Conducting and disseminating research in LMIC

Neurosurgeon’s experiences of conducting and disseminating clinical research in low- and middle-income countries.

Research from developing countries is underrepresented in the empirical literature1-3. A retrospective bibliographic analysis of publications from 2015-2017 found only 4.52% of 6708 published reports had an LMIC affiliation2. In a further bibliographic analysis Africa and Southeast Asia were found to be responsible for less than 3% of publication productivity4. If journal publication is a reliable indicator of the quality and quantity of research, then LMIC are severely underrepresented in an international context2. Several factors have been discussed in the literature including lack of time and resources2, poor research production; poor preparation of manuscripts; poor access to scientific literature; poor participation in publication-related decision-making processes and bias of journals which all exacerbate low engagement5. However, these assumptions have not been explored in depth or subjected to a rigorous analysis.

To examine this problem we will conduct a qualitative study using focus groups and follow-up interviews. Focus groups will be held online and are asynchronous in nature allowing participants from across the globe to participate at a convenient time. Questions for the focus group include:

  • What are your personal experiences of conducting clinical research and what personal and/or organisational factors motivate you to conduct research?
  • What specific barriers are there to you conducting clinical research within your hospital?
  • In what ways is research shared between colleagues, the public, and the wider academic community?
  • What would help you to conduct and publish good clinical research?
  • What unique factors are there that should be considered to nurture research capacity in low and middle income countries?

Following preliminary analysis of the focus group data we will design an appropriate semi-structured interview schedule reflecting the themes drawn out of the focus group analysis.

A thematic analysis of all qualitative data is proposed using Braun and Clarke’s6 six stage analytical framework. Final themes will represent the challenges, barriers and facilitators of clinical research in LMIC and will inform recommendations to improve engagement in, and publication of, research by neurosurgeons in LMIC.

  1. Langer A, Diaz-Olavarrieta C, Berdichevsky K, et al. Why is research from developing countries underrepresented in international health literature, and what can be done about it? Bull World Health Organ2004;82(10):802-3. [published Online First: 2005/01/13]
  1. Servadei F, Tropeano MP, Spaggiari R, et al. Footprint of Reports From Low- and Low- to Middle-Income Countries in the Neurosurgical Data: A Study From 2015 to 2017. World Neurosurg2019;130:e822-e30. doi: 10.1016/j.wneu.2019.06.230 [published Online First: 2019/07/12]
  1. Kolias AG, Rubiano AM, Figaji A, et al. Traumatic brain injury: global collaboration for a global challenge. Lancet Neurol2019;18(2):136-37. doi: 10.1016/S1474-4422(18)30494-0 [published Online First: 2019/01/22]
  1. Tropeano M, Spaggiari R, Ileyassoff H, et al. A comparison of publication to TBI burden ratio of low- and middle-income countries versus high-income countries: how can we improve worldwide care of TBI? Neurosurgical Focus2019;47(5):E5 p.1-6.
  1. Langer A, Diaz-Olavarrieta C, Berdichevsky K, et al. Why is research from developing countries underrepresented in international health literature, and what can be done about it? Bull World Health Organ2004;82(10):802-3. [published Online First: 2005/01/13]
  1. Braun V, Clarke V. What can “thematic analysis” offer health and wellbeing researchers? Int J Qual Stud Health Well-being2014;9:26152. doi: 10.3402/qhw.v9.26152 [published Online First: 2014/10/19]