Health Providers’ Perceptions of Clinical Trials: Lessons from Ghana, Kenya and Burkina Faso
Identifieur interne : 000327 ( Main/Exploration ); précédent : 000326; suivant : 000328Health Providers’ Perceptions of Clinical Trials: Lessons from Ghana, Kenya and Burkina Faso
Auteurs : Vibian Angwenyi [Kenya] ; Kwaku-Poku Asante [Ghana] ; Abdoulaye Traoré [Burkina Faso] ; Lawrence Gyabaa Febir [Ghana] ; Charlotte Tawiah [Ghana] ; Anthony Kwarteng [Ghana] ; Alphonse Ouédraogo [Burkina Faso] ; Sodiomon Bienvenue Sirima [Burkina Faso] ; Seth Owusu-Agyei [Ghana] ; Egeruan Babatunde Imoukhuede [Allemagne] ; Jayne Webster [Royaume-Uni] ; Daniel Chandramohan [Royaume-Uni] ; Sassy Molyneux [Kenya, Royaume-Uni] ; Caroline Jones [Kenya, Royaume-Uni]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
Clinical trials conducted in Africa often require substantial investments to support trial centres and public health facilities. Trial resources could potentially generate benefits for routine health service delivery but may have unintended consequences. Strengthening ethical practice requires understanding the potential effects of trial inputs on the perceptions and practices of routine health care providers. This study explores the influence of malaria vaccine trials on health service delivery in Ghana, Kenya and Burkina Faso.
We conducted: audits of trial inputs in 10 trial facilities and among 144 health workers; individual interviews with frontline providers (n=99) and health managers (n=14); and group discussions with fieldworkers (n=9 discussions). Descriptive summaries were generated from audit data. Qualitative data were analysed using a framework approach.
Facilities involved in trials benefited from infrastructure and equipment upgrades, support with essential drugs, access to trial vehicles, and placement of additional qualified trial staff. Qualified trial staff in facilities were often seen as role models by their colleagues; assisting with supportive supervision and reducing facility workload. Some facility staff in place before the trial also received formal training and salary top-ups from the trials. However, differential access to support caused dissatisfaction, and some interviewees expressed concerns about what would happen at the end of the trial once financial and supervisory support was removed.
Clinical trials function as short-term complex health service delivery interventions in the facilities in which they are based. They have the potential to both benefit facilities, staff and communities through providing the supportive environment required for improvements in routine care, but they can also generate dissatisfaction, relationship challenges and demoralisation among staff. Minimising trial related harm and maximising benefits requires careful planning and engagement of key actors at the outset of trials, throughout the trial and on its’ completion.
Url:
DOI: 10.1371/journal.pone.0124554
PubMed: 25933429
PubMed Central: 4416706
Affiliations:
- Allemagne, Burkina Faso, Ghana, Kenya, Royaume-Uni
- Angleterre, Bade-Wurtemberg, District de Karlsruhe, Grand Londres, Oxfordshire
- Heidelberg, Londres, Oxford
- Université d'Oxford
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 000020
- to stream Pmc, to step Curation: 000020
- to stream Pmc, to step Checkpoint: 000169
- to stream Ncbi, to step Merge: 000815
- to stream Ncbi, to step Curation: 000815
- to stream Ncbi, to step Checkpoint: 000815
- to stream Main, to step Merge: 000327
- to stream Main, to step Curation: 000327
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Health Providers’ Perceptions of Clinical Trials: Lessons from Ghana, Kenya and Burkina Faso</title><author><name sortKey="Angwenyi, Vibian" sort="Angwenyi, Vibian" uniqKey="Angwenyi V" first="Vibian" last="Angwenyi">Vibian Angwenyi</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation></author><author><name sortKey="Asante, Kwaku Poku" sort="Asante, Kwaku Poku" uniqKey="Asante K" first="Kwaku-Poku" last="Asante">Kwaku-Poku Asante</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Traore, Abdoulaye" sort="Traore, Abdoulaye" uniqKey="Traore A" first="Abdoulaye" last="Traoré">Abdoulaye Traoré</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01</wicri:regionArea><wicri:noRegion>Ouagadougou 01</wicri:noRegion></affiliation></author><author><name sortKey="Febir, Lawrence Gyabaa" sort="Febir, Lawrence Gyabaa" uniqKey="Febir L" first="Lawrence Gyabaa" last="Febir">Lawrence Gyabaa Febir</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Tawiah, Charlotte" sort="Tawiah, Charlotte" uniqKey="Tawiah C" first="Charlotte" last="Tawiah">Charlotte Tawiah</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Kwarteng, Anthony" sort="Kwarteng, Anthony" uniqKey="Kwarteng A" first="Anthony" last="Kwarteng">Anthony Kwarteng</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Ouedraogo, Alphonse" sort="Ouedraogo, Alphonse" uniqKey="Ouedraogo A" first="Alphonse" last="Ouédraogo">Alphonse Ouédraogo</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01</wicri:regionArea><wicri:noRegion>Ouagadougou 01</wicri:noRegion></affiliation></author><author><name sortKey="Sirima, Sodiomon Bienvenue" sort="Sirima, Sodiomon Bienvenue" uniqKey="Sirima S" first="Sodiomon Bienvenue" last="Sirima">Sodiomon Bienvenue Sirima</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01</wicri:regionArea><wicri:noRegion>Ouagadougou 01</wicri:noRegion></affiliation></author><author><name sortKey="Owusu Agyei, Seth" sort="Owusu Agyei, Seth" uniqKey="Owusu Agyei S" first="Seth" last="Owusu-Agyei">Seth Owusu-Agyei</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Imoukhuede, Egeruan Babatunde" sort="Imoukhuede, Egeruan Babatunde" uniqKey="Imoukhuede E" first="Egeruan Babatunde" last="Imoukhuede">Egeruan Babatunde Imoukhuede</name><affiliation wicri:level="3"><nlm:aff id="aff004"><addr-line>European Vaccine Initiative (EVI),Universitäts Klinikum Heidelberg, Im Neuenheimer Feld 326, 69120, Heidelberg, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>European Vaccine Initiative (EVI),Universitäts Klinikum Heidelberg, Im Neuenheimer Feld 326, 69120, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Webster, Jayne" sort="Webster, Jayne" uniqKey="Webster J" first="Jayne" last="Webster">Jayne Webster</name><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Chandramohan, Daniel" sort="Chandramohan, Daniel" uniqKey="Chandramohan D" first="Daniel" last="Chandramohan">Daniel Chandramohan</name><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Molyneux, Sassy" sort="Molyneux, Sassy" uniqKey="Molyneux S" first="Sassy" last="Molyneux">Sassy Molyneux</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff006"><addr-line>The Ethox Centre, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Ethox Centre, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>The Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>The Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25933429</idno><idno type="pmc">4416706</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4416706</idno><idno type="RBID">PMC:4416706</idno><idno type="doi">10.1371/journal.pone.0124554</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000020</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000020</idno><idno type="wicri:Area/Pmc/Curation">000020</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000020</idno><idno type="wicri:Area/Pmc/Checkpoint">000169</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000169</idno><idno type="wicri:Area/Ncbi/Merge">000815</idno><idno type="wicri:Area/Ncbi/Curation">000815</idno><idno type="wicri:Area/Ncbi/Checkpoint">000815</idno><idno type="wicri:Area/Main/Merge">000327</idno><idno type="wicri:Area/Main/Curation">000327</idno><idno type="wicri:Area/Main/Exploration">000327</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Health Providers’ Perceptions of Clinical Trials: Lessons from Ghana, Kenya and Burkina Faso</title><author><name sortKey="Angwenyi, Vibian" sort="Angwenyi, Vibian" uniqKey="Angwenyi V" first="Vibian" last="Angwenyi">Vibian Angwenyi</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation></author><author><name sortKey="Asante, Kwaku Poku" sort="Asante, Kwaku Poku" uniqKey="Asante K" first="Kwaku-Poku" last="Asante">Kwaku-Poku Asante</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Traore, Abdoulaye" sort="Traore, Abdoulaye" uniqKey="Traore A" first="Abdoulaye" last="Traoré">Abdoulaye Traoré</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01</wicri:regionArea><wicri:noRegion>Ouagadougou 01</wicri:noRegion></affiliation></author><author><name sortKey="Febir, Lawrence Gyabaa" sort="Febir, Lawrence Gyabaa" uniqKey="Febir L" first="Lawrence Gyabaa" last="Febir">Lawrence Gyabaa Febir</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Tawiah, Charlotte" sort="Tawiah, Charlotte" uniqKey="Tawiah C" first="Charlotte" last="Tawiah">Charlotte Tawiah</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Kwarteng, Anthony" sort="Kwarteng, Anthony" uniqKey="Kwarteng A" first="Anthony" last="Kwarteng">Anthony Kwarteng</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Ouedraogo, Alphonse" sort="Ouedraogo, Alphonse" uniqKey="Ouedraogo A" first="Alphonse" last="Ouédraogo">Alphonse Ouédraogo</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01</wicri:regionArea><wicri:noRegion>Ouagadougou 01</wicri:noRegion></affiliation></author><author><name sortKey="Sirima, Sodiomon Bienvenue" sort="Sirima, Sodiomon Bienvenue" uniqKey="Sirima S" first="Sodiomon Bienvenue" last="Sirima">Sodiomon Bienvenue Sirima</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01, Burkina Faso</addr-line></nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Centre National de Recherche et de Formation sur le Paludisme (CNRFP), 01 BP 2208, Ouagadougou 01</wicri:regionArea><wicri:noRegion>Ouagadougou 01</wicri:noRegion></affiliation></author><author><name sortKey="Owusu Agyei, Seth" sort="Owusu Agyei, Seth" uniqKey="Owusu Agyei S" first="Seth" last="Owusu-Agyei">Seth Owusu-Agyei</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Kintampo Health Research Centre (KHRC), P.O. Box 200, Kintampo</wicri:regionArea><wicri:noRegion>Kintampo</wicri:noRegion></affiliation></author><author><name sortKey="Imoukhuede, Egeruan Babatunde" sort="Imoukhuede, Egeruan Babatunde" uniqKey="Imoukhuede E" first="Egeruan Babatunde" last="Imoukhuede">Egeruan Babatunde Imoukhuede</name><affiliation wicri:level="3"><nlm:aff id="aff004"><addr-line>European Vaccine Initiative (EVI),Universitäts Klinikum Heidelberg, Im Neuenheimer Feld 326, 69120, Heidelberg, Germany</addr-line></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>European Vaccine Initiative (EVI),Universitäts Klinikum Heidelberg, Im Neuenheimer Feld 326, 69120, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Webster, Jayne" sort="Webster, Jayne" uniqKey="Webster J" first="Jayne" last="Webster">Jayne Webster</name><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Chandramohan, Daniel" sort="Chandramohan, Daniel" uniqKey="Chandramohan D" first="Daniel" last="Chandramohan">Daniel Chandramohan</name><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Molyneux, Sassy" sort="Molyneux, Sassy" uniqKey="Molyneux S" first="Sassy" last="Molyneux">Sassy Molyneux</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff006"><addr-line>The Ethox Centre, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Ethox Centre, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>The Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Department of Public Health Research, KEMRI/Wellcome Trust Research Programme (KWTRP), P.O. Box, 230–80108, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="aff005"><addr-line>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Disease Control Department, London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, WC1E 7HT, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff007"><addr-line>The Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Centre for Clinical Vaccinology and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>Clinical trials conducted in Africa often require substantial investments to support trial centres and public health facilities. Trial resources could potentially generate benefits for routine health service delivery but may have unintended consequences. Strengthening ethical practice requires understanding the potential effects of trial inputs on the perceptions and practices of routine health care providers. This study explores the influence of malaria vaccine trials on health service delivery in Ghana, Kenya and Burkina Faso.</p></sec><sec id="sec002"><title>Methods</title><p>We conducted: audits of trial inputs in 10 trial facilities and among 144 health workers; individual interviews with frontline providers (n=99) and health managers (n=14); and group discussions with fieldworkers (n=9 discussions). Descriptive summaries were generated from audit data. Qualitative data were analysed using a framework approach.</p></sec><sec id="sec003"><title>Results</title><p>Facilities involved in trials benefited from infrastructure and equipment upgrades, support with essential drugs, access to trial vehicles, and placement of additional qualified trial staff. Qualified trial staff in facilities were often seen as role models by their colleagues; assisting with supportive supervision and reducing facility workload. Some facility staff in place before the trial also received formal training and salary top-ups from the trials. However, differential access to support caused dissatisfaction, and some interviewees expressed concerns about what would happen at the end of the trial once financial and supervisory support was removed.</p></sec><sec id="sec004"><title>Conclusion</title><p>Clinical trials function as short-term complex health service delivery interventions in the facilities in which they are based. They have the potential to both benefit facilities, staff and communities through providing the supportive environment required for improvements in routine care, but they can also generate dissatisfaction, relationship challenges and demoralisation among staff. Minimising trial related harm and maximising benefits requires careful planning and engagement of key actors at the outset of trials, throughout the trial and on its’ completion.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lang, Ta" uniqKey="Lang T">TA Lang</name></author><author><name sortKey="Kokwaro, Go" uniqKey="Kokwaro G">GO Kokwaro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mwangoka, G" uniqKey="Mwangoka G">G Mwangoka</name></author><author><name sortKey="Ogutu, B" uniqKey="Ogutu B">B Ogutu</name></author><author><name sortKey="Msambichaka, B" uniqKey="Msambichaka B">B Msambichaka</name></author><author><name sortKey="Mzee, T" uniqKey="Mzee T">T Mzee</name></author><author><name sortKey="Salim, N" uniqKey="Salim N">N Salim</name></author><author><name sortKey="Kafuruki, S" uniqKey="Kafuruki S">S Kafuruki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rao, Vb" uniqKey="Rao V">VB Rao</name></author><author><name sortKey="Schellenberg, D" uniqKey="Schellenberg D">D Schellenberg</name></author><author><name sortKey="Ghani, Ac" uniqKey="Ghani A">AC Ghani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dickson, Ke" uniqKey="Dickson K">KE Dickson</name></author><author><name sortKey="Simen Kapeu, A" uniqKey="Simen Kapeu A">A Simen-Kapeu</name></author><author><name sortKey="Kinney, Mv" uniqKey="Kinney M">MV Kinney</name></author><author><name sortKey="Huicho, L" uniqKey="Huicho L">L Huicho</name></author><author><name sortKey="Vesel, L" uniqKey="Vesel L">L Vesel</name></author><author><name sortKey="Lackritz, E" uniqKey="Lackritz E">E Lackritz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Senkubuge, F" uniqKey="Senkubuge F">F Senkubuge</name></author><author><name sortKey="Modisenyane, M" uniqKey="Modisenyane M">M Modisenyane</name></author><author><name sortKey="Bishaw, T" uniqKey="Bishaw T">T Bishaw</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Tinto, H" uniqKey="Tinto H">H Tinto</name></author><author><name sortKey="Noor, Ra" uniqKey="Noor R">RA Noor</name></author><author><name sortKey="Wanga, Cl" uniqKey="Wanga C">CL Wanga</name></author><author><name sortKey="Valea, I" uniqKey="Valea I">I Valea</name></author><author><name sortKey="Mbaye, Mn" uniqKey="Mbaye M">MN Mbaye</name></author><author><name sortKey="D Alessandro, U" uniqKey="D Alessandro U">U D'Alessandro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lang, T" uniqKey="Lang T">T Lang</name></author><author><name sortKey="Siribaddana, S" uniqKey="Siribaddana S">S Siribaddana</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cutts, Ft" uniqKey="Cutts F">FT Cutts</name></author><author><name sortKey="Enwere, G" uniqKey="Enwere G">G Enwere</name></author><author><name sortKey="Zaman, Sma" uniqKey="Zaman S">SMA Zaman</name></author><author><name sortKey="Yallop, Fg" uniqKey="Yallop F">FG Yallop</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liheluka, Ea" uniqKey="Liheluka E">EA Liheluka</name></author><author><name sortKey="Lusingu, Jp" uniqKey="Lusingu J">JP Lusingu</name></author><author><name sortKey="Manongi, Rn" uniqKey="Manongi R">RN Manongi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Idoko, Ot" uniqKey="Idoko O">OT Idoko</name></author><author><name sortKey="Kochhar, S" uniqKey="Kochhar S">S Kochhar</name></author><author><name sortKey="Agbenyega, Te" uniqKey="Agbenyega T">TE Agbenyega</name></author><author><name sortKey="Ogutu, B" uniqKey="Ogutu B">B Ogutu</name></author><author><name sortKey="Ota, Mo" uniqKey="Ota M">MO Ota</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jaffar, S" uniqKey="Jaffar S">S Jaffar</name></author><author><name sortKey="Amuron, B" uniqKey="Amuron B">B Amuron</name></author><author><name sortKey="Birungi, J" uniqKey="Birungi J">J Birungi</name></author><author><name sortKey="Namara, G" uniqKey="Namara G">G Namara</name></author><author><name sortKey="Nabiryo, C" uniqKey="Nabiryo C">C Nabiryo</name></author><author><name sortKey="Coutinho, A" uniqKey="Coutinho A">A Coutinho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mbuagbaw, L" uniqKey="Mbuagbaw L">L Mbuagbaw</name></author><author><name sortKey="Thabane, L" uniqKey="Thabane L">L Thabane</name></author><author><name sortKey="Ongolo Zogo, P" uniqKey="Ongolo Zogo P">P Ongolo-Zogo</name></author><author><name sortKey="Lang, T" uniqKey="Lang T">T Lang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Angwenyi, V" uniqKey="Angwenyi V">V Angwenyi</name></author><author><name sortKey="Kamuya, D" uniqKey="Kamuya D">D Kamuya</name></author><author><name sortKey="Mwachiro, D" uniqKey="Mwachiro D">D Mwachiro</name></author><author><name sortKey="Kalama, B" uniqKey="Kalama B">B Kalama</name></author><author><name sortKey="Marsh, V" uniqKey="Marsh V">V Marsh</name></author><author><name sortKey="Njuguna, P" uniqKey="Njuguna P">P Njuguna</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Febir, Lg" uniqKey="Febir L">LG Febir</name></author><author><name sortKey="Asante, Kp" uniqKey="Asante K">KP Asante</name></author><author><name sortKey="Dzorgbo, Db" uniqKey="Dzorgbo D">DB Dzorgbo</name></author><author><name sortKey="Senah, Ka" uniqKey="Senah K">KA Senah</name></author><author><name sortKey="Letsa, Ts" uniqKey="Letsa T">TS Letsa</name></author><author><name sortKey="Owusu Agyei, S" uniqKey="Owusu Agyei S">S Owusu-Agyei</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Asante, Kp" uniqKey="Asante K">KP Asante</name></author><author><name sortKey="Agyemang, Ct" uniqKey="Agyemang C">CT Agyemang</name></author><author><name sortKey="Zandoh, C" uniqKey="Zandoh C">C Zandoh</name></author><author><name sortKey="Saah, J" uniqKey="Saah J">J Saah</name></author><author><name sortKey="Febir, Lg" uniqKey="Febir L">LG Febir</name></author><author><name sortKey="Donlebo, Ck" uniqKey="Donlebo C">CK Donlebo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nyika, A" uniqKey="Nyika A">A Nyika</name></author><author><name sortKey="Chilengi, R" uniqKey="Chilengi R">R Chilengi</name></author><author><name sortKey="Ishengoma, D" uniqKey="Ishengoma D">D Ishengoma</name></author><author><name sortKey="Mtenga, S" uniqKey="Mtenga S">S Mtenga</name></author><author><name sortKey="Thera, Ma" uniqKey="Thera M">MA Thera</name></author><author><name sortKey="Sissoko, Ms" uniqKey="Sissoko M">MS Sissoko</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tinto, H" uniqKey="Tinto H">H Tinto</name></author><author><name sortKey="Valea, I" uniqKey="Valea I">I Valea</name></author><author><name sortKey="Sorgho, H" uniqKey="Sorgho H">H Sorgho</name></author><author><name sortKey="Tahita, Mc" uniqKey="Tahita M">MC Tahita</name></author><author><name sortKey="Traore, M" uniqKey="Traore M">M Traore</name></author><author><name sortKey="Bihoun, B" uniqKey="Bihoun B">B Bihoun</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kochhar, S" uniqKey="Kochhar S">S Kochhar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Molyneux, S" uniqKey="Molyneux S">S Molyneux</name></author><author><name sortKey="Njue, M" uniqKey="Njue M">M Njue</name></author><author><name sortKey="Boga, M" uniqKey="Boga M">M Boga</name></author><author><name sortKey="Akello, L" uniqKey="Akello L">L Akello</name></author><author><name sortKey="Olupot Olupot, P" uniqKey="Olupot Olupot P">P Olupot-Olupot</name></author><author><name sortKey="Engoru, C" uniqKey="Engoru C">C Engoru</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chuma, J" uniqKey="Chuma J">J Chuma</name></author><author><name sortKey="Okungu, V" uniqKey="Okungu V">V Okungu</name></author><author><name sortKey="Molyneux, C" uniqKey="Molyneux C">C Molyneux</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chuma, J" uniqKey="Chuma J">J Chuma</name></author><author><name sortKey="Gilson, L" uniqKey="Gilson L">L Gilson</name></author><author><name sortKey="Molyneux, C" uniqKey="Molyneux C">C Molyneux</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wakaba, M" uniqKey="Wakaba M">M Wakaba</name></author><author><name sortKey="Mbindyo, P" uniqKey="Mbindyo P">P Mbindyo</name></author><author><name sortKey="Ochieng, J" uniqKey="Ochieng J">J Ochieng</name></author><author><name sortKey="Kiriinya, R" uniqKey="Kiriinya R">R Kiriinya</name></author><author><name sortKey="Todd, J" uniqKey="Todd J">J Todd</name></author><author><name sortKey="Waudo, A" uniqKey="Waudo A">A Waudo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Willis Shattuck, M" uniqKey="Willis Shattuck M">M Willis-Shattuck</name></author><author><name sortKey="Bidwell, P" uniqKey="Bidwell P">P Bidwell</name></author><author><name sortKey="Thomas, S" uniqKey="Thomas S">S Thomas</name></author><author><name sortKey="Wyness, L" uniqKey="Wyness L">L Wyness</name></author><author><name sortKey="Blaauw, D" uniqKey="Blaauw D">D Blaauw</name></author><author><name sortKey="Ditlopo, P" uniqKey="Ditlopo P">P Ditlopo</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Chuma, J" uniqKey="Chuma J">J Chuma</name></author><author><name sortKey="Maina, T" uniqKey="Maina T">T Maina</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mills, A" uniqKey="Mills A">A Mills</name></author><author><name sortKey="Ally, M" uniqKey="Ally M">M Ally</name></author><author><name sortKey="Goudge, J" uniqKey="Goudge J">J Goudge</name></author><author><name sortKey="Gyapong, J" uniqKey="Gyapong J">J Gyapong</name></author><author><name sortKey="Mtei, G" uniqKey="Mtei G">G Mtei</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Philibert, A" uniqKey="Philibert A">A Philibert</name></author><author><name sortKey="Ridde, V" uniqKey="Ridde V">V Ridde</name></author><author><name sortKey="Bado, A" uniqKey="Bado A">A Bado</name></author><author><name sortKey="Fournier, P" uniqKey="Fournier P">P Fournier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Waweru, E" uniqKey="Waweru E">E Waweru</name></author><author><name sortKey="Opwora, A" uniqKey="Opwora A">A Opwora</name></author><author><name sortKey="Toda, M" uniqKey="Toda M">M Toda</name></author><author><name sortKey="Fegan, G" uniqKey="Fegan G">G Fegan</name></author><author><name sortKey="Edwards, T" uniqKey="Edwards T">T Edwards</name></author><author><name sortKey="Goodman, C" uniqKey="Goodman C">C Goodman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jehu Appiah, C" uniqKey="Jehu Appiah C">C Jehu-Appiah</name></author><author><name sortKey="Aryeetey, G" uniqKey="Aryeetey G">G Aryeetey</name></author><author><name sortKey="Spaan, E" uniqKey="Spaan E">E Spaan</name></author><author><name sortKey="De Hoop, T" uniqKey="De Hoop T">T de Hoop</name></author><author><name sortKey="Agyepong, I" uniqKey="Agyepong I">I Agyepong</name></author><author><name sortKey="Baltussen, R" uniqKey="Baltussen R">R Baltussen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Owusu Agyei, S" uniqKey="Owusu Agyei S">S Owusu-Agyei</name></author><author><name sortKey="Asante, Kp" uniqKey="Asante K">KP Asante</name></author><author><name sortKey="Owusu, R" uniqKey="Owusu R">R Owusu</name></author><author><name sortKey="Adjuik, M" uniqKey="Adjuik M">M Adjuik</name></author><author><name sortKey="Amenga Etego, S" uniqKey="Amenga Etego S">S Amenga-Etego</name></author><author><name sortKey="Dosoo, Dk" uniqKey="Dosoo D">DK Dosoo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Owusu Agyei, S" uniqKey="Owusu Agyei S">S Owusu-Agyei</name></author><author><name sortKey="Ansong, D" uniqKey="Ansong D">D Ansong</name></author><author><name sortKey="Asante, K" uniqKey="Asante K">K Asante</name></author><author><name sortKey="Kwarteng Owusu, S" uniqKey="Kwarteng Owusu S">S Kwarteng Owusu</name></author><author><name sortKey="Owusu, R" uniqKey="Owusu R">R Owusu</name></author><author><name sortKey="Wireko Brobby, Na" uniqKey="Wireko Brobby N">NA Wireko Brobby</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Asante, Kp" uniqKey="Asante K">KP Asante</name></author><author><name sortKey="Abdulla, S" uniqKey="Abdulla S">S Abdulla</name></author><author><name sortKey="Agnandji, S" uniqKey="Agnandji S">S Agnandji</name></author><author><name sortKey="Lyimo, J" uniqKey="Lyimo J">J Lyimo</name></author><author><name sortKey="Vekemans, J" uniqKey="Vekemans J">J Vekemans</name></author><author><name sortKey="Soulanoudjingar, S" uniqKey="Soulanoudjingar S">S Soulanoudjingar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Makanga, M" uniqKey="Makanga M">M Makanga</name></author><author><name sortKey="Premji, Z" uniqKey="Premji Z">Z Premji</name></author><author><name sortKey="Falade, C" uniqKey="Falade C">C Falade</name></author><author><name sortKey="Karbwang, J" uniqKey="Karbwang J">J Karbwang</name></author><author><name sortKey="Mueller, Ea" uniqKey="Mueller E">EA Mueller</name></author><author><name sortKey="Andriano, K" uniqKey="Andriano K">K Andriano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bejon, P" uniqKey="Bejon P">P Bejon</name></author><author><name sortKey="Ogada, E" uniqKey="Ogada E">E Ogada</name></author><author><name sortKey="Mwangi, T" uniqKey="Mwangi T">T Mwangi</name></author><author><name sortKey="Milligan, P" uniqKey="Milligan P">P Milligan</name></author><author><name sortKey="Lang, T" uniqKey="Lang T">T Lang</name></author><author><name sortKey="Fegan, G" uniqKey="Fegan G">G Fegan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Olotu, A" uniqKey="Olotu A">A Olotu</name></author><author><name sortKey="Lusingu, J" uniqKey="Lusingu J">J Lusingu</name></author><author><name sortKey="Leach, A" uniqKey="Leach A">A Leach</name></author><author><name sortKey="Lievens, M" uniqKey="Lievens M">M Lievens</name></author><author><name sortKey="Vekemans, J" uniqKey="Vekemans J">J Vekemans</name></author><author><name sortKey="Msham, S" uniqKey="Msham S">S Msham</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chilengi, R" uniqKey="Chilengi R">R Chilengi</name></author><author><name sortKey="Juma, R" uniqKey="Juma R">R Juma</name></author><author><name sortKey="Abdallah, Am" uniqKey="Abdallah A">AM Abdallah</name></author><author><name sortKey="Bashraheil, M" uniqKey="Bashraheil M">M Bashraheil</name></author><author><name sortKey="Lodenyo, H" uniqKey="Lodenyo H">H Lodenyo</name></author><author><name sortKey="Nyakundi, P" uniqKey="Nyakundi P">P Nyakundi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sirima, Sb" uniqKey="Sirima S">SB Sirima</name></author><author><name sortKey="Tiono, Ab" uniqKey="Tiono A">AB Tiono</name></author><author><name sortKey="Gansane, A" uniqKey="Gansane A">A Gansane</name></author><author><name sortKey="Diarra, A" uniqKey="Diarra A">A Diarra</name></author><author><name sortKey="Ouedraogo, A" uniqKey="Ouedraogo A">A Ouedraogo</name></author><author><name sortKey="Konate, At" uniqKey="Konate A">AT Konate</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sirima, Sb" uniqKey="Sirima S">SB Sirima</name></author><author><name sortKey="Tiono, Ab" uniqKey="Tiono A">AB Tiono</name></author><author><name sortKey="Ouedraogo, A" uniqKey="Ouedraogo A">A Ouedraogo</name></author><author><name sortKey="Diarra, A" uniqKey="Diarra A">A Diarra</name></author><author><name sortKey="Ouedraogo, Al" uniqKey="Ouedraogo A">AL Ouedraogo</name></author><author><name sortKey="Yaro, Jb" uniqKey="Yaro J">JB Yaro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kirkwood, Br" uniqKey="Kirkwood B">BR Kirkwood</name></author><author><name sortKey="Hurt, L" uniqKey="Hurt L">L Hurt</name></author><author><name sortKey="Amenga Etego, S" uniqKey="Amenga Etego S">S Amenga-Etego</name></author><author><name sortKey="Tawiah, C" uniqKey="Tawiah C">C Tawiah</name></author><author><name sortKey="Zandoh, C" uniqKey="Zandoh C">C Zandoh</name></author><author><name sortKey="Danso, S" uniqKey="Danso S">S Danso</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Njue, M" uniqKey="Njue M">M Njue</name></author><author><name sortKey="Kombe, F" uniqKey="Kombe F">F Kombe</name></author><author><name sortKey="Mwalukore, S" uniqKey="Mwalukore S">S Mwalukore</name></author><author><name sortKey="Molyneux, S" uniqKey="Molyneux S">S Molyneux</name></author><author><name sortKey="Marsh, V" uniqKey="Marsh V">V Marsh</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Richie, J" uniqKey="Richie J">J Richie</name></author><author><name sortKey="Spencer, L" uniqKey="Spencer L">L Spencer</name></author><author><name sortKey="Alan, B" uniqKey="Alan B">B Alan</name></author><author><name sortKey="Robert, B" uniqKey="Robert B">B Robert</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Green, J" uniqKey="Green J">J Green</name></author><author><name sortKey="Thorogood, N" uniqKey="Thorogood N">N Thorogood</name></author><author><name sortKey="Silverman, D" uniqKey="Silverman D">D Silverman</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Gikonyo, C" uniqKey="Gikonyo C">C Gikonyo</name></author><author><name sortKey="Kamuya, D" uniqKey="Kamuya D">D Kamuya</name></author><author><name sortKey="Mbete, B" uniqKey="Mbete B">B Mbete</name></author><author><name sortKey="Njuguna, P" uniqKey="Njuguna P">P Njuguna</name></author><author><name sortKey="Olotu, A" uniqKey="Olotu A">A Olotu</name></author><author><name sortKey="Bejon, P" uniqKey="Bejon P">P Bejon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mbindyo, P" uniqKey="Mbindyo P">P Mbindyo</name></author><author><name sortKey="Gilson, L" uniqKey="Gilson L">L Gilson</name></author><author><name sortKey="Blaauw, D" uniqKey="Blaauw D">D Blaauw</name></author><author><name sortKey="English, M" uniqKey="English M">M English</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mathauer, I" uniqKey="Mathauer I">I Mathauer</name></author><author><name sortKey="Imhoff, I" uniqKey="Imhoff I">I Imhoff</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ofori Adjei, D" uniqKey="Ofori Adjei D">D Ofori-Adjei</name></author><author><name sortKey="Arhinful, Dk" uniqKey="Arhinful D">DK Arhinful</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pariyo, Gw" uniqKey="Pariyo G">GW Pariyo</name></author><author><name sortKey="Gouws, E" uniqKey="Gouws E">E Gouws</name></author><author><name sortKey="Bryce, J" uniqKey="Bryce J">J Bryce</name></author><author><name sortKey="Burnham, G" uniqKey="Burnham G">G Burnham</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rowe, Ak" uniqKey="Rowe A">AK Rowe</name></author><author><name sortKey="De Savigny, D" uniqKey="De Savigny D">D de Savigny</name></author><author><name sortKey="Lanata, Cf" uniqKey="Lanata C">CF Lanata</name></author><author><name sortKey="Victora, Cg" uniqKey="Victora C">CG Victora</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zurovac, D" uniqKey="Zurovac D">D Zurovac</name></author><author><name sortKey="Njogu, J" uniqKey="Njogu J">J Njogu</name></author><author><name sortKey="Akhwale, W" uniqKey="Akhwale W">W Akhwale</name></author><author><name sortKey="Hamer, Dh" uniqKey="Hamer D">DH Hamer</name></author><author><name sortKey="Snow, Rw" uniqKey="Snow R">RW Snow</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rowe, Ak" uniqKey="Rowe A">AK Rowe</name></author><author><name sortKey="Onikpo, F" uniqKey="Onikpo F">F Onikpo</name></author><author><name sortKey="Lama, M" uniqKey="Lama M">M Lama</name></author><author><name sortKey="Osterholt, Dm" uniqKey="Osterholt D">DM Osterholt</name></author><author><name sortKey="Rowe, Sy" uniqKey="Rowe S">SY Rowe</name></author><author><name sortKey="Deming, Ms" uniqKey="Deming M">MS Deming</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wasunna, B" uniqKey="Wasunna B">B Wasunna</name></author><author><name sortKey="Zurovac, D" uniqKey="Zurovac D">D Zurovac</name></author><author><name sortKey="Bruce, J" uniqKey="Bruce J">J Bruce</name></author><author><name sortKey="Jones, C" uniqKey="Jones C">C Jones</name></author><author><name sortKey="Webster, J" uniqKey="Webster J">J Webster</name></author><author><name sortKey="Snow, Rw" uniqKey="Snow R">RW Snow</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chandler, Ci" uniqKey="Chandler C">CI Chandler</name></author><author><name sortKey="Jones, C" uniqKey="Jones C">C Jones</name></author><author><name sortKey="Boniface, G" uniqKey="Boniface G">G Boniface</name></author><author><name sortKey="Juma, K" uniqKey="Juma K">K Juma</name></author><author><name sortKey="Reyburn, H" uniqKey="Reyburn H">H Reyburn</name></author><author><name sortKey="Whitty, Cj" uniqKey="Whitty C">CJ Whitty</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gabbay, J" uniqKey="Gabbay J">J Gabbay</name></author><author><name sortKey="May, Al" uniqKey="May A">Al May</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chandler, Ci" uniqKey="Chandler C">CI Chandler</name></author><author><name sortKey="Kizito, J" uniqKey="Kizito J">J Kizito</name></author><author><name sortKey="Taaka, L" uniqKey="Taaka L">L Taaka</name></author><author><name sortKey="Nabirye, C" uniqKey="Nabirye C">C Nabirye</name></author><author><name sortKey="Kayendeke, M" uniqKey="Kayendeke M">M Kayendeke</name></author><author><name sortKey="Diliberto, D" uniqKey="Diliberto D">D Diliberto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wenger, E" uniqKey="Wenger E">E Wenger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chandler, Ci" uniqKey="Chandler C">CI Chandler</name></author><author><name sortKey="Diliberto, D" uniqKey="Diliberto D">D DiLiberto</name></author><author><name sortKey="Nayiga, S" uniqKey="Nayiga S">S Nayiga</name></author><author><name sortKey="Taaka, L" uniqKey="Taaka L">L Taaka</name></author><author><name sortKey="Nabirye, C" uniqKey="Nabirye C">C Nabirye</name></author><author><name sortKey="Kayendeke, M" uniqKey="Kayendeke M">M Kayendeke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rowe, Ak" uniqKey="Rowe A">AK Rowe</name></author><author><name sortKey="Onikpo, F" uniqKey="Onikpo F">F Onikpo</name></author><author><name sortKey="Lama, M" uniqKey="Lama M">M Lama</name></author><author><name sortKey="Osterholt, Dm" uniqKey="Osterholt D">DM Osterholt</name></author><author><name sortKey="Rowe, Sy" uniqKey="Rowe S">SY Rowe</name></author><author><name sortKey="Deming, Ms" uniqKey="Deming M">MS Deming</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>Burkina Faso</li><li>Ghana</li><li>Kenya</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Bade-Wurtemberg</li><li>District de Karlsruhe</li><li>Grand Londres</li><li>Oxfordshire</li></region><settlement><li>Heidelberg</li><li>Londres</li><li>Oxford</li></settlement><orgName><li>Université d'Oxford</li></orgName></list><tree><country name="Kenya"><noRegion><name sortKey="Angwenyi, Vibian" sort="Angwenyi, Vibian" uniqKey="Angwenyi V" first="Vibian" last="Angwenyi">Vibian Angwenyi</name></noRegion><name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name><name sortKey="Molyneux, Sassy" sort="Molyneux, Sassy" uniqKey="Molyneux S" first="Sassy" last="Molyneux">Sassy Molyneux</name></country><country name="Ghana"><noRegion><name sortKey="Asante, Kwaku Poku" sort="Asante, Kwaku Poku" uniqKey="Asante K" first="Kwaku-Poku" last="Asante">Kwaku-Poku Asante</name></noRegion><name sortKey="Febir, Lawrence Gyabaa" sort="Febir, Lawrence Gyabaa" uniqKey="Febir L" first="Lawrence Gyabaa" last="Febir">Lawrence Gyabaa Febir</name><name sortKey="Kwarteng, Anthony" sort="Kwarteng, Anthony" uniqKey="Kwarteng A" first="Anthony" last="Kwarteng">Anthony Kwarteng</name><name sortKey="Owusu Agyei, Seth" sort="Owusu Agyei, Seth" uniqKey="Owusu Agyei S" first="Seth" last="Owusu-Agyei">Seth Owusu-Agyei</name><name sortKey="Tawiah, Charlotte" sort="Tawiah, Charlotte" uniqKey="Tawiah C" first="Charlotte" last="Tawiah">Charlotte Tawiah</name></country><country name="Burkina Faso"><noRegion><name sortKey="Traore, Abdoulaye" sort="Traore, Abdoulaye" uniqKey="Traore A" first="Abdoulaye" last="Traoré">Abdoulaye Traoré</name></noRegion><name sortKey="Ouedraogo, Alphonse" sort="Ouedraogo, Alphonse" uniqKey="Ouedraogo A" first="Alphonse" last="Ouédraogo">Alphonse Ouédraogo</name><name sortKey="Sirima, Sodiomon Bienvenue" sort="Sirima, Sodiomon Bienvenue" uniqKey="Sirima S" first="Sodiomon Bienvenue" last="Sirima">Sodiomon Bienvenue Sirima</name></country><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Imoukhuede, Egeruan Babatunde" sort="Imoukhuede, Egeruan Babatunde" uniqKey="Imoukhuede E" first="Egeruan Babatunde" last="Imoukhuede">Egeruan Babatunde Imoukhuede</name></region></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Webster, Jayne" sort="Webster, Jayne" uniqKey="Webster J" first="Jayne" last="Webster">Jayne Webster</name></region><name sortKey="Chandramohan, Daniel" sort="Chandramohan, Daniel" uniqKey="Chandramohan D" first="Daniel" last="Chandramohan">Daniel Chandramohan</name><name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name><name sortKey="Jones, Caroline" sort="Jones, Caroline" uniqKey="Jones C" first="Caroline" last="Jones">Caroline Jones</name><name sortKey="Molyneux, Sassy" sort="Molyneux, Sassy" uniqKey="Molyneux S" first="Sassy" last="Molyneux">Sassy Molyneux</name><name sortKey="Molyneux, Sassy" sort="Molyneux, Sassy" uniqKey="Molyneux S" first="Sassy" last="Molyneux">Sassy Molyneux</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaGhanaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000327 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000327 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= SidaGhanaV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= PMC:4416706
|texte= Health Providers’ Perceptions of Clinical Trials: Lessons from Ghana, Kenya and Burkina Faso
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:25933429" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a SidaGhanaV1
| This area was generated with Dilib version V0.6.31. |  |