Authorship for research from Africa, 2014-2015: a bibliometric analysis
Nicholas H. Neufeld , Herve Momo Jeufack , Bethany Hedt-Gauthier , Jimmy Volmink , Miriam Shuchman 
 University of Toronto,  Accenture,  Harvard Medical School,  Stellenbosch University
Introduction Power imbalances complicate partnerships between low-and middle-income country (LMIC) researchers and their collaborators from high-income countries. To quantify this issue, we conducted a bibliometric analysis of recent health research in LMICs relating country affiliations of the authors to their authorship position in the publication. Specifically, we compared authorship position of authors from LMICs in sub-Saharan Africa to that of authors from high-income countries in the United States, Canada and the European Union.
Methods We searched PubMed for articles on LMIC-related health research using search terms containing “health” and MeSH specification of “sub-Saharan Africa.” We restricted analysis to papers published from January 1, 2014 to December 31, 2015. We searched abstracts to identify country of paper’s focus and only included papers focused on a single country and with author affiliations specified.
Results We identified 2094 papers published in the specified time period with the majority of papers coming from South Africa (290), Ethiopia (260), Uganda (243), and Kenya (233). Of the 2094 articles identified:
•11.5% of papers had no author from the country of paper’s focus;
•37.8% of papers had fewer than 50% of authors from the country of paper’s focus;
•50.3% of all authors are from the same country as the paper's focus; however, these individuals are significantly less likely to occupy the first or senior positions (p<0.05; 47.0% of first authors and 41.9% of last authors are from the country of the paper's focus);
•43.1% of all authors are from North American or European Union (NA/EU); and these individuals are significantly more likely to occupy the first or senior positions (p<0.05; 46.0% of first authors and 52.1% of last authors are from NA/EU).
Conclusions Authors from high-income countries dominate the highest ranking authorship positions in LMIC-based collaborative health research about sub-Saharan Africa. In our database, the majority of authors in the prestigious senior or last author position are from high-income countries and credit for first author position is evenly distributed between authors from the LMIC country of paper’s focus and NA/EU authors, despite the majority of authors coming from the LMIC of paper’s focus. This lopsided literature may reflect traditions at the level of funders, institutions, or journals, such as traditional methods of project sponsorship that result in NA/EU scholars dominating; ‘annexed sites’ of research in LMICs tied to senior authors at NA/EU institutions; and the willingness of most journals, though not all, to publish data from LMICs absent authors from those countries. Our findings should encourage innovative approaches to collaborative health research including reforms aimed at ensuring that credit beyond low-ranking middle authorship is given where due.