Access to data in health information systems.

This issue of the Bulletin contains a series of articles on the creation of health information systems in developing countries. A broad range of themes is raised — from what information a properly formed health information system ought to collect, to rationalizing the collection of information across agencies or institutions, and a consideration of the costs, benefits and potential uses of information that is amassed. The issue of ensuring access to data in developing countries is striking in both similarity to and differences from the situation in developed countries. The main difference is that in developing countries access is limited by a sheer lack of data: concerns and priorities of health information systems are often about collecting information that does not yet exist. Efforts focus on putting basic vital event registries in place, or in making better use of those registries by permitting relatively straightforward linkages of census and death records so that basic demographic measures such as life expectancy can be produced (see AbouZahr & Boerma (pp. 578–583) and Bambas Nolen et al. (597–603)). Similarities lie in the fragmented approaches that are often undertaken to develop new data collections as well as in the lack of explicit attention at the outset to processes that would enable resourceful use of data. The primary reason for collection might be programme evaluation or the production of statistics that can be compared across countries, for example. Attention to future data access and use issues prior to data collection may help create the capacity to conduct comparisons across countries, to monitor changes over time, and to use the data in combination with other data holdings. In developed countries, such as Canada, the lack of explicit consideration of future uses of data in the planning stages of collection has resulted in a fragmented world of data where some