TY - JOUR
T1 - The ethics of health systems research in low- and middle-income countries
T2 - A call to action
AU - Hyder, Adnan A.
AU - Pratt, Bridget
AU - Ali, Joseph
AU - Kass, Nancy
AU - Sewankambo, Nelson
N1 - Publisher Copyright:
© 2014 Taylor & Francis.
PY - 2014/10/13
Y1 - 2014/10/13
N2 - The increasing conduct of health systems research (HSR) in low- and middle-income countries (LMICs) has not been matched by concurrent work to clarify the field's ethical dimensions. To begin to address this gap, a two-day workshop on the ethics of HSR in LMICs was convened at Johns Hopkins University in June 2013. Participants included health systems researchers, philosophers, lawyers, bioethicists and institutional review board members from Botswana, Uganda, the UK, USA and Zambia. Based on discussions from the workshop, the paper affirms that, while HSR in LMICs raises ethical issues in relation to constructs (i.e. consent, risk, equipoise) common to international clinical research, the nature of the issues that arise often differ between the two fields. Three salient features of HSR and the ethical considerations associated with each of them in LMICs are described to demonstrate this point. Recommendations for institutional review boards’ oversight of HSR in LMICs are presented. Finally, a call is made for further action to develop thinking and guidance around the ethics of HSR in resource-poor settings.
AB - The increasing conduct of health systems research (HSR) in low- and middle-income countries (LMICs) has not been matched by concurrent work to clarify the field's ethical dimensions. To begin to address this gap, a two-day workshop on the ethics of HSR in LMICs was convened at Johns Hopkins University in June 2013. Participants included health systems researchers, philosophers, lawyers, bioethicists and institutional review board members from Botswana, Uganda, the UK, USA and Zambia. Based on discussions from the workshop, the paper affirms that, while HSR in LMICs raises ethical issues in relation to constructs (i.e. consent, risk, equipoise) common to international clinical research, the nature of the issues that arise often differ between the two fields. Three salient features of HSR and the ethical considerations associated with each of them in LMICs are described to demonstrate this point. Recommendations for institutional review boards’ oversight of HSR in LMICs are presented. Finally, a call is made for further action to develop thinking and guidance around the ethics of HSR in resource-poor settings.
KW - IRB oversight
KW - developing countries
KW - ethics
KW - health systems research
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U2 - 10.1080/17441692.2014.931998
DO - 10.1080/17441692.2014.931998
M3 - Article
C2 - 25104051
AN - SCOPUS:84912045082
SN - 1744-1692
VL - 9
SP - 1008
EP - 1022
JO - Global public health
JF - Global public health
IS - 9
ER -