The experiences of MTRH researchers in application of the principle of justice in HIV research at AMPATH – Eldoret

Abstract

Background- The impact of HIV in Sub- Sahara Africa in low-income countries like Kenya has led to increased research activities. During research activities there is need to apply ethical principle of justice where justice is about doing what is morally right and proper treatment of persons. But it is not always easy to maintain justice in research especially in poor resource setting. Objectives – The study objectives were i) to analyze the Institution Research and Ethics Committee (IREC) guidelines for application of the principles of justice, ii) examine the factors that MTRH researchers consider in application of the principle of justice, iii) explore the challenges encountered by MTRH health researchers at AMPATH in application of justice in HIV research. Method- This was a cross sectional exploratory qualitative study design. 16 researchers from MTRH working at AMPATH and 5 members of IREC in Eldoret Kenya was purposively selected and participated in in-depth interviews between June and August 2016. They were drawn from both medical and non-medical affiliations. They were both male and female median age of 45 years. Unstructured interview guides formulated on different themes focusing on justice for HIV patients were used. Transcription of verbatim data was done, similar ideas identified and coded. Similar coded data were grouped into categories and various themes emerged. Analysis was done manually. The findings were presented as summaries including selected quotes. Results –IREC guidelines were clearly documented and available in both soft and hard copy. The researchers considered IREC requirements for approving research proposal, how to engage participants in ethical research process and the knowledge of community members about ethical research process. It was perceived by the researchers that IREC hindered their progress in ethical research process for it took a long time to get their proposal approved. The researchers had a problem with poverty level within the community which is closely associated with illiteracy and culture of handouts. Conclusion – Researchers are knowledgeable about the principle of justice in ethical research process. However, they may fail to apply the principle of justice in HIV research due to challenges associated with low income in the communities, researchers‟ attitudes and lack of practical skills. Recommendations- There is need to trained researchers on the skills of carrying out ethical research in specific contexts and sensitizes them on the role of IREC as a facilitator of ethical research.