Enrolment and retention of African women in biomedical research: the challenges.

BACKGROUND: In Africa, women have had minimal participation in biomedical research especially in clinical trials despite the epidemiologic realities of the trends and burden of diseases in the continent. The purpose of this paper is to critically examine the challenges as well as suggesting ways of over-coming them in recruiting and retaining African women in biomedical research. METHODS: Relevant biomedical research literatures on Human Research Participants from Scirus, Pubmed and Medline computerized search were critically evaluated and highlighted Information was also obtained from research ethics training as well as texts and journals in the medical libraries of the research ethics departments of the Universities of Pretoria, Kwazulu-Natal, Johns Hopkins Berman Institute of Bioethics Baltimore and Kennedy Institute of Bioethics Georgetown University, Washington DC. RESULTS: Studies reviewed have shown that African women have an unfair participation in biomedical research. Efforts in enrolling and retaining women in biomedical research are hampered by chain reactions of events viz: gender perception, cultural barriers, ignorance and fear of adverse event, limited autonomy to give consent, lack of confidentiality especially in sensitive trials, and improper research design. CONCLUSION: Women need to participate in clinical trials because of their different biological and physiological make-up which require proper information about the effects of drugs on their bodies. A variety of harm may therefore ensue from failure to include adequate numbers of women in biomedical research such as exposure to ineffective treatment, occurrence of unexpected side-effects and delayed diagnosis and early treatment of disease.

Concurrent use of multiple antenatal care providers by women utilising free antenatal care at Ebonyi State University Teaching Hospital, Abakaliki.

Observation has revealed that women who book at Ebonyi State University Teaching Hospital, Abakaliki, concurrently use multiple antenatal care givers (formal and non-formal). This study was therefore conducted to identify the other sources of antenatal care for the women and to examine them in relation to their socio-demographic characteristics. A total of 200 antenatal women chosen from two randomly selected booking clinics were interviewed using a structured questionnaire. The results show that 25% and 30.5% respectively from the two clinics were concurrently using formal and unorthodox ANC givers. Age and education were significantly related to the practice (p < 0.0002 and p < 0.02 respectively). These findings suggest that free services alone may not be enough to make women attend ANC in the hospital. A larger study, especially investigating patient's perspective of the quality of care, is recommended.