康频道(WHC)。这将使发展中国家能够获取关键健康信息,并将重点放在对这些地区一线医护人员临床护理重要的问题上。