Original research••

Strengthening research capacity: a systematic review of manuscript writing and publishing interventions for researchers in low-income and middle-income countries

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Abstract

Introduction Health researchers from low-income and middle-income countries (LMICs) are under-represented in the academic literature. Scientific writing and publishing interventions may help researchers publish their findings; however, we lack evidence about the prevalence and effectiveness of such interventions. This review describes interventions for researchers in LMICs aimed at strengthening capacity for writing and publishing academic journal articles.

Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to report literature searches in PubMed, Embase, Global Health, Scopus and ERIC. Our keywords included LMICs, low-income and middle-income countries, health research and writing/publication support interventions, with no restrictions on publication date. Our screening process consisted of title screening, abstract review and full-text review. We collected information about the content, implementation and evaluation of each intervention, if included.

Results We identified 20 interventions designed to strengthen capacity for scientific writing and publishing. We summarised information from the 14 interventions that reported submitted or published papers as outcomes separately, reasoning that because they provide quantifiable metrics of success, they may offer particular insights into intervention components leading to publication. The writing and publishing components in this ‘Publications Reported’ group were an average length of 5.4 days compared with 2.5 days in the other group we refer to as ‘Other Interventions.’ Whereas all 14 Publications Reported interventions incorporated mentors, only two of five in the Other Interventions group incorporated mentors. Across interventions, leaders expressed the importance of a high ratio of mentors to participants, the need to accommodate time demands of busy researchers, and the necessity of a budget for open access fees and high-quality internet connectivity.

Conclusion Writing and publishing interventions in LMICs are an underutilised opportunity for capacity strengthening. To facilitate the implementation of high-quality interventions, future writing and publishing interventions should share their experiences by publishing detailed information about the approach and effectiveness of the interventions.

Summary box

What is already known?

Health researchers from low-income and middle-income countries (LMICs) are under-represented in the scientific peer-reviewed literature.
Limited evidence exists about the effectiveness of writing and publishing interventions in LMICs; for example, it is unclear what approaches best support the publication of research findings in academic journals.

What are the new findings?

Of the 20 writing and publishing interventions in our sample, we summarised information from the 14 interventions that reported submitted or published papers as outcomes separately, reasoning that because they provide quantifiable metrics of success, they may offer particular insights into intervention components leading to publication. Interventions in this ‘Publications Reported’ group were mostly part of larger research capacity interventions and the writing and publishing component was an average length of 5.4 days compared with an average of 2.5 days in the other group we refer to as ‘Other Interventions.’
All 14 Publications Reported interventions incorporated mentors to support writing and publishing and the majority offered this support after the main intervention ended; two of five ‘Other Interventions’ incorporated mentors.
Across interventions, leadership expressed the importance of a high ratio of mentors to participants, the need to accommodate time demands of busy researchers and the necessity of a budget to support open access fees and high-quality internet connectivity.

Summary box

What do the new findings imply?

Moving forward, those who implement writing and publishing interventions should write a detailed account of how they carried out the intervention in a scientific manuscript. Helpful details might include whether a needs assessment was conducted, prior research training that participants received, the length of the writing and publishing intervention, topics covered, whether one-on-one writing mentorship was provided, attendance, and outcome measures.
Gaps in this literature that require additional study include whether one comprehensive training can make a lasting impact and how to best support individuals’ overall scientific productivity (eg, publications, grants, professional promotions). The impact of a ‘train-the-trainers’ writing and publishing intervention should also be investigated.

Introduction

Researchers from low-income and middle-income countries (LMICs) are under-represented in the academic literature compared with their counterparts in high-income countries (HICs). This trend has been demonstrated across fields, including maternal health,1 community health,2 surgery,3 infectious disease4 and psychiatry.5 Though progress has been made, disparities in output between researchers from LMICs and HICs persist. A bibliometric analysis of research publications led by African authors found that the absolute number of publications more than tripled from 2000 to 2014, yet publications led by African authors made up just 1.3% of research publications worldwide in 2014.6 Moreover, in studies where authors from LMICs and HICs collaborate, authors from LMICs are less likely to be represented in the first and last author positions, which reflect leadership and decision-making power.2 4 7 8

Schneider and Maleka aptly assert that trends in research publications and the distribution of authorship are a ‘barometer of research capacity and local ownership.’2 Ultimately, these disparities in publication and authorship are a symptom of structural power imbalances in which the global health research agenda is determined and funded by HICs. Health research investments in LMICs continue to make up a woefully small percentage of global health research investments.9–11

Research by outside investigators is thus over-represented, and may lack meaningful context and interpretation.12 In contrast, findings published by resident researchers in LMICs will often define research priorities appropriate to that region, develop contextualised responses to local health problems, and connect research to policy and practice.12–14 Increasing research output from LMICs is a sound strategy for improving global health.12

Publishing in academic journals is critical to health researchers’ success, including career advancement and the attainment of grant funding. Unfortunately, many structural barriers prevent researchers in LMICs from publishing their work. Research writing instruction and support are not available in many low-resource settings, leading to poor manuscript preparation. In addition, academic journals lack the staff and budgets to offer extensive writing support to authors who submit promising, but poorly prepared, manuscripts. Tacit conventions in scientific publishing, like the importance of writing a cover letter to accompany a journal submission and the need to consult a journal’s author guidelines throughout the writing and formatting process, present further challenges to researchers who may not have scientific mentors to help them navigate the publication process.

But what types of research writing and publishing interventions warrant investment? To efficiently steward resources, it is critical to identify the characteristics of scientific writing and publishing interventions for researchers in LMICs that result in the most meaningful gains in technical writing skills and publications. To our knowledge, no such investigation of the literature exists. This study seeks to fill that gap by: (1) summarising the approach, structure and outcomes of scientific manuscript writing and/or manuscript publishing interventions in LMICs and (2) identifying gaps in this literature to support further capacity strengthening in academic writing and publishing.

Methods

Search strategy

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations,15 an experienced health sciences librarian (CS) performed literature searches in the following databases: PubMed (National Library of Medicine), Embase (Embase.com), Global Health (EBSCOhost) and ERIC (ProQuest). We used cited reference searching to evaluate eight sentinel articles in Scopus (Elsevier). All searches were completed by 30 January 2020. The main search strategy, created in PubMed and translated to other databases, was constructed by combining selected keywords and controlled vocabulary for LMICs (defined by the World Bank classification from 202016) health research, and writing and/or publication interventions. No search restrictions were placed on publication date or language. This review was not registered, but the search strategy is included in online supplemental appendix. Citations were imported into Mendeley reference manager (Mendeley), then uploaded into Covidence software (Melbourne, Australia) for the study selection process.

Screening process

We reviewed articles in three stages: title screening, abstract review and full-text review. Two independent reviewers (CEB and MK) evaluated articles at each stage. Disagreements were resolved by a third independent reviewer (ETA).

Title screening and abstract review

In the title screening stage, articles were excluded if they were obviously irrelevant. In the abstract review stage, articles were excluded if they met any of the following criteria: (1) the writing or publication intervention described in the article was not implemented in an LMIC; (2) the paper did not examine an actual intervention (eg, reviews, editorials, frameworks); (3) the intervention described in the article focused on healthcare delivery or a clinical intervention. Articles focusing on healthcare delivery or clinical interventions were specifically excluded during the abstract review stage because reviewers were confident that such articles did not include interventions pertaining to writing or publishing. Articles on other topics sometimes included information about writing or publishing in the body of the paper but not in the abstract, so they were evaluated during full-text review to minimise the risk of improper exclusion. If the reviewer was unsure of whether the intervention included information about scientific writing or publishing, they voted to include it in the full-text screening stage.

Full-text review

In the full-text review stage, an article was excluded if it met any of the following criteria: (1) it met any of the exclusion criteria from the abstract review stage; (2) the article described an intervention that did not provide instruction specific to scientific writing or publishing; (3) the article described a research capacity strengthening intervention but it did not describe a writing intervention component (citing publications as a desired or measured outcome alone was not considered a writing intervention); (4) the article described an individual mentoring programme (rather than a group programme) or (5) the article described a writing and/or publication intervention embedded within a degree granting programme. Writing retreats were included if they offered a structured writing or publishing intervention that met all inclusion criteria. Individual mentoring programmes that connect researchers with mentors without a structured intervention protocol were excluded; however, interventions that met our inclusion criteria that included a one-on-one mentorship component were included. Interventions embedded within degree granting programmes were excluded because they are not broadly accessible to researchers.

During full-text screening, we determined that articles describing 41 interventions provided insufficient detail to enable further analysis. For example, several articles simply stated that manuscript workshops were held, without describing the content of the intervention or its evaluation.

During data abstraction and analysis, the intervention was considered the unit of analysis. In some cases, more than one paper was published about a particular intervention. When this occurred, we included all of the relevant papers identified through our search in our analytical sample and information from each article was synthesised to describe that single intervention. The six papers describing Structured Operational Research Training Initiative (SORT-IT) interventions were a notable exception to this rule. Though the overall intervention was similar among the six papers, we considered each paper to be a separate intervention because each described an intervention implemented in a distinct setting and context.

This systematic review process identified 64 articles for inclusion. The final analytical sample contained 23 articles describing 20 interventions (figure 1). If a paper in our main sample cited an additional reference that described details about the intervention, pertinent details from that article were included in our analysis, but the article was not formally added to our analytical sample. Such additional references are cited in our tables and labelled ‘supporting papers.’

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Figure 1

Process for identifying articles for inclusion in systematic review of writing and publishing interventions.

Data abstraction

We abstracted details about each writing and publishing intervention, including the location of activities, whether a needs assessment was conducted, whether the writing and publishing programme was part of a larger initiative, the intervention’s content area(s), participant characteristics, the format, frequency and duration of the intervention. We summarised the instructor characteristics and country affiliation, the writing and publishing skills and topics covered, whether participants had data for their manuscript at the training event, and the type of one-on-one support provided for writing, submission and response to reviewers. Additionally, we highlighted programme attendance, evaluation methods, outcome measures, and results. We also identified whether a comparison group was included in the evaluation of the intervention. Finally, we summarised challenges and lessons learnt from each intervention as explained by the authors of the manuscript(s) describing the intervention. The specific elements identified above were determined after surveying articles and identifying emergent themes.

Presentation of results

In pursuit of our first aim, to identify approaches for strengthening capacity for writing and publishing research in academic journals, we organised our results to highlight the approaches of interventions that reported the number of submissions and/or publications. We refer to these interventions as the “Publications Reported” group. We reasoned that because they provide quantifiable metrics of success, they may offer particular insights into intervention components leading to publication.

We present information on the following variables by group (Publications Reported vs Other Interventions): needs assessments, intervention structure and delivery, the topics covered in the intervention, the support provided in follow-up period (eg, one-on-one mentorship for completing a manuscript). Also compared between the two groups are the evaluation method and outcome measures, including whether comparison groups were used, whether participant feedback on programme quality was gathered, attendance data and the cost of the writing and publishing intervention. We reasoned that this information may be different by those interventions that did and did not report publications and thus, identified the information separately by group. We aggregated intervention information from the total sample when reporting instructor characteristics, challenges and lessons learnt.

Results

Through our three-stage systematic review process, we identified 20 scientific writing and publishing interventions that provided sufficient detail for analysis. These interventions were designed to strengthen capacity for scientific writing and publishing among researchers in LMICs. Eighteen were part of broader capacity strengthening interventions that provided training for research skills beyond writing and publishing.17–34

The majority of interventions in our main sample were focused on specific content areas (table 1): five advanced operational research, three supported psychiatry and mental health, three addressed tuberculosis and two promoted research in HIV. The other seven focused on other topics or were not limited to a specific content area.

Table 1

Summaries of the location, participant characteristics, broader programme (if present), format, frequency, duration and programme content area of the 20 writing and publishing interventions in the analytical sample

Participants

Participants in the interventions in our sample came from 65 countries and included clinicians, research and professional staff and academic faculty and students (table 1). Eight interventions (8/20) did not report the gender of attendees. Twelve interventions (12/20) mentioned having women participants, and in five (5/12), women made up the majority of participants.

Comparison of Publications Reported interventions to Other Interventions

The next several subsections highlight intervention approaches of the 14 interventions that reported the number of manuscript submissions or publications (‘Publications Reported’ interventions).

Needs assessments

Three interventions28 29 ,31 (3/13) in the Publications Reported group reported conducting a needs assessment prior to the intervention (we did not include the ongoing journal club17 in the denominator). Five22–26 of the six interventions in the Other Interventions group reported conducting a needs assessment; four22–24 ,26 completed them prior to the intervention, and one intervention25 was a pilot programme intended, in part, to serve as a needs assessment.

Structure and delivery

Two writing/publishing interventions were standalone and the rest were part of larger research capacity programmes (table 1). The average length of the writing/publishing components in the Publications Reported group was 5.4 days (one Publications Reported intervention did not report length, and one other is the ongoing journal club, not included in the average). In contrast, the average length of the writing component in the Other Interventions group was 2.5 days (two did not specify length).

There were a wide range of programme formats, including structured workshops, training modules, courses, retreats and an online journal club (table 1). Twelve (12/14) interventions in the Publications Reported group and 5 (5/6) in the Other Interventions group specifically mentioned a small group interactive writing component, peer editing or peer review activities. However, four (4/14) in the Publications Reported group and just two (2/6) in the Other Interventions group provided protected time for writing or individual writing practice during the main programme.

Support for developing and submitting manuscripts and responding to reviewers was provided in some cases (one-on-one or one facilitator or mentor working with a small team) during the intervention or for some period afterward (table 2). All of the 14 interventions in the Publications Reported group incorporated mentors to support less experienced researchers. In the Other Interventions group two reported providing mentors (2/5; the train-the-trainers intervention was not included in the denominator).

Table 2

Description of instructor characteristics, topics, skills and/or learning activities covered, whether participants had data at training event, and type of mentoring support for the 20 interventions in the analytical sample

Scientific writing and publishing topics covered and data for manuscripts

In general, interventions in the Publications Reported group delivered or presented a greater breadth of content and topics in the intervention trainings. Aside from writing the basic sections of a paper, the most common topics mentioned in the didactic component of the Publications Reported interventions were responding to reviewers and revision (7/14), referencing skills and/or software (4/14), and authorship (3/14) (table 2). In the Other Interventions group, the most frequently mentioned topics were referencing skills and/or software (4/6) and English language skills (2/6).

Participants had data for their manuscript at the training event in all 14 of the Publications Reported interventions, and participants had data for their manuscript in two of the six Other Interventions training events.

Support provided in follow-up period

We define the ‘follow-up period’ as time beyond the main intervention to provide additional support or mentorship to participants. Among the Publications Reported group, intervention follow-up support lasted between 6.5 months and 3 years. Only one intervention in the Other Interventions group provided post-programme support and this was 12 months long.23

Among the follow-up support described were email feedback on manuscripts, remote editing and assistance responding to reviewers. Eleven interventions in the Publications Reported group reported providing mentoring during the follow-up period (11/13) and one (1/6) intervention in the Other Interventions group provided follow-up mentorship (table 2). eJCIndia17 was an ongoing journal club and is not included in the Publications Reported denominator above, and the train-the-trainers intervention24 was not included in the denominator for the Other Interventions group.

Evaluation method and outcome measures

None of the studies in our sample reported using a closely matched comparison group such as a within-person pre/post comparison or other similar comparison group to track participant success in publishing articles, though many provided some evaluation (table 3). One university-wide multi-component intervention in South Africa27 35 in the Publications Reported group reported a large increase in publications over the 9 years after their intervention, though it was unclear which didactic components were most effective and whether any increase in publications may have been due to an increase in faculty or other university-level policies or programmes during that time period. One intervention25 in our Other Interventions group included two pre/post survey questions related to the importance of manuscript writing and the importance of having a mentor, but did not include any questions tracking participant success with publishing articles.

Table 3

Information about attendance, evaluation method and outcome measures, and results for the 20 writing and publishing interventions in the analytical sample

Papers describing five interventions (5/14) in the Publications Reported group and four (4/6) in the Other Interventions group mentioned gathering participant feedback on the quality of the programme.

Ten of the 13 interventions in our Publications Reported group provided attendance and/or completion data for their programme, while 4 of the 6 Other Interventions reported attendance and/or completion data.

Two of the 14 Publications Reported interventions (and none of the Other Interventions group) reported the cost of the writing and publishing intervention. The Health Sciences Research Office of the University of Witwatersrand, Johannesburg, South Africa reported the cost of generating one publication via a writing retreat to be US$255, compared with the institutional subsidy of US$11 000 per publication that the University receives.27 The adapted 5.5-day Union-MSF (Médecins Sans Frontières) Operational Research Course provided to India’s National Tobacco Control Programme yielded publications and reported a cost of US$140 per participant.19

Overall sample: instructor characteristics

Of those who reported instructor information, seven (7/16) were led by a blend of instructors and facilitators/mentors from LMICs and HICs (table 2), three of which started with international instructors and shifted to local experts. Seven (7/16) interventions drew exclusively on local instructors, two (2/16) interventions were taught by HIC instructors only, and four (4/20) did not specify instructor affiliations.

Overall sample: challenges

The most frequently cited challenges related to mentoring (9/20). Specific challenges included recruiting enough qualified mentors19 ,20 21 30 31 ,34 ,36, and cost and communication barriers21 23 26 27 30 31 (technology, infrastructure, and language across cultures and nationalities). The slow pace of developing a pipeline of mentors (eventually from programme participants) was also mentioned.34 Poor long-distance communication and spotty connectivity for remote learning were major concerns18 22 26 29 31 33 34 37 38 (8/20) as well. Additionally, the cost of open access publishing and accessing literature was a concern20 21 32 33 34 37 (5/20). Time was a frequently cited challenge (4/20)21 22 24 29; concerns about cost kept programmes short, yet participants and organizers cited a scarcity of time as an impact on logistics and the quality of the learning experience. Authors stated the need for paid protected time for participants and mentors.19 25 30 33 34 37 An important related challenge involved recruiting and retaining women due to the amount and frequency of time away20 24 32 34 (4/20). Some interventions involving HIC partnerships mentioned that unanticipated cultural factors were challenging25 31 (2/20).

Overall sample: lessons learnt

Many lessons were shared from these interventions. Writing and publishing interventions benefited when they had a large number of facilitators with a high ratio of mentors to participants for writing and publishing. Articles described several strategies to overcome the challenge of having too few qualified mentors and facilitators, especially those who are women. These strategies included pairing senior and junior facilitators, pairing faculty from HIC and LMICs, drawing on faculty in a country’s diaspora, paying facilitators, and creating thematic groups of mentors and mentees. Train-the-trainer interventions, which develop and strengthen the skills of local intervention leaders, may also be helpful.

Planning and needs assessment can help to address time issues in writing interventions, which most importantly require ample protected (paid) time for writing and manuscript preparation. Other lessons learnt included the need to schedule time for people to work together and network, schedule workshop phases closer together to allow people to attend as they develop their draft paper, to arrange sessions to be cost effective for travellers and avoid wasted time by having staff onsite. Recommendations also included investing effort in the evaluation, using clearly defined measures with standard follow-up periods, and tracking outcomes.

The majority of these interventions were partnerships and collaborations. Many attributed their success to clear communication, respect for cultural differences, clearly defined roles, and a distribution of leadership.

Discussion

We conducted this systematic review to describe scientific writing and publishing interventions in LMICs and identify gaps in this literature to support capacity strengthening efforts. Research publications serve many critical purposes: they can inform health policy and health interventions, they are the currency for advancement in research careers, and they can enhance a country’s credibility and influence.12 39 Further, by publishing their scientific research, researchers in LMICs may advance professionally and thereby gain the funding and platform needed to set research priorities for their own country and region.12 40 41 Without publications, what is often a substantial financial investment in the research may be wasted.42–45

We identified only 20 writing and publishing interventions in LMICs that described their activities, evaluations and outcome measures in enough detail to enable analysis. Among these, we highlighted the approaches of interventions that reported the number of submissions and/or publications as outcomes because they offered quantifiable metrics of success. Notable approaches implemented by this subset of 14 interventions included an intervention length of approximately 5 days and the provision of one-on-one mentorship during and after the main intervention to support writing and publication. A study of mentorship at Makerere University College of Health Sciences in Uganda found that both mentors and mentees reported that lack of formal structure was a barrier to effective mentoring.46 The formal structure of writing and publishing interventions may be an ideal setting for focused, mutually beneficial mentoring relationships between experienced faculty and junior researchers or trainees.

The mentorship component of these interventions overcomes writing and publishing barriers reported in the literature, including poor access to scientific writing instruction, inadequate writing skills, a lack of dedicated time and opportunity for scientific writing, and lack of support from more experienced researchers.41 44 Several papers in our sample emphasised that their interventions benefited from a large number of facilitators with a high ratio of mentors to participants for writing and publishing.

The context in which interventions are implemented differs across settings, and writing and publishing interventions should be tailored to the preferences and needs of their intended participants. Needs assessments, which can help achieve this goal,47 were conducted in nearly half of interventions across our sample, and it is possible in some cases that they were performed but not reported. Papers in this analysis reported learning key information from needs assessments including why participants were motivated to publish and participate in the intervention; the experience and skill level of participants; and specific barriers to writing and publishing that participants faced. It is also valuable to learn about the resources available to participants, like budget, technology and library access.44 48 Needs assessments were reported less frequently in the Publications Reported group compared with the Other Interventions group; it is possible that reporting publications is related to conducting a needs assessment, but the mechanism by which these might be related is not clear. One of the Publications Reported interventions that did not report a needs assessment is the ongoing ‘eJCIndia’ journal club in India.17 A needs assessment may not be relevant for an ongoing journal club because the intervention can be modified as needs are identified across time, and because the group and their needs also likely change across time. Regardless, several papers identified the importance of conducting a needs assessment as part of the intervention planning process.

Our sample offered a rich collection of lessons learnt and suggestions for future interventions. Three lessons stood out: (1) the importance of keeping interventions short to allow researchers to balance work and family demands, (2) the value of a high ratio of mentors to mentees and (3) the need for plenty of time from senior researchers to provide detailed feedback on participants’ writing. Another recurring theme was the need for a budget to support open access fees and for accessing articles behind a paywall, as well as the need for high-quality internet connectivity. Limited time, lack of mentorship, and lack of a budget for open access fees, article access and technology infrastructure have been cited throughout the literature as barriers to publication.44 48

Though 64 articles were identified for inclusion in the analytical sample, 41 lacked sufficient detail about the content, structure and delivery of the intervention to allow for analysis. Future papers describing writing and publishing interventions should include details that will allow readers to understand and replicate an intervention. Key details include whether a needs assessment of scientific writing and publishing was conducted and how the findings informed programme design, length of the writing and publishing intervention, topics covered, whether one-on-one writing mentorship was provided, attendance and outcome measures. Articles should also include information about the residential affiliation of intervention leadership so that readers know whether leaders were local, from high-income countries, or if leadership transitioned from high-income countries to local leaders.

Careful evaluation that is contextualised to a group’s goals and particular setting will help shape scientific understanding of the power of writing and publishing interventions to strengthen capacity. Ideally, such research will offer a range of strategies to support efforts across different regions.49 In addition to providing details about the intervention’s approach and evaluation, tracking quantifiable metrics such as number of submissions and/or publications post intervention may offer insight into whether and which components of an intervention may have been most effective. Further, allocating enough follow-up time (eg, 2–3 years after an intervention) to track publications will allow greater capture of this key outcome.

Questions that will help inform future writing and publishing interventions include whether one comprehensive training can make a lasting impact in supporting individuals in greater overall productivity, including number of publications, grant applications and professional promotions.

Additionally, it would be helpful to understand whether training local senior researchers to lead, facilitate and otherwise participate in author trainings additionally supports their own professional productivity and advancement and local capacity.50 Finally, every intervention has a budget and reporting the cost of training a group of researchers can be helpful to others planning similar activities.

Writing and publishing a research paper occur in the later stages of the research process, building on a wide range of skills required to carry out research. These skills include the ability to search and understand the scientific literature in a given topic area, and to conceptualise and investigate a research question with an appropriate methodological approach. A research publication will not be successful unless these foundational skills are in place. Papers describing standalone writing and publishing interventions should describe the amount of prior research training participants had entering the programme and interventions that are part of a broader research capacity programme should describe the research training that the programme provided.

Limitations

Several limitations should be noted when interpreting our results. The analytical sample included five SORT-IT interventions19 21 32–34 and one precursor to SORT-IT (Union/MSF operational research training20); this core programme was repeated across time and in various settings. We considered these as separate interventions with the assumption that if they were published as original research, they were distinct. There was, however, overlap.

We did not capture every writing and publishing intervention conducted in LMICs, only those that were indexed in the five databases we searched and also provided sufficient detail to qualify for inclusion in our sample. Additionally, we did not capture interventions that were conducted but not published.

Our classification of interventions as Publications Reported or Other was based on whether they reported as outcomes submitted and/or published papers. It is possible that participants in interventions that did not report submissions and/or publications published papers on their own, and this was not captured in our classification. Additionally, publication can easily take 2 years or more and papers published after an intervention’s follow-up period were not included in our results.

Finally, our paper selection and data extraction process were subject to errors; for example, overlooking key details during data extraction. To minimise the risk of such errors, two authors independently reviewed papers at each stage, and a third author resolved any discrepancies.

Conclusion

Writing and publishing interventions in LMICs are an underused opportunity for capacity strengthening and merit greater consideration in the health literature.51 We offer this systematic review of existing scientific writing and publishing interventions with the hope that it provides a valuable resource for evidence-based and more integrative programme development, implementation and evaluation. We hope that this review stimulates the continued development of evidence-based writing and publication interventions to strengthen health research capacity in LMICs.

Handling editor: Seye Abimbola
Twitter: @Ellainthemitten
Contributors: ETA conceived the study and acts as the guarantor. CEB, ETA and CS developed the study methodology. EWA, ETA, CEB, MK, and CS collected and analysed study data. ETA, CEB, and EWA drafted the original text. All authors critically reviewed the approach and results and edited the manuscript text. All authors have read and agreed to the published version of the manuscript.
Funding: Funding was provided by the Center for International Reproductive Health Training. We thank Joseph C. Kolars, MD, at the University of Michigan for his insightful feedback on our manuscript.
Competing interests: ETA is the founder and editor-in-chief of the non-profit organisation PREPSS (Pre-Publication Support Service). PREPSS’s work involves writing and publishing interventions in low-income and middle-income countries, which is the topic of this systematic review paper. Former and current employees of PREPSS include ETA, EWA, CEB and MK. YRS and TE are the principal investigator and managing director of CIRHT (Center for International Reproductive Health Training), respectively. CIRHT is a client of PREPSS. CIRHT and PREPSS’s work and publications are not referred to or included in the manuscript.
Provenance and peer review: Not commissioned; externally peer reviewed.
Supplemental material: This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

Ethics statements

Patient consent for publication:

Ethics approval:

This study does not involve human participants.

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Introduction
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