A study of barriers to clinical research participation in south arica: the clinical investigator perspective
1
Business School, Stellenbosch University, Cape Town, South Africa
2
School of Public Health, Wits University, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A3720
ABSTRACT
BACKGROUND:
South Africa, despite being a regional leader in clinical trials, continues to experience limited participation from its own clinical investigators. This restricts the country’s ability to generate locally relevant research and respond effectively to its public health needs.
OBJECTIVES:
To identify the barriers that limit clinical research participation among South African clinical investigators and to explore potential strategies to overcome them.
METHODS:
A qualitative study using semi-structured interviews and focus group discussions was conducted with 13 participants representing a mix of current, former, and aspiring clinical investigators from across the country. Thematic analysis, using Braun and Clarke’s method, was conducted on data coded with ATLAS.ti software.
RESULTS:
Six central themes emerged: inadequate institutional support, complex and inconsistent regulatory approvals, lack of mentorship and structured training, funding constraints tied to short-term donor priorities, challenges in participant recruitment, and socioeconomic disparities that reduce community participation. Investigators also reported difficulty balancing research with heavy clinical workloads and navigating unclear or bureaucratic research pathways.
CONCLUSIONS:
Based on the findings, the study recommends increasing institutional investment in research infrastructure, streamlining regulatory processes, and establishing long-term funding mechanisms. Mentorship and professional development programs are also suggested to support early-career investigators. Additionally, targeted efforts to improve participant recruitment and engagement, especially in underserved communities, would enhance the research landscape. This study contributes to the literature by addressing gaps in understanding the barriers to clinical research in low- and middle-income countries (LMICs). It extensively analyses the factors limiting clinical research participation in South Africa and provides recommendations for healthcare institutions, regulatory bodies, and policymakers to strengthen the country’s research capacity
South Africa, despite being a regional leader in clinical trials, continues to experience limited participation from its own clinical investigators. This restricts the country’s ability to generate locally relevant research and respond effectively to its public health needs.
OBJECTIVES:
To identify the barriers that limit clinical research participation among South African clinical investigators and to explore potential strategies to overcome them.
METHODS:
A qualitative study using semi-structured interviews and focus group discussions was conducted with 13 participants representing a mix of current, former, and aspiring clinical investigators from across the country. Thematic analysis, using Braun and Clarke’s method, was conducted on data coded with ATLAS.ti software.
RESULTS:
Six central themes emerged: inadequate institutional support, complex and inconsistent regulatory approvals, lack of mentorship and structured training, funding constraints tied to short-term donor priorities, challenges in participant recruitment, and socioeconomic disparities that reduce community participation. Investigators also reported difficulty balancing research with heavy clinical workloads and navigating unclear or bureaucratic research pathways.
CONCLUSIONS:
Based on the findings, the study recommends increasing institutional investment in research infrastructure, streamlining regulatory processes, and establishing long-term funding mechanisms. Mentorship and professional development programs are also suggested to support early-career investigators. Additionally, targeted efforts to improve participant recruitment and engagement, especially in underserved communities, would enhance the research landscape. This study contributes to the literature by addressing gaps in understanding the barriers to clinical research in low- and middle-income countries (LMICs). It extensively analyses the factors limiting clinical research participation in South Africa and provides recommendations for healthcare institutions, regulatory bodies, and policymakers to strengthen the country’s research capacity
| eISSN: | 2654-1459 |
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