BACKGROUND:
Clinical trials for preventive interventions are increasingly being conducted in low- and middle-income countries (LMICs) such as Tanzania. However, there is no consensus on the ethically appropriate way to compensate healthy volunteers in these settings. Ethical concerns remain within the research community regarding the form and level of compensation offered to participants in resource-constrained environments.

OBJECTIVE:
We explored the ethical approaches that research personnel perceived as appropriate to research volunteers participating in several prevention trials in Tanzania.

METHODS:
This was a qualitative descriptive design interviewing a purposive sample of research personnel from six different prevention trials in two urban regions of Tanzania. A semi-structured interview guide was used, and interviews were recorded and transcribed verbatim. 36 research personnel completed the interview. Data were analyzed thematically.

RESULTS:
Several key findings emerged from this study. Monetary compensation was widely accepted; however, some participants favored a one-size-fits-all approach, while others preferred flexible rates that reflected trial type, examination demands, and local living costs. Health-related insurance was highlighted as an important non-financial compensation, with participants emphasizing its ethical relevance in case of trial-related harm. Social recognition, particularly through certificates of appreciation, was valued as a meaningful way to honor volunteer contributions. Finally, as a procedural approach, participants advocated for involving volunteers in the design of compensation structures to ensure transparency and ethical fairness.

CONCLUSIONS:
A combination of monetary and non-monetary compensation was considered the most ethically appropriate approach, with volunteers desired to have a say in the design of compensation structures.