Trends in Global Health Research among Universities in China: A Bibliometric Analysis

Trends in Global Health Research among Universities in China: A Bibliometric Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Trends in Global Health Research among Universities in China: A Bibliometric Analysis Chenkai Wu, Lijing L. Yan, Qian Long, Yunguo Liu, Jie Tan, Zhexun Lou, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2267301/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 06 Apr, 2023 Read the published version in Global Health Research and Policy → Version 1 posted 4 You are reading this latest preprint version Abstract Background: We have witnessed considerable progress in developing global health education and research in China. Nevertheless, evidence of the progress of Chinese universities’ contributions to global health research is limited. More efforts are needed to depict the progress Chinese universities have collectively made in advancing the field of global health. This study aimed to examine Chinese universities’ collective contributions to global health research by describing the longitudinal trends in global health research publications, uncovering research themes in global health, and exploring collaboration patterns. Methods: A comprehensive bibliometric analysis was conducted for original research studies of the ten founding members of the China Consortium of Universities for Global Health, one of the largest networks of global health research and education in China. Results: We found that (1) the number of research publications in the field of global health has steadily increased from 2014 to 2020, (2) non-communicable disease was the most popular research topic, accounting for over one-third of total publications, followed by maternal and child health and neurological and mental disorders and diseases, (3) less than one-fifth of papers involved primary data collection, with the majority of the study populations from low-income and lower-middle-income countries in Asia and Africa, and (4) a sizable collaboration network has been established with co-authors from over 200 oversea universities or organizations, with about one third from the US. Conclusions: More concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China. China global health health governance non-communicable disease maternal and child health. Figures Figure 1 Figure 2 Figure 3 Summary Box Chinese universities have been playing an increasingly important role in global health research as assessed by peer-reviewed publications from 2014 to 2020 of original international research studies of the ten founding members of the China Consortium of Universities for Global Health, one of the largest networks of global health research and education in China. The number of research publications in the field of global health has steadily increased, with non-communicable diseases being the most popular research topic, accounting for over one-third of total publications. Less than one-fifth of papers involved primary data collection, with majority of the study populations from low-income and lower-middle-income countries in Asia and Africa A sizable collaboration network has been established with co-authors from over 200 oversea universities or organizations, with about one-third from the US. More concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China. Introduction In 1963, the Chinese government dispatched its first medical team to Algeria, providing health care services to rural and suburban communities. This initiative, which later evolved into a signature international health aid program, marked the beginning of China’s participation in global health in modern times. Owing to the rapid economic development since the reform in 1978, China has been playing an increasingly active and essential role in global health; the focus was bilateral health aid provided in five major ways: deployment of medical teams, construction of medical facilities, donation of drugs and medical equipment, training of healthcare personnel, and infectious disease control. 1 This process was accelerated by the severe acute respiratory syndrome outbreak in 2003. 2 Since then, along with its rapidly growing economy, China has substantially increased its financial investment in global health and diversified its collaboration mechanisms. In recent years, the Chinese government has made firm commitments to global health and set an ambitious agenda for promoting health globally through strengthening multilateral collaborations, such as South-South cooperation, the Health Silk Road, and the China-Africa health cooperation. In 2018, the China International Development Cooperation Agency was founded. The establishment of this agency was a milestone in China’s foreign aid history, marking a transition from bilateral aid as the primary form to broader international development cooperation. 3 As China becomes increasingly involved in global health, the biggest challenge is enhancing the quality and broadening the scope of its global health engagement. 4 Building a global health discipline and education programs in Chinese universities and establishing research institutions focusing on global health are essential components of such a grand plan. Since the 21st century, we have witnessed considerable progress in developing global health education and research in China. In 2007, Peking University took the lead in launching the first global health institution in China, followed five years later by the first global health degree program at Wuhan University and a master's degree program at Duke Kunshan University jointly with Duke University in 2013. 5 6 These actions have kept the momentum. In November 2013, the China Consortium of Universities for Global Health (CCUGH) was launched by 10 founding universities—Central South University, Chinese University of Hong Kong, Duke Kunshan University, Fudan University, Kunming University, Peking University, Peking Union Medical College, Sun Yat-sen University, Wuhan University, and Zhejiang University—aiming to promote global health education, training, and research in Chinese universities through sharing of resources, knowledge, and experience, fostering of international and domestic partnerships, the establishment of field sites, and provision of social services. 1 The CCUGH has expanded rapidly, growing from ten founding members to 29 by 2021. Due to several driving factors, such as government’s investment in research, enhanced research capacity of Chinese scholars, and expanding international collaboration, there has been a proliferation of research publications in various global health areas. 7 – 9 In a recent paper, Kwete et al. reviewed the research capacity of global health institutions in China, focusing on several key quantitative indicators, such as scholarly publications, research grants, faculty members, course curricula, and trainees. 10 Nevertheless, evidence of the progress of Chinese universities’ contributions to global health research is generally limited. Evaluation of the trends in research output has been lacking. More efforts are needed to depict the progress Chinese universities have collectively made in advancing the field of global health, which is critical for identifying the strengths, weaknesses, opportunities, and challenges to future global health research in China. To this end, we conducted a bibliometric analysis to assess Chinese universities’ contributions to global health and their research capacity, primarily focusing on describing the emerging trends in global health research publications for studies conducted, at least partially, outside the national borders of China, uncovering major research themes in global health, and exploring collaboration patterns. The findings of this work would help identify the progress and status of global health research among Chinese universities and advance our understanding of opportunities and challenges for Chinese scholars to conducting global health research in the future. Methods Inclusion and exclusion criteria Global health is a versatile concept, and a consensus on a precise definition is lacking. Different scholars have proposed many definitions of global health over the past decades. 11 We adopted a widely recognized working definition of global health, 12 focusing on transnational health issues, determinants, and solutions. Thus, we included research conducted in at least one country other than China. Studies were included based on the following criteria: (i) original research articles published in English, (ii) published in a peer-reviewed journal in the period from January 2014 to December 2020 (the CCUGH was established in November 2013), (iii) at least one study population is not from China (including mainland China, Taiwan, Hong Kong, and Macao), (iv) the primary affiliation of first or corresponding author (including joint first or corresponding authors) is one of the ten founding members of the CCUGH; these categories are conventionally associated with the highest amount of contribution and reputation. 13 We focused on the ten founding members of the CCUGH because these institutions are the pioneers of global health research in China. The member institutions that later joined the CCUGH are still in the nascent stage of developing research capacity in global health; the time to capture their research contributions was shorter and differed from the ten founding members. We excluded meta-analyses, reviews, and studies on research methodology and non-human research. Search strategies and data extraction We conducted an extensive electronic literature search on PubMed and EMBASE from January 2014 to December 2020 for articles written in English. Because global health encompasses a wide variety of thematic areas on health issues, conducting a traditional keyword search in the Title and Abstract fields was difficult to identify eligible articles. Alternatively, we adopted an affiliation-based search strategy to identify articles published by the specific college, school, department, institute, or center of global health/public health within each founding member of the CCUGH. We did not restrict the search to global health institutions because most China-based researchers conducting global health research have a primary affiliation with a public health institution. The search strategy is available in Appendix 1. Two trained abstractors (JT & ZL) screened the titles, abstracts, and author information for inclusion based on our criteria, followed by a detailed abstract and full-text review. Disagreements and discrepancies were resolved through discussion between two abstractors and a senior researcher of the study team (CW). JT, ZL, and CW subsequently coded eligible articles in an Excel sheet, recording information on year of publication, journal, author names and affiliations, the origin of the study population (countries and continents), article type (primary data collection vs. secondary data analysis), and research topic. We classified eligible articles according to the list of global health research topics (18 categories) established by the Fogarty International Center at the US National Institute of Health. 14 Health policy and systems research was included as an additional topic because it was one of the research priorities in the CCUGH. 1 We classified each eligible article into one research topic; we used the most relevant one for papers focusing on two or more topics. Any disagreement was resolved through group discussion. Analytic approach The goal of the present study was to characterize the patterns and trends in global health research among universities in China. Therefore, we presented aggregated data over all founding members of the CCUGH instead of university-specific data. We calculated the total number of articles by year of publication (2014–2020), research topic, and origin of the study population (region [Asia, Africa, Europe, North America, Oceania, and South America] and country). Analyses were stratified by income level (low-income, lower-middle-income, upper-middle-income, and high-income) according to the latest classification of country income groups by the World Bank. 15 Linear trend analysis was used to determine whether the number of publications changed significantly over time. In addition, we counted the number of overseas collaboration institutions (i.e., not in mainland China, Taiwan, Hong Kong, or Macao) by country; only primary affiliations were included. We classified these collaboration institutions as universities and others (including government agencies, hospitals, non-governmental organizations, or international organizations). Statistical analyses were conducted using Stata 15.0 and Microsoft Excel. Results Year and topic of publications The search strategy retrieved 11,839 potentially relevant records from PubMed (n = 10,077) and EMBASE (n = 10,821) after removing duplicates. Based on the title and abstract screening, 203 papers were considered eligible; 9, 16, 14, 20, 35, 52, and 57 papers were published in 2014, 2015, 2016, 2017, 2018, 2019, and 2020, respectively (Fig. 1 ). Linear trend analysis revealed a significantly increasing trend of publications from 2014 to 2020. Figure 2 shows the number and relative frequency of these eligible publications by research topic. The number of articles was highest for NCDs (n = 76, 37.4%), followed by maternal and child health (MCH; n = 32, 15.5%), neurological and mental disorders and diseases (n = 23, 11.3%), infectious disease (n = 14, 6.9%), health systems and policy (n = 13, 6.4%), and trauma and injury (n = 12, 5.9%). The number of articles for the other 13 topics was no more than eight (3.9%). Research type Thirty-four (16.7%) papers involved primary data collection, and 169 (83.3%) papers used secondary data analysis. Of 34 papers using primary data collection, 17 (50.0%), 12 (35.3%), 3 (8.8%), 1 (2.9%), and 1 (2.9%) had study populations from Asian, African, North American, European, and Oceanian countries, respectively; 6 (17.6%), 21 (61.8%), 3 (8.8%), and 4 (11.8%) involved study populations in low-income, lower-middle-income, upper-middle-income, and high-income countries, respectively (Table 1 ). Of 169 papers using secondary data analysis, 44 (26.0%) had study populations from countries (excluding China) of at least two continents; 29 (17.2%), 6 (3.6%), 13 (7.7%), 72 (42.6%), and 5 (3.0%) had study populations in Asia, Africa, North America, Europe, and Oceania, respectively. Table 1 The number of papers by region and country. Primary data collection Secondary data analysis Total Global 0 44 a 44 Asia 17 29 b 46 Lower-middle-income Myanmar 5 0 5 Nepal 4 0 4 Vietnam 2 2 4 Bangladesh 2 0 2 India 1 0 1 Pakistan 1 0 1 Timor-Leste 0 1 1 Upper-middle-income Malaysia 2 0 2 Thailand 0 1 1 High-income Japan 0 4 4 Singapore 0 2 2 Africa 12 6 c 18 Low-income Malawi 4 0 4 Mozambique 1 1 2 Eritrea 1 0 1 Lower-middle-income Tanzania 2 2 4 Zambia 2 0 2 Ghana 1 0 1 Kenya 1 0 1 Europe 1 13 d 14 High-income Denmark 0 2 2 Sweden 0 2 2 Ireland 1 0 1 North America 3 72 75 Upper-middle-income Mexico 0 2 2 High-income USA 3 68 71 Canada 0 2 2 Oceania 1 5 6 Upper-middle-income Republic of Vanuatu 1 0 1 High-income Australia 0 5 5 South America 0 0 0 a Including research with study populations from countries (not including mainland China, Taiwan, Hong Kong, or Macao) of at least two continents. b Including research with study populations from at least two countries (not including mainland China, Taiwan, Hong Kong, or Macao) in Asia. c Including research with study populations from at least two countries in Africa. d Including research with study populations from at least two countries in Europe. Collaboration institutions The global geographical distribution of overseas collaboration institutions is displayed in Fig. 3 , revealing a high concentration of institutions in coastal regions. Overall, there were 217 overseas collaboration institutions, including 154 (71.0%) universities and 63 (29.0%) government agencies, hospitals, non-governmental organizations, or international organizations (Table 2 ). North America had the highest number of collaboration institutions (n = 75, 34.6%), followed by Asia (n = 64, 29.5%), Europe (n = 36, 16.6%), Africa (n = 17, 7.8%), Oceania (n = 15, 6.9%), and South America (n = 6, 2.8%). Four (1.8%), 36 (16.6%), 21 (9.7%), and 152 (70.0%) collaboration institutions were in low-income, lower-middle-income, upper-middle-income, and high-income countries, respectively. The number of collaboration institutions was highest in the US (n = 62, 28.6%), followed by Japan (n = 21, 9.7%), Australia (n = 13, 6.0%), India and UK (n = 11, 5.1%), and Canada (n = 10, 4.6%). Table 2 Number of overseas collaboration institutions by country. Countries Universities Others Total Lower-middle-income Asia Total: 64 Bangladesh 2 1 3 Cambodia 0 1 1 India 3 8 11 Pakistan 3 1 4 Vietnam 3 1 4 Iran 1 0 1 Myanmar 0 1 1 Philippines 1 0 1 Upper-middle-income Malaysia 5 1 6 Thailand 0 1 1 High-income Japan 14 7 21 Singapore 1 3 4 South Korea 4 0 4 Saudi Arabia 1 0 1 United Arab Emirates 0 1 1 Africa Total: 17 Low-income Malawi 1 2 3 Mozambique 1 0 1 Lower-middle-income Tanzania 2 2 4 Kenya 2 0 2 Egypt 1 0 1 Ghana 1 0 1 Nigeria 1 0 1 Zambia 1 0 1 Upper-middle-income South Africa 3 0 3 Upper-middle-income Turkey 1 0 1 High-income Europe Total: 36 UK 10 1 11 Sweden 5 0 5 Denmark 2 2 4 Netherlands 2 1 3 Ireland 2 0 2 Finland 0 2 2 Belgium 1 0 1 France 0 1 1 Germany 0 1 1 Greece 1 0 1 Italy 0 1 1 Norway 1 0 1 Poland 1 0 1 Spain 0 1 1 Upper-middle income North America Total: 75 Mexico 0 3 3 High-income USA 53 9 62 Canada 9 1 10 Upper-middle-income Oceania Total: 15 Republic of Vanuatu 0 2 2 High-income Australia 11 2 13 Upper-middle-income Argentina 0 2 2 South America Total: 6 Colombia 1 1 2 Peru 1 0 1 High-income Chile 1 0 1 Others a 0 1 1 Total 154 63 217 a World Health Organization was a co-author’s first affiliation for one peer-reviewed paper. Discussion Between 2014 and 2020, the number of research publications in the field of global health has steadily increased since the establishment of the CCUGH. Only nine papers were published in 2014, whereas this number increased to 57 in 2020. These results were consistent with previous research showing an increasing trend in publication records for global health institutions in China. 10 We noticed discrepancies in the number of publications between the two studies. This is primarily due to the differences in search strategies and inclusion criteria between the two studies. One major difference was that we only included articles whose first or corresponding authors were affiliated with eligible institutions. Our rationale is that these categories, which are conventionally associated with the highest contribution and reputation, 13 more accurately reflect the research capacity. Although the research output in global health has increased, the overall size of the research output and the volume of research activity is much smaller than that of public health and many other disciplines. 16 – 18 Previous literature has documented several challenges and barriers hindering the development of global health, such as shortage of funding opportunities, lack of societal and policy support, and insufficient global experience. 19 20 More efforts are needed to create a nurturing, collaborative environment for global health research to keep up the pace of China’s ambition to become a responsible and strong leader in global health. We found imbalanced development in global health research areas among Chinese universities. Of 19 research topics considered, NCDs were the most popular, accounting for over one-third of total publications. MCH and neurological and mental disorders and diseases were the second and third popular topics, accounting for 15.5% and 11.3% of all publications, respectively. A sizeable portion of publications also focused on infectious disease, health system and policy, and trauma and injury. However, the other two-thirds of the topics were under-researched, with fewer than 10 publications. We propose several plausible explanations for the predominant focus on NCDs research. First, China has experienced an epidemiological transition from infectious diseases to NCDs over a short period. 21 Deaths from infectious diseases have decreased by over 70% since 1990 in China, whereas the burden of NCDs has increased dramatically, accounting for nearly 90% of all deaths in recent years. 22 Prevention and control of NCDs and their modifiable risk factors have become one of the formidable challenges facing the healthcare system. The need to address NCDs through research is enormous. Second, NCDs and their risk factors are widely available in publicly accessible databases. Massive amount of NCDs data has been collected in a wide variety of research activities, including surveys, surveillance, and registries; many of these data sources are easily accessible electronically. For example, seven papers used data from the National Health and Nutrition Examination Survey to conduct epidemiological research on NCDs. 23 – 29 While NCDs are one of many health challenges globally, more efforts are needed to diversify the global health research portfolios among global health institutions in China. As China has been increasingly becoming an aid donor and resource provider instead of an aid and funding recipient, 30 strengthening research capacity in other global health areas is a critical step for China to broaden the scope and deepen the level of its global health engagement. Global health research is versatile in methodology. The collection of primary data from the research field and secondary data analysis are the two most used approaches in original investigations. Of the 203 papers included, over 80% analyzed existing data, while < 20% involved primary data collection. Increasing access to and sharing health data is one driving force behind this phenomenon. On the other hand, researchers in China are hindered by the system, financial, and personal barriers to implementing field-based research with primary data collection oversea. 1 19 Compared to secondary data analyses, researchers are more likely to gain a deeper understanding of the research questions, design, procedures, and participants from field-based research. Field-based research provides an excellent opportunity to design and implement geopolitically and culturally relevant projects to tackle transnational health issues in real-world settings. The limited availability of funding sources is another challenge to conducting global health research outside of China. Most of the funding for global health research conducted outside of China comes from private foundations and bilateral agencies, with China Medical Board and the UK Department for International Development being the two major contributors. 19 31 It is necessary for China’s government funding agencies, such as the National Natural Science Foundation of China, to launch new funding mechanisms dedicated to global health research. The importance of international collaborations to global health research cannot be overestimated. In this study, we found that scholars in Chinese global health institutions have collaborated with over 200 overseas institutions (i.e., primary affiliations of co-authors); a solid collaboration research network has been established. We noticed that these collaboration institutions were not evenly distributed globally, with over one-third and nearly 30% in North America and Asia, respectively. Country-specific results showed that the US had the highest number of collaboration institutions (n = 62; 28.6%). Collaborators from these US institutions mainly served as co-authors on papers analyzing secondary data. The size of research collaboration with institutions in low- and middle-income countries (LMICs) is relatively small, especially in Africa. These results suggest that profound political and economic relations with African countries do not naturally help identify research partners or establish research collaborations. Trilateral and multilateral platforms that expand from an existing collaboration between institutions in China and high-income countries to include other LMICs particularly African countries, are one feasible solution to overcome barriers to nurturing collaborations. 10 We acknowledge several limitations. First, our bibliometric analyses only considered articles written in English. Although most Chinese researchers prefer writing research articles in China, they mainly submit scholarly work to English-language journals primarily due to the pressure from the institutional academic evaluation system. 32 Second, authorship order and affiliation are imperfect measures of research capacity. However, the academic evaluation system in China has a long tradition of valuing primary affiliation and first/corresponding author of research publications. We, therefore, adopted a stringent criterion for selecting articles based on first/corresponding author to reflect the research contribution and capacity more accurately. Third, this study is by no means a thorough investigation of Chinese universities' research capacity in the global health field. We only considered articles published by ten founding members of the CCUGH. We might miss important trends in research conducted outside universities and emerging global health research institutions. Nevertheless, the ten founding members are the pioneers and leaders of global health research in China. They likely represent the general trends in global health research in China. Fourth, we did not include studies conducted entirely in China, which, strictly speaking, are also part of global health research. Our goal is to understand the trend and patterns of Chinese universities’ contributions to global health research (outside of China). In summary, Chinese universities have been playing an increasingly important role in global health research as assessed by peer-reviewed publications from 2014 to 2020 of original international research studies of the ten founding members of CCUGH. We also identified important gaps in current trends. More work is needed to diversify the global health research portfolios, promote investment in field-based research, and strengthen research collaborations with institutions in LMICs. Our study, although not exhaustive, provides a practical basis for planning and evaluating priority areas in global health research for Chinese universities. More concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China. Declarations Ethics approval and consent to participate: This study does not involve human participants and ethical approval was not required. Consent for publication: All authors have agreed to send this manuscript for publication. Availability of data and materials: Data are extracted from open access research databases. Summary data are available upon request. Competing interests: Not applicable. Funding: Not applicable Authors' contributions: CW conducted the data analysis, interpreted the study findings, and drafted the manuscript. LLY, QL, and YL contributed to interpretation of research findings and manuscript revision. JT and ZL conducted the literature review and data extraction. ST conceived of the research topic and contributed to interpretation of research findings and manuscript revision. Acknowledgements: Not applicable. References Liu P, Guo Y, Qian X, et al. China's distinctive engagement in global health. Lancet. 2014;384(9945):793–804. doi: 10.1016/S0140-6736(14)60725-X . Chan LH, Chen L, Xu J. China's engagement with global health diplomacy: was SARS a watershed? PLoS Med. 2010;7(4):e1000266. doi: 10.1371/journal.pmed.1000266 [published Online First: 20100427]. China SCIOotPsRo. China’s International Development Cooperation in the New Era: The State Council Information Office of the People’s Republic of China Beijing, 2021. Chen L, Yang M. New opportunities for China in global health. Lancet Glob Health. 2018;6(7):e722-e23. doi: 10.1016/s2214-109x(18)30263-8 . Guo Y. Development of global health research in China. J Glob Health. 2017;7(2):020102. doi: 10.7189/jogh.07.020102 . Sun L, Zhao D, Xiong S, et al. Disciplinary development of global health academic degree programs in China. Global Health Journal. 2021;5(2):102–11. Sweileh WM, AbuTaha AS, Sawalha AF, et al. Bibliometric analysis of worldwide publications on multi-, extensively, and totally drug - resistant tuberculosis (2006–2015). Multidiscip Respir Med. 2016;11:45. doi: 10.1186/s40248-016-0081-0 [published Online First: 20170111]. Bai J, Li W, Huang YM, et al. Bibliometric study of research and development for neglected diseases in the BRICS. Infect Dis Poverty. 2016;5(1):89. doi: 10.1186/s40249-016-0182-1 [published Online First: 20160906]. Liu P, Mu X, Hao X, et al. China's scientific footprint in the global HIV/AIDS research: Productivity, impact and collaboration. Malaysian J Libr Inform Sci. 2016;21(1):83–108. Kwete X, Tang K, Cheng F, et al. Research capacity of global health institutions in China: a gap analysis focusing on their collaboration with other low-income and middle-income countries. BMJ Glob Health 2021;6(7) doi: 10.1136/bmjgh-2021-005607 . Salm M, Ali M, Minihane M, et al. Defining global health: findings from a systematic review and thematic analysis of the literature. BMJ Glob Health 2021;6(6) doi: 10.1136/bmjgh-2021-005292 . Koplan JP, Bond TC, Merson MH, et al. Towards a common definition of global health. The Lancet. 2009;373(9679):1993–95. Bendels MHK, Muller R, Brueggmann D, et al. Gender disparities in high-quality research revealed by Nature Index journals. PLoS ONE. 2018;13(1):e0189136. doi: 10.1371/journal.pone.0189136 [published Online First: 20180102]. Center FI. Global Health Research Topics 2021 [Available from: https://www.fic.nih.gov/researchtopics accessed 09/20 2022. Bank W. World Bank Country and Lending Groups 2021 [Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups accessed 09/20 2022. Lee L. The current state of public health in China. Annu Rev Public Health. 2004;25:327–39. doi: 10.1146/annurev.publhealth.25.101802.123116 . Tollefson J. China declared world's largest producer of scientific articles. Nature. 2018;553(7689):390. doi: 10.1038/d41586-018-00927-4 . Li H, He Q. Public health research in China: some recent findings and implications. Asia Pac J Public Health 2015;27(2 Suppl):4s-6s. doi: 10.1177/1010539515575239 [published Online First: 20150225]. Xu DR, Cheng F, Chen Y, et al. Harnessing China's universities for global health. Lancet. 2016;388(10054):1860–62. doi: 10.1016/s0140-6736(16)31839-6 . Tuangratananon T, Tang K, Suphanchaimat R, et al. China: leapfrogging to become a leader in global health? J Glob Health. 2019;9(1):010312. doi: 10.7189/jogh.09.010312 . Yang G, Kong L, Zhao W, et al. Emergence of chronic non-communicable diseases in China. Lancet. 2008;372(9650):1697–705. doi: 10.1016/S0140-6736(08)61366-5 [published Online First: 20081017]. Zhou M, Wang H, Zhu J, et al. Cause-specific mortality for 240 causes in China during 1990–2013: a systematic subnational analysis for the Global Burden of Disease Study 2013. Lancet. 2016;387(10015):251–72. doi: 10.1016/s0140-6736(15)00551-6 [published Online First: 20151026]. Li Y, Meng L, Li Y, et al. Depression-related differences in lean body mass distribution from National Health and Nutrition Examination Survey 2005–2006. J Affect Disord. 2014;157:1–7. doi: 10.1016/j.jad.2013.12.040 [published Online First: 20140108]. Leng X, Xia J, Zeng X, et al. Prevalence and Associated Factors of Lupus in the United States: Third National Health and Nutritional Examination Survey (NHANES III). Front Med (Lausanne). 2020;7:213. doi: 10.3389/fmed.2020.00213 [published Online First: 20200527]. Dong B, Peng Y, Wang Z, et al. Joint association between body fat and its distribution with all-cause mortality: A data linkage cohort study based on NHANES (1988–2011). PLoS ONE. 2018;13(2):e0193368. doi: 10.1371/journal.pone.0193368 [published Online First: 20180223]. Guo J, Huang Y, Bian S, et al. Associations of urinary polycyclic aromatic hydrocarbons with bone mass density and osteoporosis in U.S. adults, NHANES 2005–2010. Environ Pollut. 2018;240:209–18. doi: 10.1016/j.envpol.2018.04.108 [published Online First: 20180505]. Cao C, Hu L, Xu T, et al. Prevalence, correlates and misperception of depression symptoms in the United States, NHANES 2015–2018. J Affect Disord. 2020;269:51–7. doi: 10.1016/j.jad.2020.03.031 [published Online First: 20200314]. Guo J, Wu C, Zhang J, et al. Associations of melamine and cyanuric acid exposure with markers of kidney function in adults: Results from NHANES 2003–2004. Environ Int. 2020;141:105815. doi: 10.1016/j.envint.2020.105815 [published Online First: 20200529]. Li JB, Wu Y, Gu D, et al. Prevalence and temporal trends of presarcopenia metrics and related body composition measurements from the 1999 to 2006 NHANES. BMJ Open. 2020;10(8):e034495. doi: 10.1136/bmjopen-2019-034495 [published Online First: 20200805]. Bank W. Data: net official development assistance and official aid received (current US $ ). 2022 [Available from: http://data.worldbank.org/indicator/DT.ODA.ALLD.CD accessed 09/20 2022. Husain L, Bloom G, McPherson S. The China-UK Global Health Support Programme: looking for new roles and partnerships in changing times. Glob Health Res Policy. 2020;5:26. doi: 10.1186/s41256-020-00156-1 [published Online First: 20200603]. Salager-Meyer F. Writing and publishing in peripheral scholarly journals: How to enhance the global influence of multilingual scholars? J Engl Acad Purp. 2014;13:78–82. Supplementary Files CCUGHManuscriptBMJOSuppl.pdf Cite Share Download PDF Status: Published Journal Publication published 06 Apr, 2023 Read the published version in Global Health Research and Policy → Version 1 posted Reviewers agreed at journal 15 Nov, 2022 Reviewers invited by journal 15 Nov, 2022 Editor assigned by journal 14 Nov, 2022 First submitted to journal 14 Nov, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2267301","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":152198488,"identity":"e5b23c10-5fff-438e-bec3-50df217b29f9","order_by":0,"name":"Chenkai Wu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABIklEQVRIiWNgGAWjYDACCQYGxgYQycB8QILhAIMBkMUGkTpAUAtbAklaQIDHgDgt/LObjz2cUWPBYHAj5+NtnjM2xga32589+LmDQY7vRgLj5wIsltw5lm644ZgEUEvuZmueG2lmBnfOmBv2nmEwlryRwCw9A1OLgUSOmeQDNgkGsxu526R5Phy2AVrHJsHbxpC44UYCGzMPNi353yQf/ANpyXkG1PIfqCX9meTfNoZ63Fpy2CQ3toG1sEnz3DhgZnAjwUwaaEuCAQ4tEkDXS87sk+CxP/PM2HLOmWSgF3LMpGXbJAxnnnnYLI1FC/+M5GeSPd/q5CTbkx/eeHPMzrAP5LC3bTbyfMeTD37GogUGMKRAkQuNsFEwCkbBKBgFJAMA5lVoTzOlsOAAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-2256-0653","institution":"Duke Kunshan University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Chenkai","middleName":"","lastName":"Wu","suffix":""},{"id":152198489,"identity":"0450c468-8c28-4201-8c59-3b8500463469","order_by":1,"name":"Lijing L. Yan","email":"","orcid":"","institution":"Duke Kunshan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lijing","middleName":"L.","lastName":"Yan","suffix":""},{"id":152198490,"identity":"49ae1ab0-b96c-487a-93a8-7cc0bd488a84","order_by":2,"name":"Qian Long","email":"","orcid":"","institution":"Duke Kunshan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Qian","middleName":"","lastName":"Long","suffix":""},{"id":152198491,"identity":"1a1c3587-f65c-483d-98bb-d021bf4acc12","order_by":3,"name":"Yunguo Liu","email":"","orcid":"","institution":"Duke Kunshan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yunguo","middleName":"","lastName":"Liu","suffix":""},{"id":152198492,"identity":"7f07c1a9-d965-4f41-95cf-e7174f9f7993","order_by":4,"name":"Jie Tan","email":"","orcid":"","institution":"Duke Kunshan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jie","middleName":"","lastName":"Tan","suffix":""},{"id":152198493,"identity":"cce2b27e-38c3-465d-8c32-d5df43a14543","order_by":5,"name":"Zhexun Lou","email":"","orcid":"","institution":"Duke Kunshan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhexun","middleName":"","lastName":"Lou","suffix":""},{"id":152198494,"identity":"7ab06432-7851-45fb-ac12-e035d272b2c8","order_by":6,"name":"Shenglan Tang","email":"","orcid":"","institution":"Duke Kunshan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Shenglan","middleName":"","lastName":"Tang","suffix":""}],"badges":[],"createdAt":"2022-11-13 01:28:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2267301/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2267301/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s41256-023-00295-1","type":"published","date":"2023-04-06T20:23:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":29209258,"identity":"0e29843d-299d-4887-8e33-46115f9fd66a","added_by":"auto","created_at":"2022-11-17 20:02:07","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":16321,"visible":true,"origin":"","legend":"\u003cp\u003eYearly peer-reviewed publications by ten founding members of the Chinese Consortium of Universities for Global Health from 2014 to 2020.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNotes:\u003c/strong\u003eTen founding members of the Chinese Consortium of Universities for Global Health are (in alphabetical order): Central South University, Duke Kunshan University, Fudan University, Kunming Medical University, Peking University, Peking Union Medical College, Sun Yat-sen University, The Chinese University of Hong Kong, Wuhan University, and Zhejiang University.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-2267301/v1/8d0f33bc861c1fd47c0c2b01.png"},{"id":29209769,"identity":"c54977b3-076d-4222-b923-d7c6a39e680f","added_by":"auto","created_at":"2022-11-17 20:10:07","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":49479,"visible":true,"origin":"","legend":"\u003cp\u003eNumber of peer-reviewed papers by global health research topic.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNotes:\u003c/strong\u003e The classification is based on the Fogarty International Center Global Health Research Topics: \u003ca href=\"https://www.fic.nih.gov/researchtopics\"\u003ehttps://www.fic.nih.gov/researchtopics\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eHealth systems and policy, one of the Chinese Consortium of Universities for Global Health research priorities, is also included as a research topic.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-2267301/v1/aeedd6f80253cd8fc23b81c5.png"},{"id":29209259,"identity":"6077bbaf-6ae7-4650-b14a-5977ecb4fe26","added_by":"auto","created_at":"2022-11-17 20:02:07","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":133782,"visible":true,"origin":"","legend":"\u003cp\u003eGlobal distribution of overseas collaboration institutions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNotes:\u003c/strong\u003e Country names were provided in Table 2.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-2267301/v1/5bb9d111124a9b931df86ba5.png"},{"id":44724381,"identity":"cba158b3-cc81-47ae-9e4e-d2cf2b8bf12f","added_by":"auto","created_at":"2023-10-16 20:29:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":579416,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2267301/v1/47c45002-4028-4ebe-8f4f-e6860a296e14.pdf"},{"id":29209261,"identity":"06b825a1-1089-4435-a25f-643e3be8bd8f","added_by":"auto","created_at":"2022-11-17 20:02:07","extension":"pdf","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":119511,"visible":true,"origin":"","legend":"","description":"","filename":"CCUGHManuscriptBMJOSuppl.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2267301/v1/8a74658b0fdbea351d9b8590.pdf"}],"financialInterests":"","formattedTitle":"Trends in Global Health Research among Universities in China: A Bibliometric Analysis","fulltext":[{"header":"Summary Box","content":"\u003cul\u003e\n \u003cli\u003eChinese universities have been playing an increasingly important role in global health research\u0026nbsp;as assessed by peer-reviewed publications from 2014 to 2020 of original international research studies of the ten founding members of the China Consortium of Universities for Global Health, one of the largest networks of global health research and education in China.\u003c/li\u003e\n \u003cli\u003eThe number of research publications in the field of global health has steadily increased, with non-communicable diseases being the most popular research topic, accounting for over one-third of total publications.\u003c/li\u003e\n \u003cli\u003eLess than one-fifth of papers involved primary data collection, with majority of the study populations from low-income and lower-middle-income countries in Asia and Africa\u003c/li\u003e\n \u003cli\u003eA sizable collaboration network has been established with co-authors from over 200 oversea universities or organizations, with about one-third from the US.\u003c/li\u003e\n \u003cli\u003eMore concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eIn 1963, the Chinese government dispatched its first medical team to Algeria, providing health care services to rural and suburban communities. This initiative, which later evolved into a signature international health aid program, marked the beginning of China\u0026rsquo;s participation in global health in modern times. Owing to the rapid economic development since the reform in 1978, China has been playing an increasingly active and essential role in global health; the focus was bilateral health aid provided in five major ways: deployment of medical teams, construction of medical facilities, donation of drugs and medical equipment, training of healthcare personnel, and infectious disease control.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e This process was accelerated by the severe acute respiratory syndrome outbreak in 2003.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e Since then, along with its rapidly growing economy, China has substantially increased its financial investment in global health and diversified its collaboration mechanisms. In recent years, the Chinese government has made firm commitments to global health and set an ambitious agenda for promoting health globally through strengthening multilateral collaborations, such as South-South cooperation, the Health Silk Road, and the China-Africa health cooperation. In 2018, the China International Development Cooperation Agency was founded. The establishment of this agency was a milestone in China\u0026rsquo;s foreign aid history, marking a transition from bilateral aid as the primary form to broader international development cooperation.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAs China becomes increasingly involved in global health, the biggest challenge is enhancing the quality and broadening the scope of its global health engagement.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e Building a global health discipline and education programs in Chinese universities and establishing research institutions focusing on global health are essential components of such a grand plan. Since the 21st century, we have witnessed considerable progress in developing global health education and research in China. In 2007, Peking University took the lead in launching the first global health institution in China, followed five years later by the first global health degree program at Wuhan University and a master's degree program at Duke Kunshan University jointly with Duke University in 2013.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e These actions have kept the momentum. In November 2013, the China Consortium of Universities for Global Health (CCUGH) was launched by 10 founding universities\u0026mdash;Central South University, Chinese University of Hong Kong, Duke Kunshan University, Fudan University, Kunming University, Peking University, Peking Union Medical College, Sun Yat-sen University, Wuhan University, and Zhejiang University\u0026mdash;aiming to promote global health education, training, and research in Chinese universities through sharing of resources, knowledge, and experience, fostering of international and domestic partnerships, the establishment of field sites, and provision of social services.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e The CCUGH has expanded rapidly, growing from ten founding members to 29 by 2021. Due to several driving factors, such as government\u0026rsquo;s investment in research, enhanced research capacity of Chinese scholars, and expanding international collaboration, there has been a proliferation of research publications in various global health areas.\u003csup\u003e\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn a recent paper, Kwete et al. reviewed the research capacity of global health institutions in China, focusing on several key quantitative indicators, such as scholarly publications, research grants, faculty members, course curricula, and trainees.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e Nevertheless, evidence of the progress of Chinese universities\u0026rsquo; contributions to global health research is generally limited. Evaluation of the trends in research output has been lacking. More efforts are needed to depict the progress Chinese universities have collectively made in advancing the field of global health, which is critical for identifying the strengths, weaknesses, opportunities, and challenges to future global health research in China. To this end, we conducted a bibliometric analysis to assess Chinese universities\u0026rsquo; contributions to global health and their research capacity, primarily focusing on describing the emerging trends in global health research publications for studies conducted, at least partially, outside the national borders of China, uncovering major research themes in global health, and exploring collaboration patterns. The findings of this work would help identify the progress and status of global health research among Chinese universities and advance our understanding of opportunities and challenges for Chinese scholars to conducting global health research in the future.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003eGlobal health is a versatile concept, and a consensus on a precise definition is lacking. Different scholars have proposed many definitions of global health over the past decades.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e We adopted a widely recognized working definition of global health,\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e focusing on transnational health issues, determinants, and solutions. Thus, we included research conducted in at least one country other than China.\u003c/p\u003e \u003cp\u003eStudies were included based on the following criteria: (i) original research articles published in English, (ii) published in a peer-reviewed journal in the period from January 2014 to December 2020 (the CCUGH was established in November 2013), (iii) at least one study population is not from China (including mainland China, Taiwan, Hong Kong, and Macao), (iv) the primary affiliation of first or corresponding author (including joint first or corresponding authors) is one of the ten founding members of the CCUGH; these categories are conventionally associated with the highest amount of contribution and reputation.\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e We focused on the ten founding members of the CCUGH because these institutions are the pioneers of global health research in China. The member institutions that later joined the CCUGH are still in the nascent stage of developing research capacity in global health; the time to capture their research contributions was shorter and differed from the ten founding members. We excluded meta-analyses, reviews, and studies on research methodology and non-human research.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSearch strategies and data extraction\u003c/h2\u003e \u003cp\u003eWe conducted an extensive electronic literature search on PubMed and EMBASE from January 2014 to December 2020 for articles written in English. Because global health encompasses a wide variety of thematic areas on health issues, conducting a traditional keyword search in the Title and Abstract fields was difficult to identify eligible articles. Alternatively, we adopted an affiliation-based search strategy to identify articles published by the specific college, school, department, institute, or center of global health/public health within each founding member of the CCUGH. We did not restrict the search to global health institutions because most China-based researchers conducting global health research have a primary affiliation with a public health institution. The search strategy is available in Appendix 1.\u003c/p\u003e \u003cp\u003eTwo trained abstractors (JT \u0026amp; ZL) screened the titles, abstracts, and author information for inclusion based on our criteria, followed by a detailed abstract and full-text review. Disagreements and discrepancies were resolved through discussion between two abstractors and a senior researcher of the study team (CW). JT, ZL, and CW subsequently coded eligible articles in an Excel sheet, recording information on year of publication, journal, author names and affiliations, the origin of the study population (countries and continents), article type (primary data collection vs. secondary data analysis), and research topic. We classified eligible articles according to the list of global health research topics (18 categories) established by the Fogarty International Center at the US National Institute of Health.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e Health policy and systems research was included as an additional topic because it was one of the research priorities in the CCUGH.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e We classified each eligible article into one research topic; we used the most relevant one for papers focusing on two or more topics. Any disagreement was resolved through group discussion.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eAnalytic approach\u003c/h2\u003e \u003cp\u003eThe goal of the present study was to characterize the patterns and trends in global health research among universities in China. Therefore, we presented aggregated data over all founding members of the CCUGH instead of university-specific data. We calculated the total number of articles by year of publication (2014\u0026ndash;2020), research topic, and origin of the study population (region [Asia, Africa, Europe, North America, Oceania, and South America] and country). Analyses were stratified by income level (low-income, lower-middle-income, upper-middle-income, and high-income) according to the latest classification of country income groups by the World Bank.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e Linear trend analysis was used to determine whether the number of publications changed significantly over time. In addition, we counted the number of overseas collaboration institutions (i.e., not in mainland China, Taiwan, Hong Kong, or Macao) by country; only primary affiliations were included. We classified these collaboration institutions as universities and others (including government agencies, hospitals, non-governmental organizations, or international organizations). Statistical analyses were conducted using Stata 15.0 and Microsoft Excel.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n\u003ch2\u003eYear and topic of publications\u003c/h2\u003e\n\u003cp\u003eThe search strategy retrieved 11,839 potentially relevant records from PubMed (n\u0026thinsp;=\u0026thinsp;10,077) and EMBASE (n\u0026thinsp;=\u0026thinsp;10,821) after removing duplicates. Based on the title and abstract screening, 203 papers were considered eligible; 9, 16, 14, 20, 35, 52, and 57 papers were published in 2014, 2015, 2016, 2017, 2018, 2019, and 2020, respectively (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Linear trend analysis revealed a significantly increasing trend of publications from 2014 to 2020. Figure\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e shows the number and relative frequency of these eligible publications by research topic. The number of articles was highest for NCDs (n\u0026thinsp;=\u0026thinsp;76, 37.4%), followed by maternal and child health (MCH; n\u0026thinsp;=\u0026thinsp;32, 15.5%), neurological and mental disorders and diseases (n\u0026thinsp;=\u0026thinsp;23, 11.3%), infectious disease (n\u0026thinsp;=\u0026thinsp;14, 6.9%), health systems and policy (n\u0026thinsp;=\u0026thinsp;13, 6.4%), and trauma and injury (n\u0026thinsp;=\u0026thinsp;12, 5.9%). The number of articles for the other 13 topics was no more than eight (3.9%).\u003c/p\u003e\n\u003ch2\u003eResearch type\u003c/h2\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n\u003cp\u003eThirty-four (16.7%) papers involved primary data collection, and 169 (83.3%) papers used secondary data analysis. Of 34 papers using primary data collection, 17 (50.0%), 12 (35.3%), 3 (8.8%), 1 (2.9%), and 1 (2.9%) had study populations from Asian, African, North American, European, and Oceanian countries, respectively; 6 (17.6%), 21 (61.8%), 3 (8.8%), and 4 (11.8%) involved study populations in low-income, lower-middle-income, upper-middle-income, and high-income countries, respectively (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Of 169 papers using secondary data analysis, 44 (26.0%) had study populations from countries (excluding China) of at least two continents; 29 (17.2%), 6 (3.6%), 13 (7.7%), 72 (42.6%), and 5 (3.0%) had study populations in Asia, Africa, North America, Europe, and Oceania, respectively.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eThe number of papers by region and country.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePrimary data collection\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSecondary data analysis\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGlobal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e44\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e44\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAsia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e29\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eLower-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMyanmar\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNepal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eVietnam\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBangladesh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIndia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePakistan\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTimor-Leste\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMalaysia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThailand\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eJapan\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSingapore\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAfrica\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eLow-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMalawi\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMozambique\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEritrea\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eLower-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTanzania\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eZambia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGhana\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKenya\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEurope\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13\u003csup\u003ed\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDenmark\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSweden\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIreland\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNorth America\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e72\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e75\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMexico\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUSA\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e68\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e71\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCanada\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOceania\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRepublic of Vanuatu\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAustralia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSouth America\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\"\u003e\u003csup\u003ea\u003c/sup\u003e Including research with study populations from countries (not including mainland China, Taiwan, Hong Kong, or Macao) of at least two continents.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\"\u003e\u003csup\u003eb\u003c/sup\u003e Including research with study populations from at least two countries (not including mainland China, Taiwan, Hong Kong, or Macao) in Asia.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\"\u003e\u003csup\u003ec\u003c/sup\u003e Including research with study populations from at least two countries in Africa.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\"\u003e\u003csup\u003ed\u003c/sup\u003e Including research with study populations from at least two countries in Europe.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n\u003ch2\u003eCollaboration institutions\u003c/h2\u003e\n\u003cp\u003eThe global geographical distribution of overseas collaboration institutions is displayed in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e, revealing a high concentration of institutions in coastal regions. Overall, there were 217 overseas collaboration institutions, including 154 (71.0%) universities and 63 (29.0%) government agencies, hospitals, non-governmental organizations, or international organizations (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). North America had the highest number of collaboration institutions (n\u0026thinsp;=\u0026thinsp;75, 34.6%), followed by Asia (n\u0026thinsp;=\u0026thinsp;64, 29.5%), Europe (n\u0026thinsp;=\u0026thinsp;36, 16.6%), Africa (n\u0026thinsp;=\u0026thinsp;17, 7.8%), Oceania (n\u0026thinsp;=\u0026thinsp;15, 6.9%), and South America (n\u0026thinsp;=\u0026thinsp;6, 2.8%). Four (1.8%), 36 (16.6%), 21 (9.7%), and 152 (70.0%) collaboration institutions were in low-income, lower-middle-income, upper-middle-income, and high-income countries, respectively. The number of collaboration institutions was highest in the US (n\u0026thinsp;=\u0026thinsp;62, 28.6%), followed by Japan (n\u0026thinsp;=\u0026thinsp;21, 9.7%), Australia (n\u0026thinsp;=\u0026thinsp;13, 6.0%), India and UK (n\u0026thinsp;=\u0026thinsp;11, 5.1%), and Canada (n\u0026thinsp;=\u0026thinsp;10, 4.6%).\u0026nbsp;\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eNumber of overseas collaboration institutions by country.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCountries\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eUniversities\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOthers\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eLower-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"17\" align=\"left\"\u003e\n\u003cp\u003eAsia\u003c/p\u003e\n\u003cp\u003eTotal: 64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBangladesh\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCambodia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIndia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePakistan\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eVietnam\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIran\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMyanmar\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePhilippines\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMalaysia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThailand\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eJapan\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSingapore\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSouth Korea\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSaudi Arabia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUnited Arab Emirates\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"12\" align=\"left\"\u003e\n\u003cp\u003eAfrica\u003c/p\u003e\n\u003cp\u003eTotal: 17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eLow-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMalawi\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMozambique\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eLower-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTanzania\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKenya\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEgypt\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGhana\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNigeria\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eZambia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSouth Africa\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTurkey\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"14\" align=\"left\"\u003e\n\u003cp\u003eEurope\u003c/p\u003e\n\u003cp\u003eTotal: 36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUK\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSweden\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDenmark\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNetherlands\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIreland\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFinland\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBelgium\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFrance\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGermany\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGreece\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eItaly\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNorway\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePoland\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSpain\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eNorth America\u003c/p\u003e\n\u003cp\u003eTotal: 75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMexico\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUSA\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e53\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e62\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCanada\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" align=\"left\"\u003e\n\u003cp\u003eOceania\u003c/p\u003e\n\u003cp\u003eTotal: 15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRepublic of Vanuatu\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAustralia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eUpper-middle-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eArgentina\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eSouth America\u003c/p\u003e\n\u003cp\u003eTotal: 6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eColombia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePeru\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eHigh-income\u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChile\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eOthers\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e154\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e217\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"5\"\u003e\u003csup\u003ea\u003c/sup\u003e World Health Organization was a co-author\u0026rsquo;s first affiliation for one peer-reviewed paper.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eBetween 2014 and 2020, the number of research publications in the field of global health has steadily increased since the establishment of the CCUGH. Only nine papers were published in 2014, whereas this number increased to 57 in 2020. These results were consistent with previous research showing an increasing trend in publication records for global health institutions in China.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e We noticed discrepancies in the number of publications between the two studies. This is primarily due to the differences in search strategies and inclusion criteria between the two studies. One major difference was that we only included articles whose first or corresponding authors were affiliated with eligible institutions. Our rationale is that these categories, which are conventionally associated with the highest contribution and reputation,\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e more accurately reflect the research capacity. Although the research output in global health has increased, the overall size of the research output and the volume of research activity is much smaller than that of public health and many other disciplines.\u003csup\u003e\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e Previous literature has documented several challenges and barriers hindering the development of global health, such as shortage of funding opportunities, lack of societal and policy support, and insufficient global experience.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e More efforts are needed to create a nurturing, collaborative environment for global health research to keep up the pace of China\u0026rsquo;s ambition to become a responsible and strong leader in global health.\u003c/p\u003e \u003cp\u003eWe found imbalanced development in global health research areas among Chinese universities. Of 19 research topics considered, NCDs were the most popular, accounting for over one-third of total publications. MCH and neurological and mental disorders and diseases were the second and third popular topics, accounting for 15.5% and 11.3% of all publications, respectively. A sizeable portion of publications also focused on infectious disease, health system and policy, and trauma and injury. However, the other two-thirds of the topics were under-researched, with fewer than 10 publications. We propose several plausible explanations for the predominant focus on NCDs research. First, China has experienced an epidemiological transition from infectious diseases to NCDs over a short period.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e Deaths from infectious diseases have decreased by over 70% since 1990 in China, whereas the burden of NCDs has increased dramatically, accounting for nearly 90% of all deaths in recent years.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e Prevention and control of NCDs and their modifiable risk factors have become one of the formidable challenges facing the healthcare system. The need to address NCDs through research is enormous. Second, NCDs and their risk factors are widely available in publicly accessible databases. Massive amount of NCDs data has been collected in a wide variety of research activities, including surveys, surveillance, and registries; many of these data sources are easily accessible electronically. For example, seven papers used data from the National Health and Nutrition Examination Survey to conduct epidemiological research on NCDs.\u003csup\u003e\u003cspan additionalcitationids=\"CR24 CR25 CR26 CR27 CR28\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e While NCDs are one of many health challenges globally, more efforts are needed to diversify the global health research portfolios among global health institutions in China. As China has been increasingly becoming an aid donor and resource provider instead of an aid and funding recipient,\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e strengthening research capacity in other global health areas is a critical step for China to broaden the scope and deepen the level of its global health engagement.\u003c/p\u003e \u003cp\u003eGlobal health research is versatile in methodology. The collection of primary data from the research field and secondary data analysis are the two most used approaches in original investigations. Of the 203 papers included, over 80% analyzed existing data, while\u0026thinsp;\u0026lt;\u0026thinsp;20% involved primary data collection. Increasing access to and sharing health data is one driving force behind this phenomenon. On the other hand, researchers in China are hindered by the system, financial, and personal barriers to implementing field-based research with primary data collection oversea.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e Compared to secondary data analyses, researchers are more likely to gain a deeper understanding of the research questions, design, procedures, and participants from field-based research. Field-based research provides an excellent opportunity to design and implement geopolitically and culturally relevant projects to tackle transnational health issues in real-world settings. The limited availability of funding sources is another challenge to conducting global health research outside of China. Most of the funding for global health research conducted outside of China comes from private foundations and bilateral agencies, with China Medical Board and the UK Department for International Development being the two major contributors. \u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e 31\u003c/sup\u003e It is necessary for China\u0026rsquo;s government funding agencies, such as the National Natural Science Foundation of China, to launch new funding mechanisms dedicated to global health research.\u003c/p\u003e \u003cp\u003eThe importance of international collaborations to global health research cannot be overestimated. In this study, we found that scholars in Chinese global health institutions have collaborated with over 200 overseas institutions (i.e., primary affiliations of co-authors); a solid collaboration research network has been established. We noticed that these collaboration institutions were not evenly distributed globally, with over one-third and nearly 30% in North America and Asia, respectively. Country-specific results showed that the US had the highest number of collaboration institutions (n\u0026thinsp;=\u0026thinsp;62; 28.6%). Collaborators from these US institutions mainly served as co-authors on papers analyzing secondary data. The size of research collaboration with institutions in low- and middle-income countries (LMICs) is relatively small, especially in Africa. These results suggest that profound political and economic relations with African countries do not naturally help identify research partners or establish research collaborations. Trilateral and multilateral platforms that expand from an existing collaboration between institutions in China and high-income countries to include other LMICs particularly African countries, are one feasible solution to overcome barriers to nurturing collaborations.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eWe acknowledge several limitations. First, our bibliometric analyses only considered articles written in English. Although most Chinese researchers prefer writing research articles in China, they mainly submit scholarly work to English-language journals primarily due to the pressure from the institutional academic evaluation system.\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e Second, authorship order and affiliation are imperfect measures of research capacity. However, the academic evaluation system in China has a long tradition of valuing primary affiliation and first/corresponding author of research publications. We, therefore, adopted a stringent criterion for selecting articles based on first/corresponding author to reflect the research contribution and capacity more accurately. Third, this study is by no means a thorough investigation of Chinese universities' research capacity in the global health field. We only considered articles published by ten founding members of the CCUGH. We might miss important trends in research conducted outside universities and emerging global health research institutions. Nevertheless, the ten founding members are the pioneers and leaders of global health research in China. They likely represent the general trends in global health research in China. Fourth, we did not include studies conducted entirely in China, which, strictly speaking, are also part of global health research. Our goal is to understand the trend and patterns of Chinese universities\u0026rsquo; contributions to global health research (outside of China).\u003c/p\u003e \u003cp\u003eIn summary, Chinese universities have been playing an increasingly important role in global health research as assessed by peer-reviewed publications from 2014 to 2020 of original international research studies of the ten founding members of CCUGH. We also identified important gaps in current trends. More work is needed to diversify the global health research portfolios, promote investment in field-based research, and strengthen research collaborations with institutions in LMICs. Our study, although not exhaustive, provides a practical basis for planning and evaluating priority areas in global health research for Chinese universities. More concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate: This study does not involve human participants and ethical approval was not required.\u003c/p\u003e\n\u003cp\u003eConsent for publication: All authors have agreed to send this manuscript for publication.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials: Data are extracted from open access research databases. Summary data are available upon request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCompeting interests: Not applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFunding: Not applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions: CW conducted the data analysis, interpreted the study findings, and drafted the manuscript. LLY, QL, and YL contributed to interpretation of research findings and manuscript revision. JT and ZL conducted the literature review and data extraction. ST conceived of the research topic and contributed to interpretation of research findings and manuscript revision.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAcknowledgements: Not applicable.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLiu P, Guo Y, Qian X, et al. China's distinctive engagement in global health. Lancet. 2014;384(9945):793\u0026ndash;804. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/S0140-6736(14)60725-X\u003c/span\u003e\u003cspan address=\"10.1016/S0140-6736(14)60725-X\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChan LH, Chen L, Xu J. China's engagement with global health diplomacy: was SARS a watershed? PLoS Med. 2010;7(4):e1000266. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pmed.1000266\u003c/span\u003e\u003cspan address=\"10.1371/journal.pmed.1000266\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20100427].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChina SCIOotPsRo. China\u0026rsquo;s International Development Cooperation in the New Era: The State Council Information Office of the People\u0026rsquo;s Republic of China Beijing, 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen L, Yang M. New opportunities for China in global health. Lancet Glob Health. 2018;6(7):e722-e23. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/s2214-109x(18)30263-8\u003c/span\u003e\u003cspan address=\"10.1016/s2214-109x(18)30263-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuo Y. Development of global health research in China. J Glob Health. 2017;7(2):020102. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7189/jogh.07.020102\u003c/span\u003e\u003cspan address=\"10.7189/jogh.07.020102\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSun L, Zhao D, Xiong S, et al. Disciplinary development of global health academic degree programs in China. Global Health Journal. 2021;5(2):102\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSweileh WM, AbuTaha AS, Sawalha AF, et al. Bibliometric analysis of worldwide publications on multi-, extensively, and totally drug - resistant tuberculosis (2006\u0026ndash;2015). Multidiscip Respir Med. 2016;11:45. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s40248-016-0081-0\u003c/span\u003e\u003cspan address=\"10.1186/s40248-016-0081-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20170111].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBai J, Li W, Huang YM, et al. Bibliometric study of research and development for neglected diseases in the BRICS. Infect Dis Poverty. 2016;5(1):89. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s40249-016-0182-1\u003c/span\u003e\u003cspan address=\"10.1186/s40249-016-0182-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20160906].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu P, Mu X, Hao X, et al. China's scientific footprint in the global HIV/AIDS research: Productivity, impact and collaboration. Malaysian J Libr Inform Sci. 2016;21(1):83\u0026ndash;108.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKwete X, Tang K, Cheng F, et al. Research capacity of global health institutions in China: a gap analysis focusing on their collaboration with other low-income and middle-income countries. BMJ Glob Health 2021;6(7) doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjgh-2021-005607\u003c/span\u003e\u003cspan address=\"10.1136/bmjgh-2021-005607\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSalm M, Ali M, Minihane M, et al. Defining global health: findings from a systematic review and thematic analysis of the literature. BMJ Glob Health 2021;6(6) doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjgh-2021-005292\u003c/span\u003e\u003cspan address=\"10.1136/bmjgh-2021-005292\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKoplan JP, Bond TC, Merson MH, et al. Towards a common definition of global health. The Lancet. 2009;373(9679):1993\u0026ndash;95.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBendels MHK, Muller R, Brueggmann D, et al. Gender disparities in high-quality research revealed by Nature Index journals. PLoS ONE. 2018;13(1):e0189136. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0189136\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0189136\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20180102].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCenter FI. Global Health Research Topics 2021 [Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.fic.nih.gov/researchtopics\u003c/span\u003e\u003cspan address=\"https://www.fic.nih.gov/researchtopics\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e accessed 09/20 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBank W. World Bank Country and Lending Groups 2021 [Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups\u003c/span\u003e\u003cspan address=\"https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e accessed 09/20 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee L. The current state of public health in China. Annu Rev Public Health. 2004;25:327\u0026ndash;39. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1146/annurev.publhealth.25.101802.123116\u003c/span\u003e\u003cspan address=\"10.1146/annurev.publhealth.25.101802.123116\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTollefson J. China declared world's largest producer of scientific articles. Nature. 2018;553(7689):390. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/d41586-018-00927-4\u003c/span\u003e\u003cspan address=\"10.1038/d41586-018-00927-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi H, He Q. Public health research in China: some recent findings and implications. \u003cem\u003eAsia Pac J Public Health\u003c/em\u003e 2015;27(2 Suppl):4s-6s. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/1010539515575239\u003c/span\u003e\u003cspan address=\"10.1177/1010539515575239\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20150225].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu DR, Cheng F, Chen Y, et al. Harnessing China's universities for global health. Lancet. 2016;388(10054):1860\u0026ndash;62. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/s0140-6736(16)31839-6\u003c/span\u003e\u003cspan address=\"10.1016/s0140-6736(16)31839-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTuangratananon T, Tang K, Suphanchaimat R, et al. China: leapfrogging to become a leader in global health? J Glob Health. 2019;9(1):010312. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7189/jogh.09.010312\u003c/span\u003e\u003cspan address=\"10.7189/jogh.09.010312\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang G, Kong L, Zhao W, et al. Emergence of chronic non-communicable diseases in China. Lancet. 2008;372(9650):1697\u0026ndash;705. doi: 10.1016/S0140-6736(08)61366-5 [published Online First: 20081017].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhou M, Wang H, Zhu J, et al. Cause-specific mortality for 240 causes in China during 1990\u0026ndash;2013: a systematic subnational analysis for the Global Burden of Disease Study 2013. Lancet. 2016;387(10015):251\u0026ndash;72. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/s0140-6736(15)00551-6\u003c/span\u003e\u003cspan address=\"10.1016/s0140-6736(15)00551-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20151026].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi Y, Meng L, Li Y, et al. Depression-related differences in lean body mass distribution from National Health and Nutrition Examination Survey 2005\u0026ndash;2006. J Affect Disord. 2014;157:1\u0026ndash;7. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jad.2013.12.040\u003c/span\u003e\u003cspan address=\"10.1016/j.jad.2013.12.040\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20140108].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeng X, Xia J, Zeng X, et al. Prevalence and Associated Factors of Lupus in the United States: Third National Health and Nutritional Examination Survey (NHANES III). Front Med (Lausanne). 2020;7:213. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fmed.2020.00213\u003c/span\u003e\u003cspan address=\"10.3389/fmed.2020.00213\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20200527].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDong B, Peng Y, Wang Z, et al. Joint association between body fat and its distribution with all-cause mortality: A data linkage cohort study based on NHANES (1988\u0026ndash;2011). PLoS ONE. 2018;13(2):e0193368. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0193368\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0193368\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20180223].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuo J, Huang Y, Bian S, et al. Associations of urinary polycyclic aromatic hydrocarbons with bone mass density and osteoporosis in U.S. adults, NHANES 2005\u0026ndash;2010. Environ Pollut. 2018;240:209\u0026ndash;18. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.envpol.2018.04.108\u003c/span\u003e\u003cspan address=\"10.1016/j.envpol.2018.04.108\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20180505].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCao C, Hu L, Xu T, et al. Prevalence, correlates and misperception of depression symptoms in the United States, NHANES 2015\u0026ndash;2018. J Affect Disord. 2020;269:51\u0026ndash;7. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jad.2020.03.031\u003c/span\u003e\u003cspan address=\"10.1016/j.jad.2020.03.031\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20200314].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuo J, Wu C, Zhang J, et al. Associations of melamine and cyanuric acid exposure with markers of kidney function in adults: Results from NHANES 2003\u0026ndash;2004. Environ Int. 2020;141:105815. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.envint.2020.105815\u003c/span\u003e\u003cspan address=\"10.1016/j.envint.2020.105815\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20200529].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi JB, Wu Y, Gu D, et al. Prevalence and temporal trends of presarcopenia metrics and related body composition measurements from the 1999 to 2006 NHANES. BMJ Open. 2020;10(8):e034495. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjopen-2019-034495\u003c/span\u003e\u003cspan address=\"10.1136/bmjopen-2019-034495\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20200805].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBank W. Data: net official development assistance and official aid received (current US\u003cspan\u003e$\u003c/span\u003e). 2022 [Available from: \u003cspan class=\"ExternalRef\"\u003e \u003cspan class=\"RefSource\"\u003ehttp://data.worldbank.org/indicator/DT.ODA.ALLD.CD\u003c/span\u003e \u003cspan address=\"http://data.worldbank.org/indicator/DT.ODA.ALLD.CD\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e \u003c/span\u003e accessed 09/20 2022.\u003c/span\u003e \u003c/li\u003e \u003cli\u003e\u003cspan\u003eHusain L, Bloom G, McPherson S. The China-UK Global Health Support Programme: looking for new roles and partnerships in changing times. Glob Health Res Policy. 2020;5:26. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s41256-020-00156-1\u003c/span\u003e\u003cspan address=\"10.1186/s41256-020-00156-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e [published Online First: 20200603].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSalager-Meyer F. Writing and publishing in peripheral scholarly journals: How to enhance the global influence of multilingual scholars? J Engl Acad Purp. 2014;13:78\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"global-health-research-and-policy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ghrp","sideBox":"Learn more about [Global Health Research and Policy](http://ghrp.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/GHRP/default.aspx","title":"Global Health Research and Policy","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"China, global health, health governance, non-communicable disease, maternal and child health. ","lastPublishedDoi":"10.21203/rs.3.rs-2267301/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2267301/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e We have witnessed considerable progress in developing global health education and research in China. Nevertheless, evidence of the progress of Chinese universities’ contributions to global health research is limited. More efforts are needed to depict the progress Chinese universities have collectively made in advancing the field of global health. This study aimed to examine Chinese universities’ collective contributions to global health research by describing the longitudinal trends in global health research publications, uncovering research themes in global health, and exploring collaboration patterns.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA comprehensive bibliometric analysis was conducted for original research studies of the ten founding members of the China Consortium of Universities for Global Health, one of the largest networks of global health research and education in China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e We found that (1) the number of research publications in the field of global health has steadily increased from 2014 to 2020, (2) non-communicable disease was the most popular research topic, accounting for over one-third of total publications, followed by maternal and child health and neurological and mental disorders and diseases, (3) less than one-fifth of papers involved primary data collection, with the majority of the study populations from low-income and lower-middle-income countries in Asia and Africa, and (4) a sizable collaboration network has been established with co-authors from over 200 oversea universities or organizations, with about one third from the US.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e More concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China.\u003c/p\u003e","manuscriptTitle":"Trends in Global Health Research among Universities in China: A Bibliometric Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-11-17 20:02:02","doi":"10.21203/rs.3.rs-2267301/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2022-11-15T08:07:14+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2022-11-15T07:57:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2022-11-15T04:49:05+00:00","index":"","fulltext":""},{"type":"submitted","content":"Global Health Research and Policy","date":"2022-11-14T07:37:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"global-health-research-and-policy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ghrp","sideBox":"Learn more about [Global Health Research and Policy](http://ghrp.biomedcentral.com)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/GHRP/default.aspx","title":"Global Health Research and Policy","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0a4ad4dc-c083-4566-bc53-bca18b92deba","owner":[],"postedDate":"November 17th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-10-16T20:27:06+00:00","versionOfRecord":{"articleIdentity":"rs-2267301","link":"https://doi.org/10.1186/s41256-023-00295-1","journal":{"identity":"global-health-research-and-policy","isVorOnly":false,"title":"Global Health Research and Policy"},"publishedOn":"2023-04-06 20:23:00","publishedOnDateReadable":"April 6th, 2023"},"versionCreatedAt":"2022-11-17 20:02:02","video":"","vorDoi":"10.1186/s41256-023-00295-1","vorDoiUrl":"https://doi.org/10.1186/s41256-023-00295-1","workflowStages":[]},"version":"v1","identity":"rs-2267301","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2267301","identity":"rs-2267301","version":["v1"]},"buildId":"GqpaHPwrfC8PjnIFayRh5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}