Authorship Inequity in Global Health Research Conducted in Low- and Middle-Income Countries and Published in High-Income Country Family Medicine Journals
Alyssa Vecchio, Bridget Nandawula, Kelsey Sawyer, James Akiruga Amisi, Daria Szkwarko, Kathy Z. Chang
Abstract
PURPOSE: The current structures of global health research and academic authorship have resulted in underrepresentation of authors from low- and middle-income countries. Although authorship inequity has been shown in other specialties, the current status of authorship in family medicine has not been examined. METHODS: We conducted a bibliometric analysis of World Organization of Family Doctors (WONCA) journals based in high-income countries for articles describing research conducted in low-income countries, lower-middle-income countries, and upper-middle-income countries from 2018 to 2023. Descriptive statistics were computed to summarize the proportion of first and senior authors by the articles' study location and publication characteristics. RESULTS: We retrieved 1,030 articles through our comprehensive search. A total of 431 articles from 16 family medicine journals remained after abstract and full-text review. Over time, there was an increase in publication of research articles from low- and middle-income countries in the family medicine journals, with the majority of the studies conducted in upper-middle-income countries (55.9%). The proportion of senior authors from high-income countries was highest in articles with research conducted in low-income countries (50%) compared with those reporting research done in lower-middle-income countries (37%) and upper-middle-income countries (21%). CONCLUSIONS: About one-quarter of articles with research conducted in low- and middle-income countries and published in family medicine journals have first and/or senior authors from high-income countries; this representation is even higher when analysis is restricted to research done in low-income countries. To support authorship equity, family medicine researchers should reconsider the definition of authorship criteria, promote culturally humble mentorship, and encourage institutions to adapt promotion criteria to empower equitable global health partnerships.