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

ABSTRACT

Background: Global health research partnerships, which promote the exchange of ideas, knowledge and expertise across countries, are considered key to addressing complex challenges facing health systems. Yet, many studies report inequalities in these partnerships, particularly in those between high and low-and-middle-income countries (LMICs).

Objective: This paper examines global research collaborations on community health worker (CHW) programmes, specifically analysing the structures of authorship teams and networks in publications reporting research on CHW programmes in low-income countries (LICs).

Methods: A sub-set of 206 indexed journal articles reporting on CHW programmes in LICs was purposefully selected from a prior review of research authorship on CHW programmes in all LMICs over a five year period (2012–2016). Data on country and primary organisational affiliation and number of publications for all individual authors, programme area (e.g. maternal child health) and total citations per paper were extracted and coded in excel spreadsheets. Data were then exported and analysed in Stata/ICV.14 and Gephi.

Results: The 206 papers were authored by 1045 authors from 299 institutions, based in 43 countries. Half (50.1%) the authors came from LIC-based institutions, 43.8% from high-income country (HIC) institutions, 2.9% from middle-income country (MIC) institutions and 3.2% had different first affiliations in different publications. Authors based in the USA (302) and UK (68) accounted for just over a third (35.4%) of all authors. Partnership patterns revealed a primary mode of North–South collaboration with authors from the US, and to a lesser extent the UK, playing central bridging roles between institutions. Strong network clusters of multiple-affiliated authors were evident in research on MCH and HIV/TB aspects of CHW programmes.

Conclusion: Knowledge production on CHW programmes in LICs flows predominantly through a pool of connected HIC authors and North–South collaborations. There is a need for strategies harnessing more diverse, including South–South, forms of partnership.

KEYWORDS:

• Research capacity
• capacity strengthening
• global health partnership
• low-middle-income-countries
• publications

Responsible Editor Peter Byass, Umeå University, Sweden

Responsible Editor Peter Byass, Umeå University, Sweden

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics and consent

Not applicable.

Paper context

Inequalities in global research collaboration focusing on health priorities in LMICs still exist. Studies have provided recommendations but HIC authors remain at a core of such collaborations. This study adds to the literature by highlighting the patterns of research collaborations on CHW programmes in LICs and the unevenness of networks by country and programmatic themes. The findings point to the need for a global research collaborations that take into consideration the more equal participation of LMICs.

Additional information

Funding

This work is based on research supported by the South African Research Chairs Initiative of the Department of Science and Technology and National Research Foundation of South Africa (grant no. 98918); the National Research Foundation of South Africa (NRF)/Swedish Foundation for International Cooperation in Research and Higher Education (STINT) (Grant UID:106770); and the South African Medical Research Council. Any opinion, finding and conclusion or recommendation expressed in this material is that of the author(s) and not the funders.

Notes on contributors

Elma Nelisiwe Maleka

HS and NM jointly conceptualized the study. PK and NM independently coded the data and the three authors jointly conducted the analysis and drafted the manuscript. All authors approved the final version of the manuscript.