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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: