Experience with SARETI Training Betty Kwagala (PhD) – Makerere University

Description of SARETI Training Participated in a short course in Modules at the University of Pretoria: Evaluating Research Design Introduction to Bioethics Institutionalizing Ethical Review of health Research Public Health

Modules at the University of Kwa Zulu Natal: Critical Issues in Informed Consent Professional Ethics in Health Research Culture, Morality, and Comparative Ethics Ethical Issues in Community Based Research Ethical Issues in Womens Health Research Ethical Issues in HIV Vaccine Trials

SARETI training programme Goals Overall goal To build African capacity for the ethical review and implementation of health research and to strengthen Africas institutional training capacity to achieve and sustain this aim.

Goals To provide advanced, multi-disciplinary education in health research ethics to senior professionals in Africa whose work impacts on health research ethics To strengthen institutional capacity to continue health research ethics education, development and research in Africa To increase Ethics Review Committee awareness of ethical issues in health research To extend the impact of SARETI programmes by facilitating networking of professionals with health research ethics training and experience in Africa.

Training methods Approaches used are: Problem-based interactive learning using case studies on current topics in health research ethics with minimal emphasis on lecturing. Most activities entail individual and group study, presentations and written assignments. Exposure to comparative religion and culture studies, philosophy, bioethics, law, human rights and research design as the basis on which to build health research ethics capacity.

Training methods Contd The use of explicit assessment criteria that clearly state the knowledge, skill and value/attitudinal competencies that trainees must demonstrate Regular meetings between trainees and faculty to personalize learning and to remove obstacles to learning as they arise.

Training methods contd Mentoring of trainees is used as an essential tool to stimulate the critical use of knowledge. The mentor, a faculty member, matched on interest in research ethics and basic discipline, provides professional guidance, from proposal development through to publication. Additional activities such as attendance of meetings of the University of Pretoria Research Ethics, academic meetings; and seminars at the three participating institutions etc.

Strengths The multidisciplinary approach in terms of content – promotes wide application The relevancy of all disciplines is highlighted (through the different modules). Multidisciplinary composition of fellows (synergetic effects – learning from one another) The research assignment that is relevant to fellows contexts allows ease in application. The course resources can be used for capacity building and raising awareness on ethical issues.

Strengths contd Commitment to follow-up of fellows concerning application of what they have learnt. High levels of staff commitment, linking fellows locally and internationally with opportunities for further training, and exposure to different networks, presentation of papers at conferences, promotion of fellows. Administrative staff efficiency and ability to handle persons of diverse backgrounds and expectations. SARETI training has facilitated fellows make a significant impact in national and institutional settings. Overall the training program was excellent.

Weaknesses Course very useful but too packed to allow time for reflection, although reflection is possible thereafter.

Recommendations Possibility of refresher workshops tailored to cluster groups among follows (could be held regionally). Mentoring - possibility of partnership/co- authorship in publication in Ethics issues especially for fellows who are relatively new in the area.

Recommendations contd More is needed on approaches - for capacity building in the various areas; training of trainers (e.g. for RECs, University training, training of practitioners in the field). More on the how to/approaches. Development of some basic facilitator manuals Concerning research methods relevant for community engagement, more participatory methods which generate a better understanding of interventions and promotes ownership should be explored beyond the usual FGDs and KIs.

Questions How do we create demand for (bio) ethics in contexts where it is relevant but the need is not perceived?