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 - Funding Information:
The workshop was supported by the Berman Institute of Bioethics, the Johns Hopkins School of Public Health, the National Institutes of Health Fogarty Africa Bioethics Training programme and Future Health Systems, a research partnership coordinated from the Johns Hopkins Bloomberg School of Public Health and funded by the UK Department for International Development. BP is supported by an Australian National Health and Medical Research Council (NHMRC) Early Career Sidney Sax Public Health Overseas Fellowship [Award No. 1052346]. AAH, JA and NK are partly supported by the Fogarty International Centre and National Institute of Allergy and Infectious Diseases of the National Institutes of Health under Award Number [R25 TW 001604].
Publisher Copyright:
© 2014 Taylor & Francis.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
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
VL - 9
SP - 1008
EP - 1022
JO - Global Public Health
JF - Global Public Health
SN - 1744-1692
IS - 9
ER -