The scientific base for orthopaedic device development in South Africa: spatial and sectoral evolution of knowledge development

We assess knowledge development and knowledge diffusion for orthopaedic device innovation in South Africa over the period 2000–2015. A structural network analysis is performed on bibliometric data using co-authorship on scientific publications as an indicator of collaboration between different organisations. We apply a technological innovation system (TIS) framework, quantitatively assessing the TIS functions ‘knowledge creation’ and ‘knowledge diffusion’ in their spatial and sectoral contexts. Network metrics (degree and betweenness centralities), and empirical TIS analyses are used to describe the knowledge functions of the TIS. Our results show that scientific knowledge development has increased as time has progressed, and that university and healthcare sectors have largely been responsible. Results further indicate that, for the national healthcare and national industry sector actors, ties to university and science council actors support scientific knowledge creation. The collaboration networks were found to be sparse, and disjointed, with many actors largely unreachable, indicating barriers to knowledge exchange between actors. Initially the network displayed spatial elements of an internationalised TIS, but over time, the spatial typology changed to that of a nationalised TIS. This shift may be a positive one, as South African research and development activity shifts towards being driven by local actors and towards medical devices which address the South African burden of disease.