A preprogram appraisal of factors influencing research productivity among faculty at college of medicine, University of Lagos.

Background: A defining feature of any university is its dedication to scholarly activities, leading to the generation of knowledge and ideas Research productivity is a measure of achievement of a scholar. The number of research publications in peer-reviewed journals is an important criterion for assessing productivity and prestige in the academia. Aims and
Objectives: This cross-sectional descriptive study assessed the level of research productivity (RP) among junior faculty at the College of Medicine, University of Lagos, and investigated factors affecting their research output prior to the implementation of a 5-year training grant funded by the National Institutes of Health.
Methods: Seventy junior faculty members attended a pre-program training, and the self-reported number of peer-reviewed publications (PRPs) was used as an indicator. Intrinsic and extrinsic factors influencing RP among the attendees were assessed and ranked.
Results: The majority (42/70, 60%) of the respondents had <10 PRPs. The median (interquartile range) number of PRPs was 7 (3-18). A desire for the development of their personal skills, contribution to society, and personal research interests topped the list of intrinsic factors influencing RP. Work flexibility, research autonomy, and scholarly pursuits were the bottom three. A desire for promotion, respect from peers, and increased social standing were the top three extrinsic factors, while monetary incentives, employment opportunities, and the need to attend conferences were the lowest three. The top barriers to RP were lack of resources and lack of mentoring. Perceived older age, lack of time, and motivation were the lowest three barriers. Older age and professional cadre were associated with increased RP (P < 0.05).
Conclusion: Among the participants, research output appears to be motivated primarily by a desire for personal development,promotion, and respect from peers. Lack of access to resources was the main barrier to increased RP. These factors may need to be considered when developing programs designed to promote RP.

INTRODUCTION

Research is the core mission of academic medicine.[1] Greater research productivity (RP) is associated with better clinical care, enhanced research opportunities, appointments, promotions, and greater researcher prestige in the field.[23] Furthermore, RP has the potential to affect teaching and student quality and contributes to genuine indigenous and sustainable development.[23] Research plays a major role in institutional rankings.[4] Universities all over the world therefore impart a significant emphasis on promoting RP among faculty.

RP is low among faculty in low- and middle-income countries (LMIC) compared to their counterparts in high-income countries (HIC). A gross mismatch exists between research output and disease burden, as LMICs bear a disproportionately higher burden of disease.[5] The 1990 Commission on Health Research for Development stated that strengthening research capacity in LMICs is “one of the most powerful, cost-effective, and sustainable means of advancing health and development.”[6] Nevertheless, at the turn of the millennium, LMICs accounted for 85% of the world’s population, 92% of the global disease burden, but only 10% of global funding for health research.[7] Recognition of this gap led to renewed calls for the development of increased health RP in LMICs.[8] This in turn led to increasing international collaborations and stronger foreign support and investments in the research capacity of LMIC.[89]

The intrinsic and extrinsic factors influencing RP among faculty in resource-limited settings remain unclear. Assessing RP and the factors that influence it may provide institutional administrators with pertinent information useful for developing and designing programs that enhance the research culture and promote RP among their faculty.

In 2015, the National Institutes of Health, United States of America (USA), funded a 5-year project Building Research and Innovation in Nigeria’s Science (BRAINS), designed to build research capacity and promote RP among academic staff of the College of Medicine of the University of Lagos.(CMUL). This study set out to assess the preprogram levels of RP among junior academic staff at the CMUL prior to the implementation of the project and determine the intrinsic and extrinsic factors influencing their RP with a view to incorporating the findings in the implementation of programs and policies to enhance RP at the CMUL.

METHODS

Study setting, design, and population

The CMUL is located in Idi-Araba in Lagos State, Nigeria. The CMUL has three faculties consisting of 32 departments with 212 junior faculty members as of August 2016. A junior faculty member was defined as full-time faculty at the rank of senior lecturer and below. A cross-sectional descriptive study was conducted among full-time eligible and consenting faculty members. Visiting scholars were excluded from the study. A preimplementation training program was conducted prior to the initiation of the 5-year BRAINS project.

Data collection tools and techniques

A structured questionnaire was designed to elicit information on RP and the self-reported intrinsic and extrinsic factors influencing it. The tool was administered in-person to participants who attended the training prior to the implementation of the BRAINS project. Attempts were made to reach eligible junior faculty who did not opt to attend the training by sending an electronic link of the same survey to their e-mail addresses.

Study measures and data analysis

RP was measured by asking respondents to list their individual total number of peer-reviewed publications (PRPs). We assessed intrinsic and extrinsic factors influencing RP by asking respondents how strongly they agreed or disagreed that a given factor motivated their RP with responses on a 5-point Likert scale.[8] Barriers to RP were assessed in the same manner. Data were cleaned, entered, and analyzed using SPSS® version 17.0 (SPSS Inc., Chicago, USA). The number of PRPs was skewed and therefore presented as medians and interquartile ranges (IQRs). RP was graded as high if the number of PRPs was above the median and as low if equal to or below the median. A bivariate analysis was conducted to determine the factors associated with good RP among the respondents. P < 0.05 was considered statistically significant. Intrinsic and extrinsic factors influencing RP were scored and summed up. The factors with the top three scores were considered to be the strongest motivators of high RP among the respondents. Similar analyses were conducted for the barriers to RP. Participation in the study was voluntary, and the information obtained was treated with confidentiality. Faculty were free to decline to participate without penalty.

RESULTS

Sociodemographic characteristics

Of the 70 respondents who participated in the survey, the majority, 65/70 (92.9%), were <50 years of age; there were slightly more males (37/70, [52.9%]) and almost three-quarters (51/70, [72.9%]) had either a postgraduate doctorate or fellowship as their highest level of educational qualification [Table 1].

Table 1

Sociodemographic and work-related characteristics

Variable (n=70)	Frequency (%)
Age group
30-39	28 (40.0)
40-49	37 (52.9)
50-59	5 (7.1)
Gender
Male	37 (52.9)
Female	33 (47.1)
Highest qualification
Masters qualification	19 (27.1)
Doctorate/fellowship	51 (72.9)
Current professional cadre
Assistant lecturer	15 (21.4)
Lecturer II	12 (17.1)
Lecturer I	27 (38.6)
Senior lecturer	16 (22.9)
Has administrative responsibilities
Yes	42 (60.0)
No	28 (40.0)

Research and publication history

The median (IQR) number of total PRPs was 7 (3–18). The median (IQR) number of first author PRPs was 2 (1–6). The majority of the respondents 42/70 (60.0%) had <10 PRPs. Almost a quarter (17/70, [23.9%]) did not have any PRPs in an international journal [Table 2].

Table 2

Publication history

Variable (n=70)	Frequency (%)
Total number of publications
None	2 (2.9)
1-9	40 (57.1)
10-19	13 (18.7)
20-29	9 (12.8)
30-39	6 (8.5)
Mean (SD)	11.1 (10.9)
Median (IQR)	7 (3-18)
Number of first-author publications
None	11 (15.7)
1-5	38 (54.3)
6-10	15 (21.4)
>10	6 (8.6)
Mean (SD)	3.9 (4.6)
Median (IQR)	2 (1-6)
Number of publications in Nigerian journals
None	10 (14.3)
1-5	35 (50.0)
6-10	17 (23.8)
>10	8 (11.3)
Mean (SD)	5.0 (5.1)
Median (IQR)	3 (2-7)
Publications in international journals
None	17 (23.9)
1-5	30 (42.3)
6-10	13 (18.3)
>10	10 (14.1)
Mean (SD)	3 (0.5-10)
Median (IQR)	1 (0-3)

SD=Standard deviation, IQR=Interquartile range

Factors associated with research productivity

A desire for the development of their own personal skills (72.9% strongly agreed), a contribution to society (68.6% strongly agreed), and personal research interests (62.0% strongly agreed) topped the list as the intrinsic factors that influenced RP among the respondents. Work flexibility (10.0% strongly agreed), research autonomy (18.6% strongly agreed), and the desire for scholarly pursuits (41.4% strongly agreed) were the lowest three factors [Table 3]. A desire for promotion (72.8% strongly agreed/agreed), peer recognition (61.4% strongly agreed/ agreed), and increased social status (47.2% strongly agreed/ agreed) were the top three extrinsic factors that influenced RP, while monetary incentives (14.3% strongly agreed/agreed), employment opportunities (12.9% strongly agreed/agreed), and the need to attend conferences (30.0% strongly agreed/ agreed) were the lowest three extrinsic factors [Table 4]. The top barriers to research were a lack of resources (financial and nonfinancial; [57.1% and 32.9% strongly agreed, respectively]) and a lack of mentoring (42.9% strongly agreed). Older age (0% strongly agreed), a lack of time (0% strongly agreed), and a lack of inner motivation (2.9% strongly agreed) were the bottom three perceived barriers [Table 5]. Increasing age and professional cadre were associated with increased RP (P < 0.01) [Table 6]. After controlling for gender, professional cadre, level of education, and having additional administrative responsibilities, a multiple linear regression analysis showed that faculty aged 40–49 years were 6.4 times more likely to have higher RP compared with those younger than 40 years (adjusted odds ratio: 6.415, 95% confidence interval- 1.79–23.01, P < 0.01) [Table 7].

Table 3

Intrinsic factors motivating research productivity

Intrinsic factor (n=70)	Frequency (%)					Total score
	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
Development of personal skills	1 (1.4)	2 (2.9)	0 (0.0)	16 (22.9)	51 (72.9)	324
Contribution to society	1 (1.4)	0 (0.0)	1 (1.4)	20 (28.6)	48 (68.6)	324
Personal interest	1 (1.4)	0 (0.0)	2 (2.9)	27 (32.4)	40 (62.0)	319
Personal responsibility	1 (1.4)	0 (0.0)	2 (2.9)	27 (38.6)	40 (57.1)	319
Contribution to knowledge	0 (0.0)	1 (1.4)	5 (7.1)	24 (34.3)	40 (57.1)	313
Personal enjoyment	0 (0.0)	1 (1.4)	4 (5.7)	30 (42.9)	35 (50.0)	309
Inner sense of achievement	1 (1.4)	1 (1.4)	3 (4.3)	39 (55.7)	26 (37.1)	298
Complexity of research	0 (0.0)	2 (2.9)	9 (12.9)	30 (42.9)	29 (41.4)	296
Desire for scholarly pursuits	1 (1.4)	3 (4.3)	4 (5.7)	33 (47.1)	29 (41.4)	296
Autonomy of research	1 (1.4)	3 (4.3)	19 (27.1)	34 (48.6)	13 (18.6)	265
Work flexibility	4 (5.7)	9 (12.9)	28 (38.6)	23 (32.9)	7 (10.0)	231

Table 4

Extrinsic factors motivating research productivity

Extrinsic factor	Frequency (%)					Total score
	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
Desire for promotion	6 (8.6)	7 (10.0)	6 (8.6)	43 (61.4)	8 (11.4)	250
Peer recognition	6 (8.6)	10 (14.3)	11 (15.7)	33 (47.1)	10 (14.3)	241
Increased social status	8 (11.4)	17 (24.3)	12 (17.1)	27 (38.6)	6 (8.6)	216
Respect/admiration from students	11 (15.7)	16 (22.9)	8 (11.4)	29 (41.4)	6 (8.6)	213
Desire for awards	10 (14.3)	16 (22.9)	13 (18.6)	23 (32.9)	8 (11.4)	213
Conference attendance	13 (18.6)	24 (34.3)	12 (17.1)	18 (25.7)	3 (4.3)	184
Improved employment opportunities	21 (30.0)	28 (40.0)	12 (17.1)	6 (8.6)	3 (4.3)	152
Monetary incentives	26 (37.1)	28 (40.0)	6 (8.6)	9 (12.9)	1 (1.4)	137

Table 5

Perceived barriers to research productivity

Variable	Frequency (%)					Total score
	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
Lack of personal funds	6 (8.6)	1 (1.4)	6 (8.6)	17 (24.3)	40 (57.1)	294
Lack of adequate mentoring	3 (4.3)	6 (8.6)	16 (22.9)	15 (21.4)	30 (42.9)	283
Lack of nonfinancial resources	2 (2.9)	9 (12.9)	10 (14.3)	26 (37.1)	23 (32.9)	269
Lack of university funds	2 (2.9)	7 (10.0)	18 (25.7)	21 (30.0)	22 (31.4)	263
Poor organizational research culture	4 (5.7)	5 (7.1)	16 (22.9)	35 (50.0)	10 (14.3)	252
Lack of research skills	9 (12.9)	17 (24.3)	11 (15.7)	23 (32.9)	10 (14.3)	218
Heavy teaching load	12 (17.1)	26 (37.1)	15 (21.4)	12 (17.1)	5 (7.1)	182
Family responsibilities	11 (15.7)	30 (42.9)	11 (15.7)	15 (21.4)	3 (4.3)	179
Lack of social skills	29 (41.4)	24 (34.3)	10 (14.3)	7 (10.0)	0 (0.0)	135
Lack of inner motivation	38 (54.3)	25 (35.7)	3 (4.3)	2 (2.9)	2 (2.9)	115
The time-consuming nature of research	37 (52.9)	27 (38.6)	5 (7.1)	1 (1.4)	0 (0.0)	110
Perceived older age	41 (58.6)	22 (31.4)	7 (10.0)	0 (0.0)	0 (0.0)	106

Table 6

Factors associated with research productivity

Variable	Research productivity		Total	χ2/P
	Low	High
Age group
30-39	22 (78.6)	6 (21.4)	28 (100.0)	Fisher’s exact P<0.001
40-49	12 (32.4)	25 (67.6)	37 (100.0)
50-59	2 (40.0)	3 (60.0)	5 (100.0)
Gender
Male	21 (56.8)	16 (43.2)	37 (100.0)	χ2=0.892, P=0.345
Female	15 (45.5)	18 (54.5)	33 (100.0)
Highest qualification
Masters or less	15 (78.9)	4 (21.0)	19 (100.0)	χ2=7.906, P=0.005
Doctorate/fellowship	21 (41.2)	30 (58.8)	51 (100.0)
Current professional cadre
Lecturer II or lower	18 (66.7)	9 (33.3)	27 (100.0)	χ2=4.086, P=0.043
Lecturer I and above	18 (41.9)	25 (58.1)	43 (100.0)
Administrative responsibilities
Yes	20 (47.6)	22 (52.4)	42 (100.0)	χ2=0.610, P=0.435
No	16 (57.1)	12 (42.9)	28 (100.0)

Table 7

A multivariate analysis of the factors associated with research productivity among researchers at College of Medicine, University of Lagos

Variable	AOR	95% CI	P
Age group (years)
<40*	1
40-50	6.415	1.788-23.009	0.004
>50	5.427	0.562-49.006	0.146
Gender
Male*	1
Female	1.276	0.373-4.363	0.697
Highest educational qualification
Masters or less*	1
Doctorate/fellowship	3.795	0.620-23.213	0.149
Current professional cadre
Lecturer II or lower*	1
Lecturer I and above	1.353	0.285-6.431	0.704
Has administrative responsibilities
No*	1
Yes	1.577	0.511-4.861	0.428

*Reference category. AOR=Adjusted odds ratio, CI=Confidence interval

DISCUSSION

Career advancement is traditionally dependent on a faculty member’s RP, which may be evaluated using their self-reported number of PRPs. This study suggests that research output among researchers at the CMUL as measured by the number of PRPs may be low. Similar studies in Nigeria and other parts of Africa have reported similar levels of RP and are at variance with the research output of academic faculty in HIC who produce more than 97% of the worlds’ research output.[10111213] For instance, a study among faculty at the Makerere University College of Health Sciences, Uganda, reported a PRP per capita of 2.1.[13] These findings have important implications for policy and planning as they highlight the need for university management to intensify efforts to improve RP and output among the researchers at CMUL and other institutions in LMIC in Africa. The mean number of publications among surgical residents in the USA prior to the start of an academic career was 5.3.[14] Studies among residents in the USA report figures similar to researchers who hold full-time academic positions at the CMUL.[141516]

The belief that research contributes to societal development and the desire to develop personal research knowledge and skills top the list of intrinsic factors motivating research among this sample of researchers. This is similar to findings among Chinese researchers who were also intrinsically motivated by personal interest, scholarly improvements, and contribution to society.[8] Personal career development was also the main factor driving RP among researchers in Kenya and university librarians in Nigeria.[1718] Researchers in this study seem highly motivated to conduct research in this environment.

In this study, monetary incentives were very low on the list of extrinsic motivators. Financial rewards were also rated low as an extrinsic motivator for research among Chinese researchers.[8] However, a similar study among dental researchers in the USA cited financial remuneration as a key factor motivating research.[19] This seems quite surprising as researchers in LMIC like Nigeria and China may be receive comparatively lower incomes than their HIC counterparts.

As noted in this study, lack of access to financial and nonfinancial resources for research is a significant barrier to RP. An investigative study of RP among academic faculty in Nigerian federal universities also cited funding as a main challenge.[20] Advances in medical research improve health, save live, promote economic growth, and spur innovation. Medical research is however only possible because of investments by governments, industry, foundations, and academic institutions.[21] Available data show that Nigeria spends only 0.2% of its gross domestic product on research and development.[22] For Nigeria to remain competitive and increase involvement in the global debates on health-care policy, a national commitment to research funding is critical.

Several studies have lamented on the lack of female researchers in medical research and gender disparities in research and publications in favor of men.[232425] We however observed no gender differences in the research output of this sample of researchers at the CMUL, nor did family life seems to be a major barrier for either female or male researchers in this environment.

This study has some limitations, so its findings need to be interpreted with caution. First, RP, often determined by the number of PRPs, is a simple and well-known measure that may be used to evaluate research output.[262728] PRPs as tangible outputs of research in professional journals are central to scholarly activity and recognition; however, simply counting the number of publications reveals little about the relevance of scholarship or the impact of an individual’s research contributions on a field.[29] However, it does represent one of the simplest and straightforward measures of RP, particularly in resource-limited settings, and was used in this study.[2728] Furthermore, PRPs in this study, along with the intrinsic and extrinsic factors and barriers, were assessed by self-report, and may be subject to responder bias.

Second, only a small percentage of the junior faculty at the CMUL opted to attend the training and successfully completed the surveys. The response to the electronic survey was very poor. This low response rate may signify a lack of interest in attending this type of training or in completing such surveys or a general lack of research interest among the study population. This may affect the external validity of our findings. It also signifies that we may not have captured the barriers to RP among a large proportion of possibly under-motivated and/or time constrained researchers at the CMUL.

Finally, the cross-sectional nature of the study does not allow for causal inferences, and the findings are from only one institution and may not be generalizable to other institutions within Nigeria. Nevertheless, this is one of the first few studies to assess RP among a sample of researchers at the CMUL within the past decade. It was conducted prior to the implementation of the BRAINS project, and its findings serve as a useful baseline measure of RP among the target population.

CONCLUSIONS AND RECOMMENDATIONS

A desire for personal development, the need for promotion, and respect from peers were the primary motivators for research output among this sample of junior researchers. Lack of access to resources was the main barrier to increased RP. These factors may need to be considered in the development of programs designed to promote RP. A research environment that encourages publications in internationally relevant journals should be encouraged. Programs that provide an early start to academic publication and mentoring right from the undergraduate and early postgraduate years may need to be prioritized.

Financial support and sponsorship

The research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health under Award Number 1D43TW010134-01. The effort of OOO is supported by the Fogarty International Center of the award number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflicts of interest

There are no conflicts of interest.