Abstract
INTRODUCTION: Peer-reviewed literature is commonly used to assess academic progress and research excellency. However, representation in authorship of global health publications is biased and unfair. In order to shed light on current gaps towards attaining gender equality in scientific production and shift power asymmetries in global health research, we conducted an assessment of authorship trends from 1972 to 2021 with a focus on gender and geographic representation in scientific articles authored or co-authored by researchers affiliated with UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP). METHODS: We searched PubMed, Web of Science, and HRP public reports for publications where at least one author was affiliated with HRP. Our main outcome measures were author gender and location of author affiliation, classified by region and country income group. We used descriptive statistics to characterize the publications under analysis as well as the total number of authors from the included papers. We applied a logistic regression model to explore associations between author gender and other characteristics of published articles and a time series analysis to assess how time can influence the inclusion of women as authors in a publication. Python and R were used for all analyses. RESULTS: A total of 1,484 publications with 14,424 listed authors representing 5,950 unique authors were included in our analysis: 42.5% were female, 35.1% male, and 22.4% unknown (p<0.0001). First authorship was more likely female (56.9%) and from a high-income country (74.6%, p<0.0001) while last authorship was mostly male (53.7%) also from a high-income country (82.5%, p<0.0001). Females more frequently published papers using qualitative data (61.4%) and reviews/estimates (59.4%) while men published more case control (70.7%) and randomised controlled studies (53.0%), p<0.0001. The adjusted odds of there being a female author increased 4% for every additional year that passed. CONCLUSION: While there are more females authoring articles as compared to the past, they are still lagging behind with regards to seniority and prestige. Likewise, female representation is closely tied to what institution they are affiliated with and where that institution is located. Global health research institutions need to actively promote change by ensuring women are included in research and research outputs, giving them opportunities to lead.