Towards monitoring of global health research: an exploratory analysis of transparency and stakeholder engagement.

OBJECTIVES: Monitoring systems exist for clinical research transparency in high-income countries, but systematic assessment of these practices in global health (GH) research (GHR) is limited. We evaluated methods for monitoring GHR transparency and engagement. DESIGN: Cross-sectional study. DATA SOURCES: Three sources were used: (a) ClinicalTrials.gov, (b) publications from 20 journals with 'international' or 'global' in the title and (c) outputs from selected GH funder websites. ELIGIBILITY CRITERIA: From ClinicalTrials.gov, we selected 200 interventional trials on maternal health and tuberculosis (2008-2019), ensuring two-thirds were from low- and middle-income countries (LMIC). From journals, we included 200 trial publications (2011-2023). From funder websites, we included outputs with sufficient metadata to track trial registration and reporting. DATA EXTRACTION AND SYNTHESIS: Trials were extracted independently by two reviewers for result publications; journal articles were screened to confirm whether they reported trial results. Across all sources, we assessed registration timing, result reporting, open access and stakeholder engagement. RESULTS: For 200 trials, 37% were prospectively registered, 65% published results in journals and 15% reported summary results in ClinicalTrials.gov. Only 34% reported results in any format within 24 months of completion. Of 200 publications, 72% were freely accessible, and 23% of the 100-article subsample included stakeholder engagement statements. The funder website sample yielded insufficient metadata for analysis. CONCLUSIONS: Monitoring GHR is feasible using registries and journals, though funder websites provide limited tracking. While open-access rates are encouraging, timely reporting and engagement documentation remain weak. These results highlight opportunities for developing GHR-specific monitoring approaches through collaborative efforts among global stakeholders.