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. 2003 May 10;326(7397):1035. doi: 10.1136/bmj.326.7397.1035

Closing the digital divide

Reality may not be so rosy

Andrew D Weeks 1
PMCID: PMC1125937  PMID: 12742932

Editor—Smith applauds the progress made in providing access to the internet in the developing world.1 Unfortunately the reality on the ground may not be as rosy.

I have just completed two years in a major sub-Saharan African university that was in the first phase of HINARI access. Having been initially starved of information while there I rushed to gain access. Unfortunately I was directed to the websites of two other international projects that were also providing free access to research materials over the internet.

I found poorly presented sites with complex addresses and passwords, and with limited access to full text journals. I contacted the projects repeatedly over the following months from my local internet café, trying to get better materials, but finally gave up, frustrated. It was only on my return to the United Kingdom that I discovered that I had been directed to the wrong sites. The HINARI website (www.healthinternetwork.org/) would have provided all that I needed.

How can we ensure that access to HINARI is available to those who need it? If I—as someone who was in the university, computer literate, and keen to access journals—failed, then there is little hope for the rural majority with limited computer skills.

Communication in countries must be improved through training programmes and publicity. But it is also the responsibility of international projects participating in information supply to the developing world to direct casual searchers like myself to good quality central portals like HINARI rather than to their own poorer versions. All too often good resources can be confounded by interagency competitiveness. To ensure that the HINARI address is spread as widely as possible, all need to focus on this major portal so that the users at the sharp end do not receive confused messages.

Footnotes

Competing interests: None declared.

References

BMJ. 2003 May 10;326(7397):1035.

Financial and technical obstacles must be eliminated

Malcolm Grant 1

Editor—Like Smith, I think that HINARI is an excellent idea and one that has great potential to improve health care in developed countries.1-1 However, I had three concerns about the current programme.

Firstly, when I looked at the list of eligible countries, I noted that three south Asian countries (Pakistan, India, Bangladesh) were not included, even though all three countries would seem ideal candidates for the HINARI programme (they have a combined population of over 1000 million people and a large pool of English speaking doctors). I wondered therefore why they were excluded. Of course, their omission from the list may simply be a clerical error, but if this is the case, it needs to be corrected.

Secondly, the current uptake of HINARI seems low given its potential. Smith said that 438 institutions in 68 countries eligible for free access have signed up thus far. This gives an average of six or seven institutions per country, which means that HINARI's current penetration is still very low. Hence, obstacles to the greater uptake of HINARI need to be identified and overcome.

Thirdly, the $1000 fee payable for access to journals may be affordable by large institutions but not by community health centres or doctors working in singlehanded or small group practices. We therefore need to ensure that financial obstacles do not hinder the uptake of HINARI.

HINARI has great potential to reduce the digital divide, but we need to ensure that financial and technical obstacles do not hinder its uptake.

Footnotes

Competing interests: None declared.

References


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