Exploring knowledge and ethical issues associated with stem cell research among health workers and researchers in Ampath, Kenya

Abstract

Background: Stem cell research (SCR) holds immense transformative potential for regenerative medicine, yet its responsible progression is critically dependent on healthcare professionals' knowledge and the resolution of complex ethical issues. In Kenya, where SCR is nascent and a formal regulatory framework is under development, understanding of perspectives on SCR among frontline health workers is imperative. This study explored the level of knowledge and the ethical concerns regarding SCR among health workers at AMPATH, Kenya. Methods: An exploratory, cross-sectional mixed-methods design was employed, guided by the Theory of Planned Behavior (TPB). The quantitative sample included 161 health workers (doctors and nurses) selected via stratified random sampling from Academic Model Providing Access to Healthcare (AMPATH) Moi Teaching and Referral Hospital (MTRH) and the College of Health Sciences (CHS). A purposive sample of 15 experts (medical scientists, social scientists, and IREC members) participated in in-depth interviews. Quantitative data were analyzed using descriptive and inferential statistics (chi tests), and qualitative data underwent thematic analysis. Results: The study revealed significant knowledge gaps. Only 28.6% (46/161) of participants demonstrated good knowledge of SCR, while 49.1% (79/161) had moderate knowledge, and 22.3% (36/161) had poor knowledge. Knowledge level was significantly associated with professional cadre (p<0.001), age (p<0.001), and education level (p=0.004). Nurses constituted the largest group (46.6%) of respondents. Qualitative analysis uncovered profound ethical concerns, crystallizing around three themes: (1) strong opposition to human embryo use, rooted in the belief that life begins at conception; (2) concerns about social justice and exploitation of vulnerable donors; and (3) critiques of current informed consent practices in biobanking. Conclusion and Recommendations: There is a critical knowledge deficit regarding SCR among AMPATH, MTRH and CHS health workers, particularly among junior staff, which could impede informed patient counseling and ethical protocol development. Ethical concerns, especially regarding embryonic sources and consent, are deep-seated and reflect a complex interplay between professional role and religious beliefs. To advance SCR responsibly, we recommend: (1) implementing targeted, cadre-specific educational programs; (2) facilitating inclusive multi stakeholder dialogues to address ethical conflicts; and (3) urgently enacting a comprehensive legal framework to govern SCR and ensure ethical compliance in Kenya. Keywords: Stem cell research, Knowledge, Ethical issues, Health workers, Theory of Planned Behavior, Kenya. Key Words: Stem cell research, Knowledge, Ethical issues, stem cells