Doctoral fellows’ contribution to Covid-19 response: using artificial intelligence to make the most of this resource

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What is known, what is needed, and what exists

Annual doctoral enrolment and throughput rates are increasing, and this trend has been consistent over the last decade. Doctoral dissertations are expected to make significant contributions in their fields, whether through innovative methodology, originality of design, or ground-breaking findings. A case for engaged, highly qualified, and resourceful African researchers has been made in the form of recommendations that will constitute a New Public Health Order to address infectious diseases like the recent severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic. Recruitment, training, and retention of a public health workforce; and the promotion of mutually respectful local and international partnerships are necessities for the “New Public Health Order”. This new order requires excellent African researchers. The Consortium for Advanced Research Training in Africa (CARTA) has made an important contribution to this by training internationally competitive PhD graduates in Africa. The PhD program offers pre-PhD structured training to ensure relevant and sound PhD proposals that will yield research findings important for the context in which the research will take place. CARTA also offers training on research methods and data analysis that provides the PhD students the skills needed for them to successfully navigate their PhD and offers them professional development opportunities for them to become well-rounded academics. With a retention rate above 90% and an estimated completion time of 54months, the program has been effective at producing high-quality graduates that are retained in African academia. In this paper, we explore the contribution made by the program’s trainees to a world-disruptive health event like the COVID-19 pandemic.

The capabilities of the AI system, and how we put them to use

The CARTA Evidence platform – an AI-enhanced site able to dice and slice bibliometric data and contents of research articles - was used to test if CARTA fellows and graduates are addressing a public health priority like COVID-19.   An abstract summaries and content paraphrasing feature to facilitate content uptake and use; a bibliometric dashboard showcasing research impact and contents; and interactive Impact Search - Africa pages that curate public and population health articles and data list to improve access to evidence and data in Africa are just a few of the useful features of the platform. Using information from the CARTA Evidence platform, we assessed the research impact and contributions of CARTA PhD fellows to the COVID-19 response

The contribution of fellows in the study of COVID-19

Since the beginning of the pandemic, 64 out of about 230 CARTA fellows have either been the primary authors or contributors to 149 COVID-19-related research articles published in indexed journals. Fourteen percent of the 149 COVID-19-related research articles involved collaboration between CARTA fellows. Journals where these papers were published had an average impact factor of 7.9 and the average number of citations per paper is 19. CARTA fellows were also first author in 18% of the 149 articles. While some studies targeted multiple countries at the same time, others were conducted specifically for each CARTA member country, with varying numbers of publications per country. The fellows conducted COVID-19 research studies on a variety of intersecting topics such as health systems and policies, infectious diseases, HIV, maternal and child health, cancers, noncommunicable diseases, mental health, and food security. These studies mostly sought to understand the impact of COVID-19 to inform policy and practice. The dominant keywords in the 149 articles are COVID, patients, health, risk, and health system. 

A peer-reviewed paper was published early in July 2020 by a CARTA fellow (Chinenyenwa Ohia et al.). The article emphasizes the importance of prevention and control readiness and made recommendations for Nigeria (Africa's most populous country). This article is one example of a high impact paper in terms of citations, and the CARTA fellow is the first author. A similar study (by Omotade Ijarotimi et al.) on preparedness, published in October 2020, reviewed the practical realities of the pandemic, and made recommendations to supplement obstetric practice guidelines. Importantly, a paper by Skye Adams et al. took a system-wide approach, which is central to the way CARTA fellows are trained, and was deliberate in addressing often unnoticed or neglected needs of disabled people. Contributions were also made by Godwin Anywar et al.  on the use of medicinal plants in drug discovery process. Henry Zakumumpa and his colleagues assessed the impact of COVID-19 and response strategies in order to document lessons that can be used to improve current practice and prepare for future outbreaks. Faustin Ntirenganya contributed to the work of a global network of surgeons to estimate the number of elective surgeries that will be canceled because of COVID-19 and made recommendations for a recovery plan. Prior to this, they published a paper in August 2020 with global recommendations on surgical practice during the pandemic. These are a few examples of cross cutting work done by CARTA fellows. 

The CARTA Evidence platform enabled a quick synthesis of published articles in terms of bibliometric properties, geographic spread, persistent and emerging themes, knowledge clusters, information gaps, prolific contributors, centres of excellence on various topics, and the proximity and complementarity of published articles. These features allow the platform to find and foster synergistic partnerships, which is essential for achieving scale in public health initiatives that are impactful.

Main findings and recommendations

Publications such as those cited above demonstrate how rapidly evidence and knowledge can be increased to address public health challenges in Africa, thanks to the efforts of well-trained doctoral students and graduates. Indeed, CARTA´s multidisciplinary cohorts of doctoral fellows are producing a diverse and complementary body of knowledge that supports multilevel and comprehensive responses to complex public health needs. Twenty first century doctoral graduates need a diverse set of skills and an appreciation of multi-, inter-, and trans-disciplinary research. Such skills make doctoral students potential change agents as they can bring together data, evidence, policy, and actors through research dissemination and policy engagement activities. The CARTA model, which can inform PhD training internationally, allows for such skills to develop. 

Nonetheless, African postgraduate training programs face challenges due to inadequate investment in higher education research (Fonn et al; Fonn et al.).  A lack of staff to meet the demand for doctoral programs, brain drain, a lack of financial capacity to fund postgraduate programs, and a lack of infrastructure capacity in terms of physical space, information technology, equipment, laboratories, libraries, and books are some of the challenges. These shortcomings have implications for the number, quality, and mix of doctoral graduates needed to provide the desired scope of benefits. Given the lessons from innovative doctoral training and capacity building programs such as CARTA, there are tried and tested solutions to some of the challenges highlighted above. The good news is that efforts are underway to formalize CARTA's methods among its partner institutions. Tools like the CARTA Evidence platform are useful, efficient, and effective to track and harness doctoral students' scientific and policy contributions. This platform has applications beyond just the CARTA network.

AUTHORS: Jude Igumbor1, Marta Vicente-Crespo1 & 2 & Sharon Fonn1.

1School of Public Health, University of the Witwatersrand, Johannesburg, 2South Africa; Consortium of Advanced Research Training in Africa, African Population and Health Research Center, Nairobi, Kenya

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