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In recent years, there has been a notable increase in the participation of females in sport, as well as professionalism of female sport.1 Sports and exercise medicine (SEM) literature has, however, failed to mirror this progress, as female athletes continue to be on the margins of methodological, theoretical and empirical research.2 The absence of the female narrative in the scientific literature is even more pervasive for female athletes in Africa, which presents various challenges for athletes and clinicians. This editorial highlights the challenges associated with the scarcity of research on female African athletes.
Much of the current scientific evidence on athletes fails to account for the intersection of gender, race, culture and economics3—factors which compound the difficulties faced by female athletes. In particular, the journey of the female African athlete is significantly influenced by the following: societal expectations, culturally driven perceptions, and (lack of) access to opportunities, sports infrastructure and financial support.4 As such, interventions that do not consider the intersection between biology and the socioeconomic or cultural contexts are likely to fail if not adapted for context, with costly clinical and financial implications. Therefore, population-specific evidence that explores the impact of intersectionality on athletic performance and rehabilitation is required. Consequently, female African athletes must be intentionally added to the SEM research agenda rather than being serendipitous inclusions.
Lack of funding
This editorial does not exhaustively unpack all potential reasons for the dearth of evidence on African women in sport, and it is acknowledged that this is likely multifactorial. One important consideration, however, is poor funding of sports related research in Africa. Despite the rapid growth in sports in Africa, there is a limited budget allocated to SEM research because most African countries’ budgets are perpetually stretched amid other more urgent needs such as conflict resolution, hunger and poverty eradication. In such a setting of resource scarcity, women, children and the disabled are among those most marginalised. SEM research and practice are no different. With medical research in Africa predominantly funding studies that investigate communicable diseases, violence, injury and more recently COVID-19, issues that are exclusive to female African athletes are further side lined and given a low priority.5
Globally, funding for SEM research is highly competitive. In this environment, it is the cutting edge, distinctly novel work that is likely to be awarded funding. In contrast, studies that may be novel or highly relevant in the African context may have already been conducted in other populations and considered foregone conclusions not warranting funding. Even when funding is available, how it is directed may be influenced by the fact that sport is largely a gendered institution with processes operating within a hegemonic masculine norm. Consequently, most SEM research is conducted by (and on) males who are also the primary decision-makers on research policy, funding and design.6
Representation at all levels benefits all
African women are woefully underrepresented on the panels of SEM research funding organisations, making up less than 2% of such decision-makers.7 It is not enough to only focus on diversity within the athlete population. Increasing the number of female African SEM researchers, practitioners and policy-makers would help amplify the narratives of female African athletes and has the potential to drive innovation and new scientific discoveries. Conversely, the lack of diversity in SEM academia and practice may limit the scope and depth of research, the robustness of policy and the applicability of certain clinical protocols.8
African journals for African SEM research
Another challenge to African SEM research may be the relative paucity of SEM journals in Africa compared with other regions such as Europe or North America. SEM is a relatively new discipline in Africa, with most graduates opting for clinical practice rather than academia as a career after qualification. As a result, there are a limited number of SEM scholars with the capacity or resources to drive the development and delivery of content for African SEM journals. Admittedly, ensuring that these journals appeal to authors as a first choice for submitting articles is another significant obstacle. The irony and potential impact of this editorial being published in a non-African SEM journal is not lost on the authors.
Out of sight, out of mind
The relative invisibility of the female African athlete in literature means that issues pertaining to these athletes are not sufficiently investigated, limiting the evidence base available to be applied in clinical practice. Consequently, these athletes rely on information on injuries, recovery and training that is generated without their bodies or circumstances in mind. Improved female African representation in all aspects of research, combined with an intentional strategy to better fund research on female African athletes, may begin to bridge the female shaped gap in our SEM knowledge and subsequent practice as we strive to better serve our athletes, all of them.
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Twitter @SharonNoe17, @phatho_z
Contributors Conceptualisation of the manuscript and first draft: NSM. Revision of manuscript drafts and final draft: NSM, FC and PCZ.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests NSM and PCZ are associate editors of BJSM.
Provenance and peer review Not commissioned; externally peer reviewed.
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