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 2 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.
| Original language | English (US) |
|---|---|
| Article number | e009538 |
| Journal | BMJ Global Health |
| Volume | 7 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2022 |
Funding
The fact that the global health field remains heavily dominated by HIC funders and much of global health funding is granted to researchers from HICs has recently been called to greater attention. This power imbalance is illustrated by HIC institutions and researchers often setting the agenda and making funding allocation decisions without consideration for LMIC partner priorities. This often perpetuates LMIC researcher dependence on HIC counterparts for research opportunities and funding. As GEM projects are often funded by HIC institutions, efforts to decolonise the GEM field and restore power to local researchers with respect to funding decisions and priority-setting are needed to increase equity. Increasing the funding opportunities specifically for LMICs researchers may play a large role in recognising the expertise of LMIC researchers and allowing professional growth beyond the role of data collector and collaborator into one of setting the agenda, designing the research and disseminating results. We also found that over-representation of HIC authors was more pronounced in multicounty studies, with less than half of the studies including at least one author from each study country. Potential explanations for this finding are the amount of funding needed for larger multicountry studies may be more likely to come from large HIC funding sources, the more complex and potentially hierarchical power dynamics involved in large international collaborations or that the resources needed for larger studies such as research administration and support tend to be in HICs.
Keywords
- health policies and all other topics
- other study design
ASJC Scopus subject areas
- Health Policy
- Public Health, Environmental and Occupational Health
