Ethical Oversight of Implementation Research in Rural Settings of a Developing Country During the COVID-19 Outbreak.

Abstract

Ethical oversight of the Institutional Review Boards (IRB) could facilitate the beneficial impact on the conduct of implementation research in rural settings during the public health emergency of international concern (PHEIC). There is a knowledge gap in the application of implementation research ethics to uphold the impact on the planning of community surveys during the COVID-19 outbreak in remote rural settings. This study aimed to underscore the implementation research ethics principles incorporated in the IRB review practice at the Department of Medical Research, Myanmar by examining the records of three implementation research proposals submitted between April to October 2020. These records targeted the self-help groups, malaria volunteers, and nutrition-support groups who will introduce the innovative interventions in the remote rural areas, malaria-afflicted communities and the households of women with young children in their first 1,000-days respectively. Given that social, economic, and local administrative issues contribute for the acceptability, adoption, and effectiveness of interventions, the IRB has seriously considered the strategic plan for community engagement at vulnerable sites during PHEIC in addition to the contextual equipoise. It is also imperative to introduce the protective measures to mitigate the transmission among the research team members and the target audience in the COVID-19 period. Safe data collection modes without any interpersonal contact are desirable. The improved awareness of implementation research ethics principles and the applications is crucial for further capacity strengthening of IRBs as next steps to fit their reviews with PHEIC in a resource-constrained environment