Patterns of authorship on community health workers in low-and-middle-income countries: an analysis of publications (2012–2016)

Abstract

IntroductionStudies of authorship provide a barometer of local research capacity and ownership of research, considered key to defining appropriate research priorities, developing contextualised responses to health problems and ensuring that research informs policy and practice. This paper reports on an analysis of patterns of research authorship of the now substantial literature on community health workers (CHWs) in low-and-middle-income countries (LMICs) for the 5-year period: 2012–2016.MethodsA search of five databases identified a total of 649 indexed publications reporting on CHWs in LMICs and meeting the inclusion criteria. The country, region and income classification of studies, affiliations (country, organisation) of lead (first) and last authors, proportions of all authors locally affiliated, programme area (eg, maternal child health) and funding source were extracted.ResultsThe 649 papers reported experiences from 51 countries, 55% from middle-income countries (MICs) and 32% from low-income countries (LICs), with the remaining 13% multicountry studies. Overall, 47% and 54% of all the papers had a high-income country (HIC) lead and last author, respectively. Authorship followed three patterns: (1) a concentrated HIC pattern, with US-based authors numerically dominating LIC-based and multicountry studies; (2) an MIC pattern of autonomy, with a handful of countries—India, South Africa and Brazil, in particular—leading >70% of their CHW publications and (3) a pattern of unevenness among LICs in their lead authorship of publications varying from 14% (Malawi) to 54% (Uganda). Region, programme area and funding source were all associated with the distribution of authorship across country income categories.ConclusionThe findings in this analysis mirror closely that of other authorship studies in global health. Collectively these provide a common message—that investments in global health programmes in the Millennium Development Goal era may have benefited health but not necessarily capacity for knowledge generation in LMICs.

Research collaboration on community health worker programmes in low-income countries: an analysis of authorship teams and networks

“…An analysis of 206 indexed journal articles on CHW research undertaken in LICs over the five-year period of 2012 to 2016 was conducted. These publications included all LIC-based papers identified in a larger systematic review of CHW research in LMICs over the period [10]. The search terms and strategy, inclusion and exclusion criteria, and programmatic classifications adopted are detailed in two prior reviews [10,26].…”

“…These publications included all LIC-based papers identified in a larger systematic review of CHW research in LMICs over the period [10]. The search terms and strategy, inclusion and exclusion criteria, and programmatic classifications adopted are detailed in two prior reviews [10,26]. In sum, the review included all English language empirical studies and reviews on CHWs obtained through EBSCOHost, specifically including MEDLINE, SocINDEX, CINAHL, PsycARTICLES, and Academic Search Complete databases.…”

“…The growth in global health partnerships and funding has enabled research on a number of health priorities in LMICmaternal-child health [3], HIV/ AIDS, malaria [4] and health policy and systems research [5]. Despite this growth in research, authorship patterns (as a reflection of power relations in research collaborations) remain unequal, with high income country authors and institutions more often than not leading research publications, especially those reporting on low-income countries [6][7][8][9][10].…”

“…This paper examines research collaborations on community health worker (CHW) programmes, specifically analysing the structures of authorship teams and networks in publications on CHW programmes in low-income countries. Following the declaration of the Millennium Development Goals in 2000, there was a resurgence of interest in CHW programmes in LMICs, principally in response to high maternal, neonatal and under-5 mortality [10], and to the care and support needs generated by HIV [26]. These developments have been accompanied by a growth in research, with the number of publications on CHW programmes in LMICs increasing dramatically in the last decade and a half [26].…”

“…These developments have been accompanied by a growth in research, with the number of publications on CHW programmes in LMICs increasing dramatically in the last decade and a half [26]. However, a recent study by the authors found that patterns of authorship on CHWs are heavily skewed towards HIC institutions, scholars and sources of funding, particularly in studies on LICs, where 60% and 69% of publications on CHW programmes in 19 LICs had a HIC lead or last author, respectively [10]. This paper extends this initial analysis by exploring in more depth the nature of research partnerships on CHWs in the sub-set of papers reporting experiences in LICs.…”