PDF The willingness to participate in biomedical research involving human beings in low and middle-income countries: a systematic review

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Upload date 24 Dec 2018
Contributor Anthony Adu-Gyamfi
Geographical coverage Global
Keywords Health, low and middle- income countries, willingness to participate, barriers to participate, reasons for participation, reasons for non-participation, informed consent
Release date 24/12/2018
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Objectives: To systematically review reasons for the willingness to participate in biomedical human subjects research in low and middle-income countries (LMICs).
Methods: Five databases were systematically searched for articles published between 2000 and 2017 containing the domain of ‘human subjects research’ in ‘LMICs’ and determinant ‘reasons for (non)participation’. Reasons mentioned were extracted, ranked and results narratively described.
Results: 94 articles were included, 44 qualitative and 51 mixed-methods studies. Altruism, personal health benefits, access to health care, monetary benefit, knowledge, social support, and trust were the most important reasons for participation. Primary reasons for non-participation were safety concerns, inconvenience, stigmatization, lack of social support, confidentiality concerns, physical pain, efficacy concerns, and distrust. Stigmatization was a major concern in relation to HIV research. Reasons were similar across different regions, gender, non-patient or patient participants, and real or hypothetical study designs.
Conclusions: Addressing factors that affect (non-)participation in the planning process and during the conduct of research may enhance voluntary consent to participation and reduce barriers for potential participants.