Do Tanzanian hospitals need healthcare ethics committees? report on the 2014 dartmouth/penn research ethics training and program development for tanzania (DPRET) workshop

Ethical issues are common in the global community. The shortage of human and medical resources when working with vulnerable populations requires institutional support to address the challenges that often arise in the patient-provider relationship. The 2014 Dartmouth/Penn Research Ethics Training and Program Development for Tanzania (DPRET) workshop centred on discussions about research and clinical ethics issues unique to Tanzanian healthcare providers. This article discusses some of the ethical challenges that workshop participants reported in their day-to-day work life with patients and families, such as truth-telling, disagreements over treatment plans and patient distrust of local physicians and hospital staff, among others. The Tanzanian participants recognised the need for supportive mechanisms within their local hospital environments. Further dialogue and research on the development ofinstitutional ethics committees within hospital systems is critically needed so that healthcare providers can meet their ethical and professional obligations to patients and families and address ethical conflicts that arise in a timely and productive fashion

But is this Really the 'Parent' or 'Guardian'? Practical Strategies for Consent to Child Research in South Africa

Research ethics committees (RECs) in South Africa may require consent from a parent or legal guardian for child research. In instances where an REC determines that parental or guardianship consent is required; how far should researchers go to establish if the accompanying adult is in fact the parent or guardian? Should researchers accept disclosures at face value; probe assertions that are made; or even call for supporting documentation? In this article we set out the facts research staff should possess; propose key questions they could ask; and recommend practical steps for uncertain cases. We recognise that a parental/guardianship consent strategy may not be appropriate in all instances; but do not debate that issue in this article. This article is confined to practical advice for researchers wishing to implement a parental or guardianship consent approach

Things may not be as Expected: Surprising Findings when Updating Work Load at the Wits Human Research Ethics Committee (Medical)

Objectives. To compare numbers of applications to the University of the Witwatersrand Human Research Ethics Committee (Medical) for clearance by the full committee during 2011 - 2013; to see the proportion of clinical Master's applications in 2013 and to look for the influence of eight variables in applications reviewed from January to June 2013.Methods. A retrospective extraction of data from committee minutes (2011-2013) and application forms (January - June 2013) was done. Statistical analysis was completed using SAS for Windows (version 9.4). Variables examined were committee decision; choice of research method; supervision or not; supervisors' research degree; supervisors' publication group; university administrative entity; registered degree and month of approval after first review.Results. Total numbers were 685 (2011); 845 (2012; a 23.4% increase from 2011) and 769 (2013; a 9.0% decrease on the previous year). In 2013; 22% of applications were for clinical Master's degrees required by the Health Professions Council of South Africa (HPCSA) for specialist registration. A number of cross-tabulations of variables are presented. Logistic regression analysis (Proc Catmod) showed that three variables significantly influenced the committee's initial review decision; namely school (p=0.03); applicants' registered degree (p=0.01) and the research method chosen (p=0.03). The month of committee approval was also significantly affected by school (p=0.002). Preferred research methodologies for supervised and independent research applications differed within and between schools.Conclusion. A predicted continuous increase in number of applications from 2011 to 2013 did not happen for unknown reasons. Research method; school; and registered degree significantly influenced the committee's decision at the initial review of applications. For clinical Masters; and other Masters; a supervisor's degree had no effect on the committee's decision at the initial review of applications; however undergraduate and honours applicants having supervisors without a research degree had more than double the approval rate at first review than when supervisors had either a Doctorate or a Master's (p=0.008). Supervisors' possession of a research degree did not increase approval rate of applications nor did a supervisor's publication grouping

Review Paper on Research Ethics In Ethiopia: Experiences and Lessons Learnt from Addis Ababa University College of Health Sciences 2007-2012

Health research in Ethiopia is increasing both in volume and type; accompanied with expansion of higher education and research since the past few years. This calls for a proportional competence in the governance of medical research ethics in Ethiopia in the respective research and higher learning institutes. The paper highlights the evolution and progress of the ethics review at Addis Ababa University- College of Health Sciences (AAU-CHS) in the given context of health research review system in Ethiopia. Reflections are made on the key lessons to be drawn from the formative experiences of the Institutional Review Board (IRB) and their implications to the Ethiopian health research review system. This article is a review paper based on review of published and un published documents on research ethics in Ethiopia and the AAU-CHS (2007-2012). Thematic summaries of review findings are presented in thematic areas - formation of ethics review and key factors in the evolution of ethics review and implications The IRB at AAU-CHS has been pivotal in providing review and follow-up for important clinical studies in Ethiopia. It has been one of the first IRBs to get WHO/SIDCER recognition from Africa and Ethiopia. Important factors in the successes of the IRB among others included leadership commitment; its placement in institutional structure; and continued capacity building. Financial challenges and sustainability issues need to be addressed for the sustained gains registered so far. Similar factors are considered important for the new and younger IRBs within the emergent Universities and research centers in the country

Research Ethics Review Practices: Experiences of The Armauer Hansen Research Institute/ All Africa Leprosy and Tuberculosis Rehabilitation and Training Center Ethics Review Committee; Ethiopia

The need for ethics review committees (ERCs) is imperative in the conduct of research to ensure the protection of the rights; safety and well-being of research participants. However; the capacities of most ERCs in Africa are limited in terms of trained experts; competence; resources as well as standard operating procedures. The aim of this report is to share experiences of one of the local institutional ERCs; the Armauer Hansen Research Institute (AHRI)/All Africa Leprosy and Tuberculosis Rehabilitation and Training Center (ALERT) Ethics Review Committee (AAERC); to other ERCs found in academic and research institutions inthe Country. In this report; we used an empirical approach to reviewarchived documents of the AAERC Secretariat to assess the Committee's strengths and weaknessesThe experiences of the AAERC in terms of its composition; routine work activities; learning practices and pitfalls that require general attention are summarized. In spite of this summary; the Committee strongly acknowledges the functions and roles of other ERCs in the Country. In addition; an independent assessment of the Committee's activity in general is warranted to evaluate its performance and further assess the level of awareness or oversights among researchers about the roles of ERCs

'When I Get Better I will do the Test': Facilitators and Barriers to HIV Testing in Northwest Region of Cameroon with Implications for TB and HIV/AIDS Control Programmes

The World Health Organization has recommended collaborative activities between TB and HIV programmes with routine counselling and testing for HIV among TB patients in order to improve the uptake of HIV services. We carried out qualitative research interviews with 21 TB patients in four selected TB and HIV/AIDS treatment centres in the Northwest Region of Cameroon to explore the facilitators and barriers to HIV testing. The desire to be healthy and live longer from knowing one's status inspired by the anticipated support from loved ones; faith in a supreme being; influence and trust in the medical authority; encouraged HIV testing. Men also demonstrated their masculinity by testing; thus portraying themselves as positive role models for other men. Meanwhile; the overwhelming burden of facing both TB and HIV simultaneously; influenced by the fear of disclosure of results; harmful gender norms and practices; fear of stigma and discrimination; and misconceptions surrounding HIV/AIDS deterred HIV testing. However; as a result of conflicting emotional experiences regarding to test or not to test; the decision-making process was not straightforward and this complex process needs to be acknowledged by health care providers when advocating for routine HIV testing among TB patients