Publication barriers and facilitators of Cochrane authors in sub‐Saharan Africa: A mixed‐methods study

Background: Well-conducted systematic reviews contribute to informing clinical practice and public health guidelines. Between 2008 and 2018 Cochrane authors in sub-Saharan Africa were publishing progressively fewer Cochrane Reviews, compared to non-Cochrane reviews. The objective of this study was to determine what motivated trained Cochrane authors in sub-Saharan Africa to conduct and publish non-Cochrane reviews over Cochrane Reviews. Methods: We conducted a mixed-methods exploratory sequential study. We purposely selected 12 authors, who had published at least one Cochrane- and one non-Cochrane review, for in-depth, semi-structured interviews. We manually coded and analysed the qualitative data using Grounded Theory approach and used the results to inform the survey questions. Subsequently we surveyed 60 authors with similar publishing experience. We analysed the quantitative data using descriptive and inferential statistics. Results: Facilitators to publish with Cochrane were a high-impact factor, rigorous research, and visibility. From barriers, the main categories were protracted time to complete Cochrane Reviews, complex title registration process, and inconsistencies between Cochrane Review groups regarding editorial practices. From the survey, authors confirmed rigorous research and reviewing process (84%), high impact factor (77%), and good mentorship (73%). The major barriers included Cochrane's long reviewing process (70%) and Cochrane's complicated title registration (50%). Authors with publishing experience in the previous 10 years at <95 percentile of systematic review publications, there was no significant difference between the medians for publishing with Cochrane (1) and non-Cochrane (0) reviews, p = 0.06. Similarly, for those with publishing experience of ≥95 percentile of systematic review publication there was no significant difference between the medians for publishing with Cochrane (4) and non-Cochrane (6), p = 0.344. Conclusion: Authors considered the visibility and relevance of Cochrane research as a trade-off point. They continued publishing with Cochrane despite the barriers that they encountered. However, the concerns raised by many authors are worth addressing.