Stakeholders’ perspectives on ethical compensation for research participants in clinical research: a qualitative study in Ghana

Abstract

Compensation for research participants in clinical trials is a critical yet ethically complex issue, especially in low- and middle-income countries (LMICs) like Ghana. This study explores diverse stakeholder perspectives on appropriate compensation levels and types in clinical trials conducted within Ghana. Using an exploratory phenomenological qualitative design, we gathered views and perspectives through 6 focus group discussions with clinical trial participants and 18 in-depth interviews with clinical trial experts, including principal investigators, ethics experts, clinical trial managers, and community opinion leaders. Data collection was carried out using a focus group discussion (FGD) guide and an in-depth interview (IDI) guide. Data was thematically analysed. This study revealed a strong preference for compensation that acknowledges the time, inconvenience, and physical discomfort associated with study participation, with recommendations for both monetary and non-monetary forms. Participants emphasised the importance of compensation frameworks that consider study demands and participant vulnerabilities, while avoiding undue inducement. There was also significant support for developing national guidelines on research compensation to ensure consistency, fairness, and respect for participants’ contributions. This study adds to the existing literature on research participant compensation in low- and middle-income countries and gives in-depth viewpoints to help policymakers and ethics review boards in Ghana and elsewhere create ethical and equitable compensation frameworks.