ArticleBMJ open2017
Strategies for developing sustainable health research capacity in low and middle-income countries: a prospective, qualitative study investigating the barriers and enablers to locally led clinical trial conduct in Ethiopia, Cameroon and Sri Lanka.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- eHealth tools to assess the neurological function for research, in absence of the neurologist: a systematic review, part II (hardware).Journal of neurology · 2025Pooled it
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- Neurosurgical Randomized Trials in Low- and Middle-Income Countries.Neurosurgery · 2020Pooled it
- The IHAT-GUT Iron Supplementation Trial in Rural Gambia: Barriers, Facilitators, and Benefits.Nutrients · 2021Trial
- Characteristics of Authorized Clinical Trials in Peru, 2017-2025: A National Registry-Based Study.Therapeutic innovation & regulatory science · 2026Article
- Hepatitis B Research in Peru, 1988-2023: Geographic Inequities, Thematic Gaps, and Misalignment with Disease Burden.Pathogens (Basel, Switzerland) · 2026Article
- Advancing global equity in liver disease research funding: the case of metabolic dysfunction-associated and alcohol-associated liver disease.BMJ open gastroenterology · 2026Article
- Three decades of clinical trials in Portuguese-speaking Africa: a comprehensive scoping review protocol.BMJ open · 2026Article
- Stakeholder perception of quality management of investigator-initiated clinical trials.BMC medical ethics · 2025Article
- Clinical Trial Ethical Challenges in Low- and Middle-Income Countries: A Review of Systematic Review.Research square · 2025Article
- The long-term impact of vaccine clinical research on national stakeholders involved: Experience from a low-income Country.Human vaccines & immunotherapeutics · 2025Article
- Embedding research capacity strengthening in multicountry sexual health research.BMJ global health · 2025Article
- Navigating Artificial Intelligence in Malaysian Healthcare: Research Developments, Ethical Dilemmas, and Governance Strategies.Asian bioethics review · 2025Article
- The Holy Grail: highlighting the need for equitable access to dementia treatments and clinical trials.The Lancet regional health. Western Pacific · 2025Review
- Challenges and opportunities of translating animal research into human trials in Ethiopia.BMC medical research methodology · 2024Article
- A review of authorship in herpes simplex virus type-2 (HSV-2) research conducted in low-income and middle-income countries between 2000 and 2020.BMJ global health · 2024Review
- A Delphi consensus to identify the key screening tests/questions for a digital neurological examination for epidemiological research.Journal of neurology · 2024Article
- Review
- Is qualitative social research in global health fulfilling its potential?: a systematic evidence mapping of research on point-of-care testing in low- and middle-income contexts.BMC health services research · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIn 2013, the WHO stated that unless low-income and middle-income countries (LMICs) become producers of research, health goals would be hard to achieve. Among the capacities required to build a local evidence base, ability to conduct clinical trials is important. There is no evidence-based guidance for the best ways to develop locally led trial capacity. This research aims to identify the barriers and enablers to locally led clinical trial conduct in LMICs and determine strategies for their sustainable development.
designProspective, multiple case study design consisting of interviews (n=34), focus group discussions (n=13) and process mapping exercises (n=10).
settingCase studies took place in Ethiopia (2011), Cameroon (2012) and Sri Lanka (2013).
participantsLocal health researchers with previous experiences of clinical trials or stakeholders with an interest in trials were purposively selected through registration searches and snowball sampling (n=100). PRIMARY AND SECONDARY OUTCOME MEASURES: Discussion notes and transcripts were analysed using thematic coding analysis. Key themes and mechanisms were identified.
resultsInstitutions and individuals were variably successful at conducting trials, but there were strong commonalities in the barriers and enablers across all levels and functions of the research systems. Transferable mechanisms were summarised into the necessary conditions for trial undertaking, which included: awareness of research, motivation, knowledge and technical skills, leadership capabilities, forming collaborations, inclusive trial operations, policy relevance and uptake and macro and institutional strengthening.
conclusionsBarriers and enablers to locally led trial undertaking exist at all levels and functions of LMIC research systems. Establishing the necessary conditions to facilitate this research will require multiple, coordinated interventions that seek to resolve them in a systemic manner. The strategies presented in the discussion provide an evidence-based framework for a self-sustaining capacity development approach. This represents an important contribution to the literature that will be relevant for research funders, users and producers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.