reflections on inequalities in research capacity

Fakulteit Geneeskunde en Gesondheidswetenskappe

Faculty of Medicine and Health Sciences

Reflections on inequalities in research

capacity

Jimmy Volmink

Dean, Faculty of Medicine and Health Sciences, Stellenbosch

University

Director, SA Cochrane Centre, Medical Research Council

1

Understanding the nature of inequality in society

2

The explanation for inequalities in achievement can most often be

found in differences in opportunity rather than ability.

Such differences in opportunity are usually determined by

imbalances in wealth or power or influence, or some

combination of these three.

Champagne glass distribution of global wealth

3

World Economic Forum, 2014

4

Working for the Few, Oxfam International, 2014

Income inequality by country

5

Income inequality in South Africa

Economist 2013

So what?

7

Extreme inequality is bad for us all

1. Undermines democracy

2. Threatens social cohesion and

stability

3. Damages health and well-being

4. Environmentally destructive

5. Economically inefficient

6. Unethical

8

Inequality and health in richer (OECD) countries

President Barack Obama: “the defining challenge of our era.”

Pope Francis: "the root of social ills.”

Fakulteit Geneeskunde en Gesondheidswetenskappe

Faculty of Medicine and Health Sciences

Inequality in research capacity and output

10

Number of researchers per million population

Global Research Report – Africa (April 2010)

Publications in 2008

More than 7000

Fewer than 20

Inequality in research output

“South Africa : …it is

simultaneously a giant

within the African

context and a dwarf in

the international arena.”

Wieland Gevers

Africa’s output of publications indexed on

Thomson Reuters Web of ScienceSM

databases between 1999 and 2008

The continent’s output was

about 27,000 articles per

year of which SA produced

the lion’s share

13

South Africa vs. Brazil

Number of

students

Number of

publications

PhD output

numbers

%

academic

s with

PhD’s

University of Sao

Paulo (Brazil)

90 000 9000 2400 98%

South Africa

(all institutions)

899 000 8200 1420 34%

Comparison of the output of South Africa as a country versus the University of Sao Paulo in 2010

NC Gey van Pittius (2014)

Health research output by population group in SA

14

ASSAf CONSENSUS REPORT ON REVITALISING CLINICAL RESEARCH IN SOUTH AFRICA

NOVEMBER

2009

Health research output by gender in SA

15

ASSAf CONSENSUS REPORT ON REVITALISING CLINICAL RESEARCH IN SOUTH AFRICA

NOVEMBER

2009

Health research output by age group in SA

16

ASSAf CONSENSUS REPORT ON REVITALISING CLINICAL RESEARCH IN SOUTH AFRICA

NOVEMBER

2009

Fakulteit Geneeskunde en Gesondheidswetenskappe

Faculty of Medicine and Health Sciences

What are the reasons for these inequalities in

research output?

17

Academic staff from Professor to Junior Lecturer at

SA universities, 2003-2009, by population group

18 DoE HEMIS, 2011

Generic black South Africans make up less than

half of the academic staff complement (range

17-91%)

19

CREST, 2006

Permanent academic staff in health sciences in SA,

2000-2003, by population group

Academic staff from Professor to Junior Lecturer,

2003-2009, by gender

DoE HEMIS, 2011

Women comprise only 44% of the academic workforce (range 29-

51%)

Permanent academic staff in health sciences in SA,

2000-2003, by gender

21

CREST, 2006

Permanent academic staff from Professor to Junior Lecturer

by rank, age and gender, 2009

DoE HEMIS, 2011

Women are seriously underrepresented at senior level: Prof (21%) and Assoc Prof

(33%).

Doctoral graduates, 1994-2009, by gender and population

group

23 DoE HEMIS, 2011

Challenges in summary

1. SA’s research output is low compared to other BRICS

countries

2. The academic workforce is currently not

representative of the SA population: white and male

3. Research output is driven mainly by academics who

are close to retirement age

4. There are insufficient numbers of people, especially

those in the under-represented groups (URG), moving

through the academic and postgraduate pipelines to

replace them

24

Fakulteit Geneeskunde en Gesondheidswetenskappe

Faculty of Medicine and Health Sciences

What can we do to address the current

inequalities in research capacity?

Begin by understanding the underlying factors

25

1) Historical context

26

Number of doctors graduating per year,

1966-86

Between 1968-77 production of

doctors (per 100,000) inversely related

to size of population group

Digby, 2013

2) Current economic realities

27

• Poverty

• Inequality

• Unemployment

NDP: key challenges

Consequences of economic disadvantage:

• Negative effects on early childhood development

• Poor health and social circumstances

• Lower quality schooling (maths and science)

• Lower participation rate in higher education

• Higher drop out rate

• Reduced likelihood of obtaining postgraduate

qualifications

3) Institutional factors

• Institutional or professional cultures may be alienating

and exclusionary (patriarchal, sexist, racist, intolerant of

diversity)

• Work arrangements may not be attractive to women

and/or younger people (Generation Y)

• Lack of role models and mentors for URG

• URG may be expected to spend more time on

teaching, administration and committee work

• Lack of funding to recruit, develop and retain URG

• Non-competitive salaries

• Mobility

28

Strengthening the academic pipeline

Attract

• Contribute to improving high school

education

• Raise awareness of careers in science

• Early exposure to doing research

• Mentoring

Individuals from

underrepresented

groups

Independent

researcher/

Leader-

Mentor

Develop

• Skills

• Protected time

• Funding (career development awards)

• Mentoring

Retain

• Economic and social

issues

• Family responsibilities

• Career progression

• Mentoring

Mentorship is everything

30

“everyone who makes it has a mentor”

Harvard Business Review, 1978

31

Mentors are people who can see more in you than you see in

yourself. They create a vision and development plan that take

advantage of your own strengths, abilities, and potential for

growth.

Effective mentors are so unshakably convinced that we have

greatness in us, and their vision of what is possible is so clear and

powerful, that they wind up convincing us too.

• Prevalence of mentoring varies widely across various

fields

• Important influence on career choice, career

progression, faculty retention and productivity, including

publication and grant success

• Individuals from underrepresented groups have more

difficulty finding mentors

• Many different mentoring models ranging from informal

relationships based on shared interests and personal

chemistry to formal, systematic arrangements

• Usually comprises a combination of emotional and

psychological support, guidance on career and

professional development

• Many unanswered questions

32

What do we know about mentoring in the health

sciences?

33

• Increase research output and sustainability

• Promote excellence and innovation (diversity of people,

perspectives and ideas)

• Improve chances of closing current gaps in health and health care

• Promote social justice (allow people to develop to their full potential)

• Contribute to a more inclusive and egalitarian society

• Improve likelihood of SA becoming a winning nation

In closing

Addressing the current inequalities in research capacity

will benefit us all: