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Oliveira-Ciabati L, Thorson A, Brizuela V. Scientific production in sexual and reproductive health and rights research according to gender and affiliation: An analysis of publications from 1972 to 2021. PLoS One 2024; 19:e0304659. [PMID: 38923959 PMCID: PMC11207172 DOI: 10.1371/journal.pone.0304659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/15/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Peer-reviewed literature is commonly used to assess academic progress and research excellency. However, representation in authorship of global health publications is biased and unfair. In order to shed light on current gaps towards attaining gender equality in scientific production and shift power asymmetries in global health research, we conducted an assessment of authorship trends from 1972 to 2021 with a focus on gender and geographic representation in scientific articles authored or co-authored by researchers affiliated with UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP). METHODS We searched PubMed, Web of Science, and HRP public reports for publications where at least one author was affiliated with HRP. Our main outcome measures were author gender and location of author affiliation, classified by region and country income group. We used descriptive statistics to characterize the publications under analysis as well as the total number of authors from the included papers. We applied a logistic regression model to explore associations between author gender and other characteristics of published articles and a time series analysis to assess how time can influence the inclusion of women as authors in a publication. Python and R were used for all analyses. RESULTS A total of 1,484 publications with 14,424 listed authors representing 5,950 unique authors were included in our analysis: 42.5% were female, 35.1% male, and 22.4% unknown (p<0.0001). First authorship was more likely female (56.9%) and from a high-income country (74.6%, p<0.0001) while last authorship was mostly male (53.7%) also from a high-income country (82.5%, p<0.0001). Females more frequently published papers using qualitative data (61.4%) and reviews/estimates (59.4%) while men published more case control (70.7%) and randomised controlled studies (53.0%), p<0.0001. The adjusted odds of there being a female author increased 4% for every additional year that passed. CONCLUSION While there are more females authoring articles as compared to the past, they are still lagging behind with regards to seniority and prestige. Likewise, female representation is closely tied to what institution they are affiliated with and where that institution is located. Global health research institutions need to actively promote change by ensuring women are included in research and research outputs, giving them opportunities to lead.
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Affiliation(s)
- Livia Oliveira-Ciabati
- Health Innovation Techcenter (HIT), Hospital Israelita Albert Einstein, São Paulo, Brazil
- Barão de Mauá University Center, Ribeirão Preto, SP, Brazil
| | - Anna Thorson
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Vanessa Brizuela
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Jamil H, Ranganathan S, Fissha AB, Vinck EE, Vervoort D. Low-Cost Innovations in Global Cardiac Surgery. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2024:15569845241252441. [PMID: 38828943 DOI: 10.1177/15569845241252441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, costing the lives of 18 million people annually, with up to one-third being attributable to cardiac surgical conditions. Approximately 6 billion people do not have access to safe, timely, and affordable cardiac surgery, predominantly affecting populations living in low-middle income countries. Cardiac surgical care is costly, resulting in few centers in variable-resource contexts operating continuously or with the resources observed in higher-resource environments. As a result, innovations may be formally developed or informally adopted to bypass resource constraints and ensure care delivery. Innovations have been observed across the cardiac surgical care continuum and across settings, potentially benefiting both high-income countries, where growing health care costs are becoming unsustainable, and low- and middle-income countries, where competing health agendas may limit investments into cardiac surgery. This narrative review attempts to address the costs associated with cardiac surgery, placing an emphasis on frugal innovations in the perioperative and postoperative care spectrum.
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Affiliation(s)
- Hera Jamil
- Life Sciences, Department of Biological Sciences, University of Toronto Scarborough, ON, Canada
| | | | - Aemon B Fissha
- College of Health Sciences, School of Medicine, Addis Ababa University, Ethiopia
| | - Eric E Vinck
- Division of Cardiac Surgery, Pontifical Bolivarian University, Medellín, Colombia
| | - Dominique Vervoort
- Division of Cardiac Surgery, University of Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada
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Kusurkar RA, Lilley P, Harden R. Medical Teacher's equity diversity inclusion policy. MEDICAL TEACHER 2024; 46:730-731. [PMID: 38557241 DOI: 10.1080/0142159x.2024.2334394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
Medical Teacher is a leading international journal in health professions education. The Journal recognizes its responsibility to publish papers that reflect the breadth of topics that meet the needs of its readers around the globe including contributions from countries underrepresented in the health professions education arena. This paper sets out the Journal's policy with regard to Equity Diversity Inclusion (EDI) and the steps to be taken to implement the policy in practice.
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Affiliation(s)
- Rashmi A Kusurkar
- Research in Education, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
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Eldridge L, Garton EM, Duncan K, Gopal S. Authorship of Publications Supported by NCI-Funded Grants Involving Low- and Middle-Income Countries. JAMA Netw Open 2024; 7:e243215. [PMID: 38551565 PMCID: PMC10980966 DOI: 10.1001/jamanetworkopen.2024.3215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/28/2024] [Indexed: 04/01/2024] Open
Abstract
Importance Scientific publication is an important tool for knowledge dissemination and career advancement, but authors affiliated with institutions in low- and middle-income countries (LMICs) are historically underrepresented on publications. Objective To assess the country income level distribution of author affiliations for publications resulting from National Cancer Institute (NCI)-supported extramural grants between 2015 and 2019, with international collaborating institutions exclusively in 1 or more LMICs. Design and Setting This cross-sectional study assessed authorship on publications resulting from NCI-funded grants between October 1, 2015, and September 30, 2019. Grants with collaborators in LMICs were identified in the National Institutes of Health (NIH) Query/View/Report and linked to publications using Dimensions for NIH, published between 2011 and 2020. Statistical analysis was performed from May 2021 to July 2022. Main Outcomes and Measures Author institutional affiliation was used to classify author country and related income level as defined by the World Bank. Relative citation ratio and Altmetric data from Dimensions for NIH were used to compare citation impact measures using the Wilcoxon rank sum test. Results In this cross-sectional study, 159 grants were awarded to US institutions with collaborators in LMICs, and 5 grants were awarded directly to foreign institutions. These 164 grants resulted in 2428 publications, of which 1242 (51%) did not include any authors affiliated with an institution in an LMIC. In addition, 1884 (78%) and 2009 (83%) publications had a first or last author, respectively, affiliated with a high-income country (HIC). Publications with HIC-affiliated last authors also demonstrated greater citation impact compared with publications with LMIC-affiliated last authors as measured by relative citation ratios and Altmetric Attention Scores; publications with HIC-affiliated first authors also had higher Altmetric Attention Scores. Conclusions and Relevance This cross-sectional study suggests that LMIC-affiliated authors were underrepresented on publications resulting from NCI-funded grants involving LMICs. It is critical to promote equitable scientific participation by LMIC institutions in cancer research, including through current and planned programs led by the NCI.
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Affiliation(s)
- Linsey Eldridge
- Center for Global Health, National Cancer Institute, Rockville, Maryland
| | - Elise M. Garton
- Center for Global Health, National Cancer Institute, Rockville, Maryland
| | - Kalina Duncan
- Center for Global Health, National Cancer Institute, Rockville, Maryland
| | - Satish Gopal
- Center for Global Health, National Cancer Institute, Rockville, Maryland
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Gustafsson LL. Strengthening Global Health Research. Glob Health Action 2023; 16:2290638. [PMID: 38133655 PMCID: PMC10763898 DOI: 10.1080/16549716.2023.2290638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023] Open
Abstract
Global Health is a young discipline with equity of health and services as its core value. The discipline has a tradition of close links between practice and research in line with the 'Health for All' declaration launched by the World Health Organization (WHO) in 1978. The multitude of existential health crises facing mankind require a research agenda in line with Global Health Research core values and methods, such as transdisciplinary collaboration, long time series of population-based observations and multifaceted interventions. Knowledge gaps cover climate effects on health and mechanisms for global spread and control of antibiotic resistance across species. Such health threats are preferably studied at Health and Demographic Surveillance Sites, a scientific infrastructure for Global Health Research in Africa and Asia, that gains to expand and monitor climate parameters and include sites in the northern hemisphere. Global Health Scientists together with science societies can ensure long-term funding of a global network of population-based health-climate sites. Global Health Scientists and scientific journals should jointly provide data and evidence on global health to governance bodies on regional, national and global levels, in particular to WHO and United Nations in charge of the programme with Sustainable Development Goals.
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Affiliation(s)
- Lars L. Gustafsson
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
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Skrivankova VW, Hossmann S, Cornell M, Ballif M, Dupont C, Huwa J, Seintaridis K, Kalua T, Wandeler G, Kassanjee R, Haas AD, Technau KG, Fenner L, Low N, Davies MA, Egger M. Authorship inequalities in global health research: the IeDEA Southern Africa collaboration. BMJ Glob Health 2023; 8:e013316. [PMID: 38103897 PMCID: PMC10729048 DOI: 10.1136/bmjgh-2023-013316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The International epidemiology Databases to Evaluate AIDS conducts research in several regions, including in Southern Africa. We assessed authorship inequalities for the Southern African region, which is led by South African and Swiss investigators. METHODS We analysed authorships of publications from 2007 to 2020 by gender, country income group, time and citation impact. We used 2020 World Bank categories to define income groups and the relative citation ratio (RCR) to assess citation impact. Authorship parasitism was defined as articles without authors from the countries where the study was conducted. A regression model examined the probability of different authorship positions. RESULTS We included 313 articles. Of the 1064 contributing authors, 547 (51.4%) were women, and 223 (21.0%) were from 32 low-income/lower middle-income countries (LLMICs), 269 (25.3%) were from 13 upper middle-income countries and 572 (53.8%) were from 25 high-income countries (HICs). Most articles (150/157, 95.5%) reporting data from Southern Africa included authors from all participating countries. Women were more likely to be the first author than men (OR 1.74; 95% CI 1.06 to 2.83) but less likely to be last authors (OR 0.63; 95% CI 0.40 to 0.99). Compared with HIC, LLMIC authors were less likely to publish as first (OR 0.21; 95% CI 0.11 to 0.41) or last author (OR 0.20; 95% CI 0.09 to 0.42). The proportion of women and LLMIC first and last authors increased over time. The RCR tended to be higher, indicating greater impact, if first or last authors were from HIC (p=0.06). CONCLUSIONS This analysis of a global health collaboration co-led by South African and Swiss investigators showed little evidence of authorship parasitism. There were stark inequalities in authorship position, with women occupying more first and men more last author positions and researchers from LLMIC being 'stuck in the middle' on the byline. Global health research collaborations should monitor, analyse and address authorship inequalities.
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Affiliation(s)
| | - Stefanie Hossmann
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | - Morna Cornell
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Marie Ballif
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
- Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Carole Dupont
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | | | | | - Thokozani Kalua
- Department of HIV and AIDS, Malawi Ministry of Health, Lilongwe, Malawi
| | - Gilles Wandeler
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
- Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Andreas D Haas
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | - Karl-Gunter Technau
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lukas Fenner
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
| | - Mary-Ann Davies
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), Universität Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Liwanag HJ, James O, Frahsa A. A review and analysis of accountability in global health funding, research collaborations and training: towards conceptual clarity and better practice. BMJ Glob Health 2023; 8:e012906. [PMID: 38084477 PMCID: PMC10711908 DOI: 10.1136/bmjgh-2023-012906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/21/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Accountability is a complex idea to unpack and involves different processes in global health practice. Calls for accountability in global health would be better translated to action through a better understanding of the concept and practice of accountability in global health. We sought to analyse accountability processes in practice in global health funding, research collaborations and training. METHODS This study is a literature review that systematically searched PubMed and Scopus for articles on formal accountability processes in global health. We charted information on processes based on accountability lines ('who is accountable to whom') and the outcomes the processes were intended for ('accountability for what'). We visualised the representation of accountability in the articles by mapping the processes according to their intended outcomes and the levels where processes were implemented. RESULTS We included 53 articles representing a wide range of contexts and identified 19 specific accountability processes for various outcomes in global health funding, research collaborations and training. Target setting and monitoring were the most common accountability processes. Other processes included interinstitutional networks for peer checking, litigation strategies to enforce health-related rights, special bodies that bring actors to account for commitments, self-accountability through internal organisational processes and multipolar accountability involving different types of institutional actors. Our mapping identified gaps at the institutional, interinstitutional and broader system levels where accountability processes could be enhanced. CONCLUSION To rebalance power in global health, our review has shown that analysing information on existing accountability processes regarding 'who is accountable to whom' and 'accountability for what' would be useful to characterise existing lines of accountability and create lines where there are gaps. However, we also suggest that institutional and systems processes for accountability must be accompanied by political engagement to mobilise collective action and create conditions where a culture of accountability thrives in global health.
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Affiliation(s)
- Harvy Joy Liwanag
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Oria James
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Rubagumya F, Fundytus A, Keith-Brown S, Hopman WM, Gyawali B, Mukherji D, Hammad N, Pramesh CS, Aggarwal A, Eniu A, Sengar M, Riechelmann RSR, Sullivan R, Booth CM. Allocation of authorship and patient enrollment among global clinical trials in oncology. Cancer 2023; 129:2856-2863. [PMID: 37382190 DOI: 10.1002/cncr.34919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/11/2023] [Accepted: 03/29/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Oncology randomized controlled trials (RCTs) are increasingly global in scope. Whether authorship is equitably shared between investigators from high-income countries (HIC) and low-middle/upper-middle incomes countries (LMIC/UMIC) is not well described. The authors conducted this study to understand the allocation of authorship and patient enrollment across all oncology RCTs conducted globally. METHODS A cross-sectional retrospective cohort study of phase 3 RCTs (published 2014-2017) that were led by investigators in HIC and recruited patients in LMIC/UMIC. FINDINGS During 2014-2017, 694 oncology RCTs were published; 636 (92%) were led by investigators from HIC. Among these HIC-led trials, 186 (29%) enrolled patients in LMIC/UMIC. One-third (33%, 62 of 186) of RCTs had no authors from LMIC/UMIC. Forty percent (74 of 186) of RCTs reported patient enrollment by country; in 50% (37 of 74) of these trials, LMIC/UMIC contributed <15% of patients. The relationship between enrollment and authorship proportion is very strong and is comparable between LMIC/UMIC and HIC (Spearman's ρ LMIC/UMIC 0.824, p < .001; HIC 0.823, p < .001). Among the 74 trials that report country enrollment, 34% (25 of 74) have no authors from LMIC/UMIC. CONCLUSIONS Among trials that enroll patients in HIC and LMIC/UMIC, authorship appears to be proportional to patient enrollment. This finding is limited by the fact that more than half of RCTs do not report enrollment by country. Moreover, there are important outliers as a significant proportion of RCTs had no authors from LMIC/UMIC despite enrolling patients in these countries. The findings in this study reflect a complex global RCT ecosystem that still underserves cancer control outside high-income settings.
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Affiliation(s)
- Fidel Rubagumya
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
- Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda
| | - Adam Fundytus
- British Columbia Cancer Agency, Victoria, British Columbia, Canada
| | - Sophie Keith-Brown
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada
| | - Wilma M Hopman
- Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Bishal Gyawali
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
- Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | | | - Nazik Hammad
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - C S Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Ajay Aggarwal
- Institute of Cancer Policy, King's College London, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Manju Sengar
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | | | | | - Christopher M Booth
- Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
- Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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Akudinobi EA, Rietmeijer CA, Ndowa FJ, Kilmarx PH. Bibliometric Analysis of Authorship of Publications About Sub-Saharan Africa Published in the Journal Sexually Transmitted Diseases , 2011 to 2020. Sex Transm Dis 2023; 50:555-558. [PMID: 36943809 PMCID: PMC10430671 DOI: 10.1097/olq.0000000000001808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND As a potential indicator of equity in research partnerships, we conducted a bibliometric analysis of author affiliations and author order in publications about sub-Saharan Africa published in the journal Sexually Transmitted Diseases . METHODS We identified articles in the journal Sexually Transmitted Diseases that were about sub-Saharan Africa and published from 2011 to 2020. Medical Subject Heading terms in PubMed were used to identity articles about sub-Saharan Africa. Authors with at least 1 affiliation in sub-Saharan Africa were characterized as sub-Saharan Africa-affiliated authors. RESULTS Of the 1439 articles that were published in Sexually Transmitted Diseases from 2011 to 2020, 148 (10%) had a Medical Subject Heading term for a sub-Saharan African country. Of the 604 authors of these 148 articles, 53 (36%) of the first authors, 493 (53%) of the middle authors, and 58 (40%) of the last authors had a sub-Saharan African affiliation; 13 (8.8%) of the articles had no authors with a sub-Saharan African affiliation. The proportions of sub-Saharan African-affiliated authors in first and last authorship positions did not change significantly from 2011-2015 (77 articles) to 2016-2020 (71 articles). CONCLUSIONS The underrepresentation of Africans in first and last authorship positions suggests power imbalances in global scientific partnerships. Funders, researchers, editors, publishers, and grant and manuscript reviewers each have roles in promoting equity in global health research. This study may serve as an example for journals to establish benchmarks and monitor progress toward a more equitable research environment.
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Affiliation(s)
- Ezinne A. Akudinobi
- From the Fogarty International Center, US National Institutes of Health, Bethesda, MD
| | | | | | - Peter H. Kilmarx
- From the Fogarty International Center, US National Institutes of Health, Bethesda, MD
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Iwai Y, Toumbou K, Zuze T, Morgan JS, Simwinga L, Wright ST, Fedoriw Y, Oladeru OT, Balogun OD, Roberson ML, Olopade OI, Tomoka T, Elmore SN. Breast Cancer Germline Genetic Counseling and Testing for Populations of African Heritage Globally: A Scoping Review on Research, Practice, and Bioethical Considerations. JCO Glob Oncol 2023; 9:e2300154. [PMID: 37944088 PMCID: PMC10645409 DOI: 10.1200/go.23.00154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/05/2023] [Accepted: 09/05/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE Despite the disproportionately high risk of breast cancer among women of African heritage, little is known about the facilitators and barriers to implementing germline genetic testing and counseling (GT/C). METHODS This scoping review followed guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Published manuscripts from database inception through 2021 were sourced from PubMed, Cumulative Index to Nursing and Allied Health Literature via EBSCO, Embase, Cochrane Library, and Scopus. Search terms were used to retrieve articles addressing (1) African heritage, (2) breast cancer, and (3) GT or GC. The screening involved abstract and title review and full-text review. Data were extracted for all articles meeting the inclusion criteria. RESULTS A total of 154 studies were included. Most studies that took place were conducted in the United States (71.4%), and most first authors (76.9%) were from the United States. GT was conducted in 73 (49.7%) studies. BRCA1/BRCA2 were the most commonly studied genes for germline mutations. GC was conducted in 49 studies (33.3%), and perspectives on GC were evaluated in 43 (29.3%). The use of racial/ethnic categories varied broadly, although African American was most common (40.1%). Racism was mentioned in three studies (2.0%). CONCLUSION There is a growing body of literature on GT/C for breast cancer in women of African heritage. Future studies on GT/C of African populations should consider increased clarity around racial/ethnic categorizations, continued community engagement, and intentional processes for informed consent.
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Affiliation(s)
- Yoshiko Iwai
- University of North Carolina School of Medicine, Chapel Hill, NC
| | | | | | - Jenny S. Morgan
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
- Department of Clinical Medicine, Indiana University School of Medicine, Indianapolis, IN
- Department of Global Health, Indiana University School of Medicine, Indianapolis, IN
| | | | - Sarah T. Wright
- UNC Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yuri Fedoriw
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Oluwadamilola T. Oladeru
- Department of Radiation Oncology, University of Florida, Gainesville, FL
- Department of Radiation Oncology, Mayo Clinic in Florida, Jacksonville, FL
| | | | - Mya L. Roberson
- Department of Health Policy, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | | | | | - Shekinah N.C. Elmore
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
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Amisi JA, Cuba-Fuentes MS, Johnston EM, Makwero M, Prasad S, Ras T, Szkwarko D, von Pressentin K. A pragmatic approach to equitable global health partnerships in academic health sciences. BMJ Glob Health 2023; 8:bmjgh-2022-011522. [PMID: 37230545 DOI: 10.1136/bmjgh-2022-011522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/21/2023] [Indexed: 05/27/2023] Open
Abstract
Global partnerships offer opportunities for academic departments in the health sciences to achieve mutual benefits. However, they are often challenged by inequities in power, privilege and finances between partners that have plagued the discipline of global health since its founding. In this article, a group of global health practitioners in academic medicine offer a pragmatic framework and practical examples for designing more ethical, equitable and effective collaborative global relationships between academic health science departments, building on the principles laid out by the coalition Advocacy for Global Health Partnerships in the Brocher declaration.
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Affiliation(s)
- James A Amisi
- AMPATH Kenya, Eldoret, Kenya
- Department of Family Medicine, Community Health and Medical Education, Moi University College of Health Sciences, Eldoret, Kenya
| | - María Sofía Cuba-Fuentes
- Center for Research in Primary Health Care, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Esther M Johnston
- The Wright Center National Family Medicine Residency Program at HealthPoint, Auburn, Washington, USA
| | - Martha Makwero
- Department of Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Shailendra Prasad
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tasleem Ras
- Department of Family, Community and Emergency Care, University of Cape Town, Rondebosch, South Africa
| | - Daria Szkwarko
- AMPATH Kenya, Eldoret, Kenya
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Klaus von Pressentin
- Department of Family, Community and Emergency Care, University of Cape Town, Rondebosch, South Africa
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Shambe I, Thomas K, Bradley J, Marchant T, Weiss HA, Webb EL. Bibliometric analysis of authorship patterns in publications from a research group at the London School of Hygiene & Tropical Medicine, 2016-2020. BMJ Glob Health 2023; 8:bmjgh-2022-011053. [PMID: 36792228 PMCID: PMC9933664 DOI: 10.1136/bmjgh-2022-011053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/11/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Authors from low and middle-income country (LMIC) institutions are under-represented in publications of research based in LMICs. This case study of publications from authors within the Medical Research Council International Statistics and Epidemiology Group (MRC-ISEG), a global health research group affiliated to the London School of Hygiene & Tropical Medicine in the UK, aims to describe patterns in authorship and factors associated with under-representation. METHODS Papers were included if they were published between January 2016 and December 2020 inclusive, included an author from the MRC-ISEG and described work conducted in a LMIC. Authors' affiliations were classified using World Bank country income classifications into LMIC affiliations only, high-income country (HIC) affiliations only and mixed LMIC/HIC affiliations. Multinomial logistic regression analysis was used to assess associations of author affiliation category with authorship position, and whether patterns varied by journal impact factor quartile and multiple versus single-country studies. RESULTS A total of 882 papers, including 10 570 authors describing research conducted in 61 LMICs, were included. Compared with authors of HIC-only affiliation, those with LMIC-only affiliation were less likely to be in first authorship position (relative risk ratio (RRR)=0.51, 95% CI 0.44 to 0.60) and mixed HIC/LMIC affiliation authors were more likely (RRR=2.80, 95% CI 2.35 to 3.34). Compared with authors of HIC-only affiliation, those with LMIC-only affiliation were less likely to be in last authorship position (RRR=0.20, 95% CI 0.16 to 0.24) and those with mixed HIC/LMIC affiliations were more likely (RRR=1.95, 95% CI 1.65 to 2.30). The proportion of senior authors with LMIC-only affiliation was lowest for the highest impact journals, and in multicountry versus single-country studies. CONCLUSION Alongside increasing research capacity within LMICs, HIC institutions should ensure that LMIC-affiliated researchers are properly represented in global research. Academics working in global health should be judged on their involvement in representative collaborative research rather than individual achievements in authorship position.
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Affiliation(s)
- Iornum Shambe
- Department of Obstetrics and Gynaecology, University of Jos, Jos, Nigeria
| | - Katherine Thomas
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - John Bradley
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - Tanya Marchant
- Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Helen A Weiss
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | - Emily L Webb
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
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Mutebi M, Lewison G, Aggarwal A, Alatise OI, Booth C, Cira M, Grover S, Ginsburg O, Gralow J, Gueye S, Kithaka B, Kingham TP, Kochbati L, Moodley J, Mohammed SI, Mutombo A, Ndlovu N, Ntizimira C, Parham GP, Walter F, Parkes J, Shamely D, Hammad N, Seeley J, Torode J, Sullivan R, Vanderpuye V. Cancer research across Africa: a comparative bibliometric analysis. BMJ Glob Health 2022; 7:bmjgh-2022-009849. [PMID: 36356985 PMCID: PMC9660667 DOI: 10.1136/bmjgh-2022-009849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/29/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Research is a critical pillar in national cancer control planning. However, there is a dearth of evidence for countries to implement affordable strategies. The WHO and various Commissions have recommended developing stakeholder-based needs assessments based on objective data to generate evidence to inform national and regional prioritisation of cancer research needs and goals. METHODOLOGY Bibliometric algorithms (macros) were developed and validated to assess cancer research outputs of all 54 African countries over a 12-year period (2009-2020). Subanalysis included collaboration patterns, site and domain-specific focus of research and understanding authorship dynamics by both position and sex. Detailed subanalysis was performed to understand multiple impact metrics and context relative outputs in comparison with the disease burden as well as the application of a funding thesaurus to determine funding resources. RESULTS African countries in total published 23 679 cancer research papers over the 12-year period (2009-2020) with the fractional African contribution totalling 16 201 papers and the remaining 7478 from authors from out with the continent. The total number of papers increased rapidly with time, with an annual growth rate of 15%. The 49 sub-Saharan African (SSA) countries together published just 5281 papers, of which South Africa's contribution was 2206 (42% of the SSA total, 14% of all Africa) and Nigeria's contribution was 997 (19% of the SSA total, 4% of all Africa). Cancer research accounted for 7.9% of all African biomedical research outputs (African research in infectious diseases was 5.1 times than that of cancer research). Research outputs that are proportionally low relative to their burden across Africa are paediatric, cervical, oesophageal and prostate cancer. African research mirrored that of Western countries in terms of its focus on discovery science and pharmaceutical research. The percentages of female researchers in Africa were comparable with those elsewhere, but only in North African and some Anglophone countries. CONCLUSIONS There is an imbalance in relevant local research generation on the continent and cancer control efforts. The recommendations articulated in our five-point plan arising from these data are broadly focused on structural changes, for example, overt inclusion of research into national cancer control planning and financial, for example, for countries to spend 10% of a notional 1% gross domestic expenditure on research and development on cancer.
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Affiliation(s)
- Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi, Kenya
| | - Grant Lewison
- King's College London, Institute of Cancer Policy, London, UK
| | - Ajay Aggarwal
- Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Olusegun Isaac Alatise
- Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Christopher Booth
- Departments of Oncology & Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Miska Cira
- National Cancer Institute Center for Global Health, Rockville, Maryland, USA
| | - Surbhi Grover
- Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA,Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Julie Gralow
- American Society of Clinical Oncology, Alexandria, Virginia, USA
| | - Serine Gueye
- Service d'urologie de l'Hopital General Idrissa Pouye, Dakar, Senegal
| | | | - T Peter Kingham
- Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lofti Kochbati
- Abderrahmen Mami Teaching Hospital, Ariana El Manar University, Tunis, Tunisia
| | | | | | | | - Ntokozo Ndlovu
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Groesbeck Preer Parham
- World Health Organization, Geneve, Switzerland,Department of Obstetrics and Gynecology, UTH-Women and Newborn Hospital, University of Zambia, Lusaka, Zambia
| | - Fiona Walter
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jeannette Parkes
- Department of Radiation Oncology, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Delva Shamely
- Faculty of Health Sciences, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Nazik Hammad
- Department of Medical Oncology, Queen's University, Kingston, Ontario, Canada
| | - Janet Seeley
- Department of Global Health & Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Julie Torode
- Global Oncology Group, King's College London, London, UK
| | | | - Verna Vanderpuye
- National Center for Radiotherapy Oncology and Nuclear Medicine and Korle Bu Teaching Hospital, Korle-Bu, Ghana
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14
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Rees CA, Sirna SJ, Manji HK, Kisenge R, Manji KP. Authorship equity guidelines in global health journals. BMJ Glob Health 2022; 7:bmjgh-2022-010421. [PMID: 36220309 PMCID: PMC9557304 DOI: 10.1136/bmjgh-2022-010421] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/24/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA,Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Stephanie J Sirna
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Hussein K Manji
- Department of Emergency Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of,Accident and Emergency Medicine, Aga Khan Hospital Dar es Salaam, Dar es Salaam, Tanzania, United Republic of
| | - Rodrick Kisenge
- Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Karim P Manji
- Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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Kivlehan SM, Hexom BJ, Bonney J, Collier A, Nicholson BD, Quao NSA, Rybarczyk MM, Selvam A, Rees CA, Roy CM, Bhaskar N, Becker TK. Global emergency medicine: A scoping review of the literature from 2021. Acad Emerg Med 2022; 29:1264-1274. [PMID: 35913419 DOI: 10.1111/acem.14575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/17/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The objective was to identify the most important and impactful peer-reviewed global emergency medicine (GEM) articles published in 2021. The top articles are summarized in brief narratives and accompanied by a comprehensive list of all identified articles that address the topic during the year to serve as a reference for clinicians, researchers, and policy makers. METHODS A systematic PubMed search was carried out to identify all GEM articles published in 2021. Title and abstract screening was performed by trained reviewers and editors to identify articles in one of three categories based on predefined criteria: disaster and humanitarian response (DHR), emergency care in resource-limited settings (ECRLS), and emergency medicine development (EMD). Included articles were each scored by two reviewers using established rubrics for original (OR) and review (RE) articles. The top 5% of articles overall and the top 5% of articles from each category (DHR, ECRLS, EMD, OR, and RE) were included for narrative summary. RESULTS The 2021 search identified 44,839 articles, of which 444 articles screened in for scoring, 25% and 22% increases from 2020, respectively. After removal of duplicates, 23 articles were included for narrative summary. ECRLS constituted the largest category (n = 16, 70%), followed by EMD (n = 4, 17%) and DHR (n = 3, 13%). The majority of top articles were OR (n = 14, 61%) compared to RE (n = 9, 39%). CONCLUSIONS The GEM peer-reviewed literature continued to grow at a fast rate in 2021, reflecting the continued expansion and maturation of this subspecialty of emergency medicine. Few high-quality articles focused on DHR and EMD, suggesting a need for further efforts in those fields. Future efforts should focus on improving the diversity of GEM research and equitable representation.
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Affiliation(s)
- Sean M Kivlehan
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Humanitarian Initiative, Cambridge, Massachusetts, USA
| | - Braden J Hexom
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Joseph Bonney
- Department of Emergency Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana.,Global Health and Infectious Disease Research Group, Kumasi Center for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Amanda Collier
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - Benjamin D Nicholson
- Department of Emergency Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nana Serwaa A Quao
- Department of Emergency Medicine, Accident and Emergency Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Megan M Rybarczyk
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anand Selvam
- Department of Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Charlotte M Roy
- Department of Emergency Medicine, Loma Linda University, Loma Linda, California, USA
| | | | - Torben K Becker
- Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA
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16
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Akudinobi EA, Kilmarx PH. Bibliometric analysis of sub-Saharan African and US authorship in publications about sub-Saharan Africa funded by the Fogarty International Center, 2008-2020. BMJ Glob Health 2022; 7:bmjgh-2022-009466. [PMID: 35998980 PMCID: PMC9403115 DOI: 10.1136/bmjgh-2022-009466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/01/2022] [Indexed: 11/04/2022] Open
Abstract
Background Authorship and author order have been used as one measure to characterise equity in research partnerships. First and last (senior) authorships often denote scientific merit as well as potential for research career advancement. A previous analysis found that only about 20%–25% of publications about Africa with coauthors from top-ranking US universities had a first or last author from the topic country. In this bibliometric analysis, we evaluated authorship of publications about sub-Saharan Africa (SSA) funded by the Fogarty International Center (FIC) of the US National Institutes of Health, an institution with a mission of training and capacity building in low-income and middle-income countries. Methods We analysed publications from PubMed and Web of Science that were funded by FIC, about SSA, and published between 2008 and 2020. Relative citation ratio (RCR) data from iCite were used to compare group citation impact measures using the Wilcoxon rank sum test. Results A total of 3446 publications met the inclusion criteria, with annual number increasing from 114 in 2008 to 352 in 2020. SSA-affiliated first authors increased from 53 (47%) in 2008 to 224 (63%) in 2020. SSA-affiliated last authors increased from 32 (28%) to 166 (47%). For both first and last authorships, the median RCR value of publications with SSA-affiliated authors was lower than for US-affiliated authors (first authors: 0.84 vs 0.95, p=0.0021; last authors: 0.88 vs 0.91, p=0.010). Conclusion The increase in first and last authorships by SSA-affiliated authors of publications about SSA suggests increasing equity in research activities funded by FIC. Further investigation and actions are needed to establish how authorship reflects other aspects of equity, the implication of the lower RCR in papers with SSA-affiliated first and last authors and what policies and practices are needed to further promote equity in global health research.
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Affiliation(s)
- Ezinne A Akudinobi
- John E. Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Peter H Kilmarx
- John E. Fogarty International Center, National Institutes of Health, Bethesda, Maryland, USA
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Tuyishime H, Hornstein P, Lasebikan N, Rubagumya F, Mutebi M, Fadelu T. Authorship Distribution and Under-Representation of Sub-Saharan African Authors in Global Oncology Publications. JCO Glob Oncol 2022; 8:e2200020. [PMID: 35696623 PMCID: PMC9225604 DOI: 10.1200/go.22.00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Local researchers must be engaged in research conducted in their populations. However, local authors from low- and middle-income countries are often under-represented in global health journals. This report aims to assess and describe the representation of authors in the Journal of Clinical Oncology Global Oncology (JCO GO). Sub-Saharan African authors are under-represented in global onc publications →* more equity is needed. *The authors would like to use an arrow emoji in their tweet.![]()
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Affiliation(s)
| | - Paula Hornstein
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Nwamaka Lasebikan
- Department of Radiation Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Miriam Mutebi
- Breast Surgical Oncology, Aga Khan University, Nairobi, Kenya
| | - Temidayo Fadelu
- Center for Global Cancer Medicine, Dana Farber Cancer Institute, Boston, MA
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18
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Garbern SC, Hyuha G, González Marqués C, Baig N, Chan JL, Dutta S, Gulamhussein MA, López Terán GP, Manji HK, Mdundo WK, Moresky RT, Mussa RY, Noste EE, Nyirenda M, Osei-Ampofo M, Rajeev S, Sawe HR, Simbila AN, Thilakasiri MCK, Turgeon N, Wachira BW, Yang RS, Yussuf A, Zhang R, Zyer A, Rees CA. Authorship representation in global emergency medicine: a bibliometric analysis from 2016 to 2020. BMJ Glob Health 2022; 7:bmjgh-2022-009538. [PMID: 35760436 PMCID: PMC9237874 DOI: 10.1136/bmjgh-2022-009538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/10/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction High-income country (HIC) authors are disproportionately represented in authorship bylines compared with those affiliated with low and middle-income countries (LMICs) in global health research. An assessment of authorship representation in the global emergency medicine (GEM) literature is lacking but may inform equitable academic collaborations in this relatively new field. Methods We conducted a bibliometric analysis of original research articles reporting studies conducted in LMICs from the annual GEM Literature Review from 2016 to 2020. Data extracted included study topic, journal, study country(s) and region, country income classification, author order, country(s) of authors’ affiliations and funding sources. We compared the proportion of authors affiliated with each income bracket using Χ2 analysis. We conducted logistic regression to identify factors associated with first or last authorship affiliated with the study country. Results There were 14 113 authors in 1751 articles. Nearly half (45.5%) of the articles reported work conducted in lower middle-income countries (MICs), 23.6% in upper MICs, 22.5% in low-income countries (LICs). Authors affiliated with HICs were most represented (40.7%); 26.4% were affiliated with lower MICs, 17.4% with upper MICs, 10.3% with LICs and 5.1% with mixed affiliations. Among single-country studies, those without any local authors (8.7%) were most common among those conducted in LICs (14.4%). Only 31.0% of first authors and 21.3% of last authors were affiliated with LIC study countries. Studies in upper MICs (adjusted OR (aOR) 3.6, 95% CI 2.46 to 5.26) and those funded by the study country (aOR 2.94, 95% CI 2.05 to 4.20) had greater odds of having a local first author. Conclusions There were significant disparities in authorship representation. Authors affiliated with HICs more commonly occupied the most prominent authorship positions. Recognising and addressing power imbalances in international, collaborative emergency medicine (EM) research is warranted. Innovative methods are needed to increase funding opportunities and other support for EM researchers in LMICs, particularly in LICs.
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Affiliation(s)
- Stephanie Chow Garbern
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Gimbo Hyuha
- Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania.,Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Catalina González Marqués
- Division of Global Emergency Medicine and Humanitarian Studies, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Noor Baig
- Department of Emergency Medicine, The Aga Khan University Hospital, Karachi, Pakistan
| | - Jennifer L Chan
- Department of Emergency Medicine, Northwestern University, Chicago, Illinois, USA.,CrisisReady, Boston, Massachusetts, USA
| | - Sanjukta Dutta
- Department of Emergency Medicine, Fortis Hospital, Kolkata, India
| | - Masuma A Gulamhussein
- Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania.,Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Gloria Paulina López Terán
- Servicio de Emergencia, Hospital Santa Inés de Ambato, Ambato, Ecuador.,Servicio de Emergencia, Hospital General Ambato, Ambato, Ecuador
| | - Hussein Karim Manji
- Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania.,Accident and Emergency Department, Aga Khan Hospital, Dar es Salaam, United Republic of Tanzania
| | - Winnie K Mdundo
- Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania.,Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Rachel T Moresky
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA.,Department of Emergency Medicine, Columbia University Medical Center, New York, New York, USA
| | - Raya Yusuph Mussa
- Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Erin E Noste
- Department of Emergency Medicine, University of California San Diego, San Diego, California, USA
| | - Mulinda Nyirenda
- Adult Emergency and Trauma Centre, Queen Elizabeth Central Hospital, Ministry of Health - Malawi, Blantyre, Malawi.,Emergency Medicine Unit, Department of Internal Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Maxwell Osei-Ampofo
- Emergency Medical Services, Ghana National Ambulance Service, Accra, Ghana.,Department of Internal Medicine, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
| | - Sindhya Rajeev
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Hendry R Sawe
- Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Alphonce Nsabi Simbila
- Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania.,Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | | | - Nikkole Turgeon
- University of Vermont College of Medicine, Burlington, Vermont, USA
| | - Benjamin W Wachira
- Accident & Emergency Department, The Aga Khan University, Nairobi, Kenya
| | - Rebecca S Yang
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Amne Yussuf
- Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, United Republic of Tanzania.,Emergency Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Raina Zhang
- Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Alishia Zyer
- Bryant University, Smithfield, Rhode Island, USA
| | - Chris A Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Emergency Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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