Nyaya Health and Global Health Delivery 2.0: Using Open-Access Technologies for Transparency and Operations Research

  • The growing field of global health delivery is in need of technological strategies to improve transparency and operations research.
  • Our organization has implemented several simple “Web 2.0” strategies while delivering medical and public health services in rural Nepal.
  • These strategies help Nyaya Health improve transparency, receive critical commentary from outside experts, and compare approaches to organizing budgets, pharmaceutical procurement, medical treatment protocols, and public health programs.
  • The platforms include quantitative outcomes data and logistics protocols on a wiki; an open-access, online deidentified patient database; geospatial data analysis through real-time maps; a blog; and a public line-by-line online budget.

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White House Signals Interest in Open Access with Public Call for Comments

On December 10, the White House Office of Science and Technology Policy (OSTP) announced a public forum to discuss public access to federally funded research. "The administration is dedicated to maximizing the return on Federal investments in R&D," reads the announcement in the Federal Register [PDF].

The discussion focuses largely on proposal to extend to other governmental agencies—such as the National Science Foundation, the Department of Defense, and NASA—a public access mandate similar to the one governing National Institute of Health-funded research. The National Institute of Health (NIH) is itself the largest federal funder of research, awarding more than $30.5 billion annually, and is covered by the December 2007 mandatory public access policy requiring the deposit of funded articles into the PubMed Central digital archive.

The OSTP post also goes on to outline a number of the arguments commonly put forward in favor of open access, including simplified access to scholarly publications and a central storage and search infrastructure that would facilitate researchers' ability to use the materials.

Blog-based discussion

In line with the Obama administration's determination to use the web as a means of engaging with the public, OSTP is soliciting comment via blog in three parts: on implementation (December 10 to 20), features and technology (December 21 to 31), and management (January 1 to 7). The discussion on OSTP's blog also parallels a more traditional call for public comment to be published in the Federal Register.

In the comments on the blog, dozens of users have weighed in on OSTP's detailed initial questions about the implementation of a mandate, including which agencies should enact public access policies, what length embargo period is appropriate, which version of an author's article to submit, and whether deposit should be mandatory or voluntary.

The overwhelming majority of comments—with a plurality from one advocate, Stevan Harnad, Professor of Cognitive Science at Southampton University—are strongly in favor of a mandatory policy with little to no embargo period, covering all or most federal agencies. (A side debate has emerged regarding Harnad's role; see commentary in the blog's comments, as well as a post registering disapproval on the Society for Scholarly Publishing's Scholarly Kitchen blog.)

Allies at 1600 Pennsylvania Avenue

The OSTP announcement comes as yet another encouraging sign for open access advocates, following the reintroduction of the Federal Research Public Access Act (FRPAA) in the Senate this year by Senators Joseph Lieberman (I-CT) and John Cornyn (R-TX), and a number of open access resolutions made by faculties nationwide.

Moreoever, given the Obama administration's consistent call for transparency and its recent push for a Comprehensive Open Government Plan, those advocates see the White House as a potentially great ally if comes out strongly in favor of open access.

"It's confirmation that this is an issue that is of national importance," said Heather Joseph, executive director of the Scholarly Publishing and Academic Resources Coalition (SPARC), adding that, while many librarians have been staunch advocates for the cause of open access, the administration could influence the debate on a much broader level.

It also seems clear that, aside from the political and legislative implications, a statement from the White House could potentially persuade some administrators and faculty at institutions where open access mandates from other campuses have failed to do so in the past.

Library issue in the end

But any federal open access mandate also stands to come back around as a library and digital archives issues eventually. “[Libraries] were the first community to clue in, on a coordinated scale, to what an open access world would look like,” Joseph said. And it will likely come back down to librarians and archivists to work out many of the practical aspects of the mandate if and when it is handed down from the legislative level.

During the comment period, it will be up to librarians to advise on how an public access mandate can be shaped in order to add the least additional burden to libraries and archives. A different policy governing each governmental agency would only increase the cost of implementation, Joseph said, and it is incumbent upon librarians to help divine the closest thing to a one-size-fits-all solution Read More!

Open access: implications for scholarly publishing and medical libraries

Purpose: The paper reviews and analyzes the evolution of the open access (OA) publishing movement and its impact on the traditional scholarly publishing model.
Procedures: A literature survey and analysis of definitions of OA, problems with the current publishing model, historical developments, funding agency responses, stakeholder viewpoints, and implications for scientific libraries and publishing are performed.
Findings: The Internet's transformation of information access has fueled interest in reshaping what many see as a dysfunctional, high-cost system of scholarly publishing. For years, librarians alone advocated for change, until relatively recently when interest in OA and related initiatives spread to the scientific community, governmental groups, funding agencies, publishers, and the general public.
Conclusions: Most stakeholders acknowledge that change in the publishing landscape is inevitable, but heated debate continues over what form this transformation will take. The most frequently discussed remedies for the troubled current system are the “green” road (self-archiving articles published in non-OA journals) and the “gold” road (publishing in OA journals). Both movements will likely intensify, with a multiplicity of models and initiatives coexisting for some time.

Karen M. Albert, MLS, AHIP, Director of Library Services. J Med Libr Assoc,94(3); Jul 2006
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A Very Brief Introduction to Open Access, by Peter Suber

Open-access (OA) literature is digital, online, free of charge, and free of most copyright and licensing restrictions. What makes it possible is the internet and the consent of the author or copyright-holder.

In most fields, scholarly journals do not pay authors, who can therefore consent to OA without losing revenue. In this respect scholars and scientists are very differently situated from most musicians and movie-makers, and controversies about OA to music and movies do not carry over to research literature.

OA is entirely compatible with peer review, and all the major OA initiatives for scientific and scholarly literature insist on its importance. Just as authors of journal articles donate their labor, so do most journal editors and referees participating in peer review.

OA literature is not free to produce, even if it is less expensive to produce than conventionally published literature. The question is not whether scholarly literature can be made costless, but whether there are better ways to pay the bills than by charging readers and creating access barriers. Business models for paying the bills depend on how OA is delivered.

There are two primary vehicles for delivering OA to research articles: OA journals and OA archives or repositories.

OA archives or repositories do not perform peer review, but simply make their contents freely available to the world. They may contain unrefereed preprints, refereed postprints, or both. Archives may belong to institutions, such as universities and laboratories, or disciplines, such as physics and economics. Authors may archive their preprints without anyone else's permission, and a majority of journals already permit authors to archive their postprints. When archives comply with the metadata harvesting protocol of the Open Archives Initiative, then they are interoperable and users can find their contents without knowing which archives exist, where they are located, or what they contain. There is now open-source software for building and maintaining OAI-compliant archives and worldwide momentum for using it.

OA journals perform peer review and then make the approved contents freely available to the world. Their expenses consist of peer review, manuscript preparation, and server space. OA journals pay their bills very much the way broadcast television and radio stations do: those with an interest in disseminating the content pay the production costs upfront so that access can be free of charge for everyone with the right equipment. Sometimes this means that journals have a subsidy from the hosting university or professional society. Sometimes it means that journals charge a processing fee on accepted articles, to be paid by the author or the author's sponsor (employer, funding agency). OA journals that charge processing fees usually waive them in cases of economic hardship. OA journals with institutional subsidies tend to charge no processing fees. OA journals can get by on lower subsidies or fees if they have income from other publications, advertising, priced add-ons, or auxiliary services. Some institutions and consortia arrange fee discounts. Some OA publishers waive the fee for all researchers affiliated with institutions that have purchased an annual membership. There's a lot of room for creativity in finding ways to pay the costs of a peer-reviewed OA journal, and we're far from having exhausted our cleverness and imagination.

For a longer introduction, with live links for further reading, see my Open Access Overview, http://www.earlham.edu/~peters/fos/overview.htm.
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