By Nuzulul Kusuma Putri, Assistant Professor, Health Policy and Administration Department, Universitas Airlangga, Indonesia and Editor-in-chief, The Indonesian Journal of Health Administration
On 9 November, I attended a session at Phase One of the Sixth Global Symposium on Health Systems Research (HSR2020) titled ‘Meet the Editors 2020: Exploring conflict of interest in academic publishing of health systems research’. As an early career researcher who is also learning to manage a scientific journal, I was mesmerized hearing the top-tier journal editors discuss the possible conflicts of interest in academic publishing of health systems research. The session was excellent, with strong opinions of potential conflicts of interest in the health policy and system research (HPSR) publication. However, let me share my reflections on how these conflicts of interest are worsened during the academic global ranking competition.
Global ranking competition and academic publishing
Global ranking in academia has impacted many dimensions of academic publishing. Though not specifically in healthcare system research, the number of published articles from Asian researchers is growing. In the early 2010s, many publishers such as Elsevier and Nature reported a consistent rise in the number of papers from Asia, making the region a new giant research community. Asian countries such as China, India, Japan, South Korea, and Taiwan have significantly improved their higher education quality and research quality. A study on the growing interest of publication in Asia revealed that this impressive growth happened as publication is highly sought after by Asian universities in their mission to become a top research institution.
However, the growing number of publications should be useful not only for researchers but also for policymakers. Unfortunately, to our knowledge, there is no clear record of how this impressive publication growth in Asia is beneficial for health systems policymaking.
For instance, even though there is a significant decline in the maternal mortality rate and under-5 mortality rate in developing Asian countries since 2000, there is no evidence to explain whether the increase in health system research on the region contributed to this health achievement. A literature review on the usefulness of research results for healthcare policymaking shows an urgent need to analyze whether the scientific knowledge in health system studies helps policymakers form and implement policy.
Are we communicating the research or just climbing as the top scorer?
A few days before the session, my colleague shared a poster with me advertising a writing workshop that guarantees publication in a reputable indexed database. Over the last few years, this kind of poster has been common in Indonesia. The training offers capacity building for any researcher from various backgrounds to be guided by an experienced author with a long list of publications. Some training is even promising, offering capacity-building to transform an undergraduate thesis into a manuscript for a reputable journal. However, how beneficial for policy will this kind of article will be? We cannot ask someone who does not work in HPSR and does not know our research context to be able to provide evidence-based policy recommendations. In this case, the researcher is incentivized to publish, not to shape the policymaking process.
As we know, research reputation is one of the leading indicators of a university’s global ranking. Hence, Indonesian universities are incentivized to boost the number of publications in reputable journal indexing databases. The competition to publish academic works in a reputable journal also triggers national journals applying to this journal databases.
Another example is from the journal we managed. Recently, the journal was rejected by a reputable indexing database. They argued that only a small number of articles in their databases cited our journal so we did not pass. We appealed the result by explaining that Indonesian articles predominantly cite our journal, but received no reply. Hence, we can see that a journal’s contribution to their nationwide research could not merely be justified as a reputable journal indicator. Academic publishing uses other indicators that do not support the utilization of health system research in the policymaking process.
Meanwhile, understanding academic articles written in English is another barrier in adopting research in policymaking process in Indonesia. Indonesia is not an English-speaking country and its English Proficiency Index only ranked at 78 among 100 countries in 2020. A study even mentioned that highly educated intellectuals in Indonesia found difficulties understanding academic works written in English. Hence, government offices commonly request local university researchers to work on research commissioned directly by the government. This leads to another issue of whether the research result will be independent or tend to be favorable for the government, since the research funder is the government itself. On the other hand, in an effort to become a top level university, Indonesian universities push their researchers to publish in internationally reputable journals, which must be written in English.
Therefore, it is crucial to rethink how the global academic ranking competition becomes another potential conflict of interest in academic publishing of health system research.