Strengthening ethics committees for health-related research in sub-Saharan Africa: a scoping review

Abstract

ObjectiveHealth-related research in sub-Saharan Africa (SSA) has grown over the years. However, concerns have been raised about the state of research ethics committees (RECs). This scoping review examines the literature on RECs for health-related research in SSA and identifies strategies that have been applied to strengthen the RECs. It focuses on three aspects of RECs: regulatory governance and leadership, administrative and financial capacity and technical capacity of members.DesignA scoping review of published literature, including grey literature, was conducted using the Joanna Briggs Institute approach.Data sourcesBioOne, CINAHL, Embase (via Ovid), Education Abstracts, Global Health, Google Scholar, Jstor, OpenEdition (French), Philosopher’s Index, PsycINFO, PubMed, Science Citation and Expanded Index (Web of Science), reference lists of included studies and specific grey literature sources.Eligibility criteriaWe included empirical studies on RECs for health-related research in SSA, covering topics on REC leadership and governance, administrative and financial capacity and the technical capacity of REC members. We included studies published between 01 January 2000 and 18 February 2022 and written in English, French, Portuguese or Swahili.Data extraction and synthesisTwo independent reviewers screened the records. Data were extracted by one reviewer and cross-checked by another. Owing to the heterogeneity of included studies, thematic analysis was used.ResultsWe included 54 studies. The findings show that most RECs in SSA work under significant administrative and financial constraints, with few opportunities for capacity building for committee members. This has an impact on the quality of reviews and the overall performance of RECs. Although most countries have national governance systems for RECs, they lack regulations on accountability, transparency and monitoring of RECs.ConclusionsThis review provides a comprehensive overview of the literature on RECs for health-related research in SSA and contributes to our understanding of how RECs can be strengthened.

Understanding the language barriers to translating informed consent documents for maternal health trials in Zambia: a qualitative study

“…This study provides a practical and tangible example of ways in which researchers and ethical review boards can begin the process of change right away. A recent scoping review highlighted the financial, administrative and regulatory barriers to good quality ethical review in low and middle-income countries31; our study provides relevant findings that may be used to address some of these concerns. A collaborative, multidisciplinary research programme in Kenya has successfully implemented a systematic approach to translating contextualised informed consent templates, drawing on community engagement processes within their research programme, which has received positive engagement from researchers and ethics committees 32.…”

Behind the scenes of research ethics committee oversight: a qualitative research study with committee chairs in the Middle East and North Africa region

“…Participants did not express the need for continuous training for their members who were assumed to be knowledgeable because of their seniority which overlooks the pivot of keeping REC members in line with emerging research ethics topics, such as gene editing or arti cial intelligence. This inconsistency of requiring ethics training has been documented by research in the region by (6) in Jordan and (11) in Sub-Saharan Africa showing that it is not seen to be necessary; while other research studies in Saudi Arabia describe proper training mechanisms and guidance for RECS (7). REC members in Saudi Arabia are required by law (Law of Ethics of Research on Living Created by the National Committee of Bio-Ethics NCBE) to complete training on ethics and regulations in order to be registered (7), which could explain the attention to this training initiative there.…”

“…A scoping review of RECs in Sub-Saharan Africa reported challenges in recruiting and retaining REC members due to the high workload involved and the lack of compensation or incentives to participate in meetings or training and impacting the quality of the reviews. Other challenges include poor administration capacity and lack of time and attention to review tasks (11). In order for RECs to conduct the oversight they are entrusted to do, institutions need to provide them with su cient resources to do their work.…”

“…inadequate knowledge of research ethics and national guidelines, and more recently di culty evaluating scienti c rigor of COVID-19 research (5,8,(11)(12)(13). Other challenges at the level of the RECs highlighted include inadequate resources, concerns about con icts of interest for their members, ambiguity as to what guidelines to follow in their reviews, challenges with complex consent forms, and inadequate frameworks for biomedical research protocols (4,5,14).…”

Clarifying our policy on requiring ethics approval in submitted manuscripts

“…citizen scientists). For instance, a scoping review by Chaudhry et al (2022) found that most research ethics committees in sub-Saharan Africa work under significant administrative and financial constraints. Additionally, in this issue, Brown (2023) describes how researchers affiliated to independent organisations and charities often do not have ready access to research ethics committees, unlike their counterparts who work within universities.…”