Health-related publications on fragile states in the alert zone: a bibliometric analysis

Abstract

Background Vulnerable and fragile settings is global health challenge. Assessing health research activity can help identify neglected health domains in fragile settings. The objective of the current study was to assess and describe health research activity on fragile states in the alert zone. Method A bibliometric method was applied using SciVerse Scopus. Research articles published on fragile states in the alert zone were retrieved and analyzed. The Fragile State Index (FSI) score was used for selection of states in the alert zone. The analysis was limited to one year; 2018. Results The search query found 2299 research articles giving an average of 2 research articles per one million people per year in the selected fragile states. The number of research articles per one million population was not significantly correlated (p=0.053; r= - 0.349) with FSI scores. However, it was significantly correlated with the extent of international research collaboration (P<0.01, r=065). Research on communicable diseases was the largest research domain (763 articles; 33.2%) followed by maternal/women’s health (430 articles; 18.7%), non-communicable diseases (291 articles; 12.7%), health system/policy (271 articles; 11.8%) and psychosocial and mental health (89; 3.9%). The top ten cited articles were mainly on infectious diseases, particularly on malaria and Lassa fever. Of all the retrieved documents, 727 (31.6%) research articles appeared in national/regional journals while the remaining appeared in international journals. The World Health organization was the most active funding organization for research on fragile states. Top ten active institutions were mainly based in fragile states with the lowest FSI score, specifically Ethiopia, Uganda, Nigeria, and Pakistan. Conclusion Research on fragile states was relatively low. Research on mental health and health system/policy should be encouraged. Collaboration and funding might help academic institutions in fragile states to make health problems in these countries more visible