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.
There are number of Non-Governmental Organisations (NGOs) in South Africa that use sport as a tool to respond to Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), however, little is reported about the outcomes and impact of these programmes. The aim of this study is to contribute to a generic monitoring and evaluation framework by improving the options for the use of outcome indicators of sport-based HIV/AIDS awareness programmes of selected NGOs in South Africa. A qualitative method study was carried out with seven employees of five selected NGOs that integrate sport to deliver HIV/AIDS programmes in South Africa. The study further involved six specialists/experts involved in the field of HIV/AIDS and an official from Sport Recreation South Africa (SRSA). Multiple data collection instruments including desktop review, narrative systematic review, document analysis, one-on-one interviews and focus group interview were used to collect information on outcomes and indicators for sport-based HIV/AIDS awareness programmes. The information was classified according to the determinants of HIV/AIDS. The overall findings revealed that the sport-based HIV/AIDS awareness programmes of five selected NGOs examined in this study focus on similar HIV prevention messages within the key priorities highlighted in the current National Strategic Plan for HIV/AIDS, STIs and TB of South Africa. However, monitoring and evaluating outcomes of sport-based HIV/AIDS programmes of the selected NGOs remains a challenge. A need exists for the improvement of the outcome statements and indicators for their sport-based HIV/AIDS awareness programmes. This study proposed a total of 51 generic outcome indicators focusing on measuring change in the knowledge of HIV/AIDS and change in attitude and intention towards HIV risk behaviours. In addition, this study further proposed a total of eight generic outcome indicators to measure predictors of HIV risk behaviour. The selected NGOs can adapt the proposed generic outcomes and indicators based on the settings of their programmes. A collaborative approach by all stakeholders is required, from international organisations, funders, governments, NGOs and communities to strengthening monitoring and evaluation of sport-based HIV/AIDS awareness programmes including other development programmes. This will assist the NGOs that use sport for development to be able to reflect accurately the information about their HIV/AIDS activities and also be able to contribute to on-going monitoring activities at a national and global level as well as to the Sustainable Development Goals.
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 subset 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 multipleaffiliated 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.
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