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1 Building an Infrastructure through Training: Best practices and Lessons learned from Nigeria Clement A. Adebamowo Chairman, National Health Research.

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Presentation on theme: "1 Building an Infrastructure through Training: Best practices and Lessons learned from Nigeria Clement A. Adebamowo Chairman, National Health Research."— Presentation transcript:

1 1 Building an Infrastructure through Training: Best practices and Lessons learned from Nigeria Clement A. Adebamowo Chairman, National Health Research Ethics Committee of Nigeria (NHREC), Director of Programs, West African Center for Bioethics

2 2 Infrastructural Requirement for ethical research Ethical researchersEthical researchers MentoringMentoring Working environment that promotes ethical research and scientific integrityWorking environment that promotes ethical research and scientific integrity Training on becoming a more ethical researcherTraining on becoming a more ethical researcher Institutional infrastructure in support of ethical conduct of research and promotion of research integrityInstitutional infrastructure in support of ethical conduct of research and promotion of research integrity Integrity OfficerIntegrity Officer Protocols for dealing with suspected cases of FFPProtocols for dealing with suspected cases of FFP

3 3 Infrastructural Requirement for ethical research Ethical review of researchEthical review of research Guidelines for ethical review of protocolsGuidelines for ethical review of protocols Informed consentInformed consent Ethics committeesEthics committees

4 4 What works- Single day training programs and seminars Useful to increase awareness of research ethicsUseful to increase awareness of research ethics Particularly so in institutions/countries where the field is relatively newParticularly so in institutions/countries where the field is relatively new They are easy to set up but have limited long term impactThey are easy to set up but have limited long term impact Impact may be sustained if they are accompanied by within-institution continuing education programsImpact may be sustained if they are accompanied by within-institution continuing education programs Participants do not develop core competency in ethical review of protocolsParticipants do not develop core competency in ethical review of protocols Systematic improvement in ethical standards of biomedical researchers who attend such programs cannot be demonstratedSystematic improvement in ethical standards of biomedical researchers who attend such programs cannot be demonstrated

5 5 What works – Short courses Duration and course contents highly variableDuration and course contents highly variable One week long programsOne week long programs Provide information about principles of informed consentProvide information about principles of informed consent May not be enough to equip participants with minimum competence needed to adequately review protocolsMay not be enough to equip participants with minimum competence needed to adequately review protocols Three weeks long programs appear ideal for provision of one university-course-equivalent of materials that covers e.g. informed consent and health research ethics committee composition, functions and managementThree weeks long programs appear ideal for provision of one university-course-equivalent of materials that covers e.g. informed consent and health research ethics committee composition, functions and management We think at least 2 to 3 courses – (a) research designs (b) informed consent, ethics committee composition and management and (c) foundations of modern research ethics are minimum requirementsWe think at least 2 to 3 courses – (a) research designs (b) informed consent, ethics committee composition and management and (c) foundations of modern research ethics are minimum requirements

6 6 What works – Short courses Short programs tend to beShort programs tend to be ExpensiveExpensive Logistically challengingLogistically challenging Probably most useful method for physicians-members of ethics committees who are unwilling to stay away from their practice for extended periodsProbably most useful method for physicians-members of ethics committees who are unwilling to stay away from their practice for extended periods In Nigeria, a diploma in health research ethics with course content equivalent to 2, 3-credit university courses and similar to CIP is being considered by National Health Research Ethics CommitteeIn Nigeria, a diploma in health research ethics with course content equivalent to 2, 3-credit university courses and similar to CIP is being considered by National Health Research Ethics Committee

7 7 What works – short courses Short programsShort programs International faculty increases course uptakeInternational faculty increases course uptake Requires expensive and intensive advertisementRequires expensive and intensive advertisement Careful selection to identify the right candidatesCareful selection to identify the right candidates May consider targeting the course to individual institutional ethical committeesMay consider targeting the course to individual institutional ethical committees Joint training of members of same institutional health research ethics committee may promote collegiality and understanding of roles and responsibilities by membersJoint training of members of same institutional health research ethics committee may promote collegiality and understanding of roles and responsibilities by members

8 8 What works – Short courses Rotation of members off committees by institutional authorities provides a continuing need for this kind of program as new members require trainingRotation of members off committees by institutional authorities provides a continuing need for this kind of program as new members require training It may also address the potential issue of producing people with advanced degrees in health research ethics who have limited career and job prospectsIt may also address the potential issue of producing people with advanced degrees in health research ethics who have limited career and job prospects Performance metrics difficult to determine but ethics committees in Nigeria are required to be registered and are being categorized based on such factors as qualification and training of members in health research ethics, mean duration of time taken to review protocols etcPerformance metrics difficult to determine but ethics committees in Nigeria are required to be registered and are being categorized based on such factors as qualification and training of members in health research ethics, mean duration of time taken to review protocols etc

9 9 What works – degree programs Major investment required to train and mentor requisite local facultyMajor investment required to train and mentor requisite local faculty High demand for university education translates into high number of applicants but many are unsuitable and have limited career and prospects in ethicsHigh demand for university education translates into high number of applicants but many are unsuitable and have limited career and prospects in ethics Careful selection of candidates needed to ensure that program meets its objectives of providing manpower needed to populate ethics committees, teach research ethics, offer services and conduct research in ethicsCareful selection of candidates needed to ensure that program meets its objectives of providing manpower needed to populate ethics committees, teach research ethics, offer services and conduct research in ethics High interest among researchers and physicians but long time away from work is a disincentiveHigh interest among researchers and physicians but long time away from work is a disincentive

10 10 What works – degree programs This category of trainees are needed to advance the cause of health research ethics within countries, provide training, conduct research and provide specialist services that extend beyond review of protocolsThis category of trainees are needed to advance the cause of health research ethics within countries, provide training, conduct research and provide specialist services that extend beyond review of protocols Systematic creation of career opportunities and enhancement of the role of health research ethics within institutions needed for trainees of such programs to function effectively and realize return on training investmentSystematic creation of career opportunities and enhancement of the role of health research ethics within institutions needed for trainees of such programs to function effectively and realize return on training investment Close relationship with the National Health Research Ethics Committee, Ministry of Health, Ministry of Education and Universities Commission helps to identify suitable candidates and supports the development of post- training career opportunitiesClose relationship with the National Health Research Ethics Committee, Ministry of Health, Ministry of Education and Universities Commission helps to identify suitable candidates and supports the development of post- training career opportunities

11 11 What works – Online training In collaboration with CITI, we offer online training in health research ethics, Good Clinical Practice and recently Responsible Conduct of ResearchIn collaboration with CITI, we offer online training in health research ethics, Good Clinical Practice and recently Responsible Conduct of Research Uptake is lower than expected – 38 individuals have completed these courses this yearUptake is lower than expected – 38 individuals have completed these courses this year More uptake when online training is integrated with courseworkMore uptake when online training is integrated with coursework Should appeal to physicians who complain of lack of timeShould appeal to physicians who complain of lack of time Requirement by the NHREC that researchers and ethics committee members undertake training in research ethics at least once every 2 years will increase demandRequirement by the NHREC that researchers and ethics committee members undertake training in research ethics at least once every 2 years will increase demand

12 12 In summary Mixed bag of training programs required because benefits are complementary and correlated disadvantages minimalMixed bag of training programs required because benefits are complementary and correlated disadvantages minimal Working synergistically with local authorities and institutionsWorking synergistically with local authorities and institutions Ensures that training programs are aligned with countrys needsEnsures that training programs are aligned with countrys needs Ensures that trainees are knowledgeable about local conditions – constitution, laws, regulations, competent authorities and the relationships between themEnsures that trainees are knowledgeable about local conditions – constitution, laws, regulations, competent authorities and the relationships between them Supports evolutionary growth of health research ethics infrastructureSupports evolutionary growth of health research ethics infrastructure Helps to define, develop and expand career and job prospects for graduatesHelps to define, develop and expand career and job prospects for graduates

13 13 In summary Trainees desire some sort of certificationTrainees desire some sort of certification Online training dependent on internet access which may be costly and inconvenient for someOnline training dependent on internet access which may be costly and inconvenient for some Online training may need to be supplemented by some on-site training or be integrated into courses/seminars/workshopsOnline training may need to be supplemented by some on-site training or be integrated into courses/seminars/workshops CME credits are available largely in the medical professions but the requirement is not enforcedCME credits are available largely in the medical professions but the requirement is not enforced

14 14 NHREC website

15 15 West African Bioethics website

16 16 Acknowledgment Members of faculty and administrative staff of West African Bioethics Training Program – Ms Yemisi Ajibose (Program Administrator)Members of faculty and administrative staff of West African Bioethics Training Program – Ms Yemisi Ajibose (Program Administrator) Professor Adebamowo and the West African Bioethics Training Program are supported by NIH Research Grant No. D43 TW007091funded by the Fogarty International Center and the National Human Genome Research Institute.Professor Adebamowo and the West African Bioethics Training Program are supported by NIH Research Grant No. D43 TW007091funded by the Fogarty International Center and the National Human Genome Research Institute.


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