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> Summary
   of the survey

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Background information
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Since its birth in 1989, the World Wide Web has grown like an inferno, and is now one of the major forms of information sources on every topic conceivable, including and especially, the health domain. This is far more so in developed countries like North America, Europe and Australia, where both health professionals and the general public have easy access to quality online information. However, in less developed continents like South America, Asia and Africa, where access to a computer is limited and the availability of online local information is limited; the Internet is far less popular as a source of information.

Objectives of study
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The study “Obtaining Reliable Medical Information Online” was carried out in French-speaking Africa, with special emphasis on Mali, to pinpoint the specific socio-cultural factors by which confidence in on-line medical content is built.

Description of study
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The year long project supported by the Geneva International Academic Network, in collaboration with the University of Geneva, the World Health Organization, the Graduate Institute of Development Studies, the Health On the Net Foundation and the Institute for Human Sciences of Mali focused, both on websites through evaluation and on health professionals through a socio-anthropological approach (discussions and questionnaires)
Complementary initiatives were also undertaken to draft recommendations for the compilation and evaluation of on-line medical data that take into account socio-cultural and economic factors. Information drawn up in accordance with those recommendations would then be eligible for inclusion into the Global Health Library project of the World Health Organisation and be certified by the Health on the Net Foundation.

Methodology used
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The two main methods used to gather information were:

  • Information gathered from health professionals
    This was based on eighty talks carried out in a sample of health professionals in Mali and Bamako from various health centres (teaching hospitals, health clinics, community health centres).
    This data was complemented with data obtained from a questionnaire distributed at the beginning of the year (January 2007) in Bamako.

  • Information gathered through website evaluation
    Websites of French-speaking Africa were identified and then evaluated by reviewers of Health On the Net, Mali in Bamako using the structured questionnaire developed and applied by the HON Foundation to evaluate website compliance to the eight principles of the HONcode.

Observed results
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Production of online medical information:

  • Locally produced sites are limited due to the absence of a market for online health information. This is mainly due to the lack of economic interest in developing this area and also the poor level of trust of health professionals with respect to locally produced information.

  • Few health professionals write material intended for the local market. In general, it was seen that medical specialists were interested in more specialized information produced in Western countries.

Access to online medical information:

  • Information reliability is not perceived as an important factor, access to the Internet being the principal difficulty.
    The lack of necessary infrastructure in certain establishments or medical departments constitutes the most important obstacle for the access of online medical information.
    In two teaching hospitals, the number of connected computers as well as the quality of connection was seen to vary from one department to another, whereas in regional health centres and private clinics, it was usually non-existent.

  • imgAdherence to editorial standards: In fact, a situation similar to that of Western countries 5 years ago was seen. The Internet is primarily used for general and anonymous reading, which also explains why, when judging by respect of the HONcode principles, there is very little importance given to confidentiality.

  • Reliable and free information sources are not well known.

  • Access to online medical information is also dependent on rank in the medical profession where there is a disparity of internet use. Those who use the Internet as an information source were seen to be mainly male medical specialists or researchers. This ‘elite’ group have almost unlimited access, whereas those more  lowly, made up two more groups; those who have a limited access  is made up of female medical specialists, general medical officers and interns while those who have almost no access to the Internet are nurses, mid-wives and nurse assistants. Others with access to the Internet include librarians, those in charge of Internet cafés etc.

Recommendations
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From these results, the following recommendations were made:

  • Support production of information for a local audience through increase of local information publication using suitable local human resources and promotion of quality accreditation of sites.

  • Diffusion of locally produced information onto a more international platform. Improve access to online information through stressing the importance of quality information, promotion of free online resources (MEDLINE, PubmedCentral, BioMedCentral, HINARI, Global Index Medicus, HON, CISMEF, Institute of the Scientific and Technical Information of CNRS), facilitation of access to groups identified to have limited or no online access and development of a technical infrastructure.

Conclusions
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This study made it possible to explore several fields related to the production and the access of online information including the hurdles of quality information access, limitation through rank and sex and lack of necessary resources.
It also highlighted the necessary changes to be made to improve conditions and provide better access to quality online medical information to health professionals in French-speaking Africa.

RUIG Panel Presentation
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A panel presentation was organized by the Graduate Institute of Development Studies (IUED) and HON on 18th September in Geneva for the presentation of the results of the project amongst all participating organizations.


More information is accessible at:
http://www.HealthOnNet.org/Projet_Afrique_FR/ - A detailed description of the study (available in French)
http://www.HealthOnNet.org/Project/regio_ruig.html - Details of the study in English http://www.who.int/ghl/en/ - Information about the Global Health Library

   
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  Last modified: october 2007