Navigating across international borders: a guide to research in low and middle-income countries for first- timers


  • Yardlee S Kauffman Philadelphia College of Pharmacy, Pennsylvania
  • Lauren Jonkman University of Pittsburgh
  • Sharon E Connor University of Pittsburgh


Global Health, Research, Low and Middle-Income Countries


Pharmacy students and residents who become involved in research in low and middle-income countries should be aware of potential challenges that may occur when working in these settings. This article aims to describe logistical and ethical issues associated with conducting research in low and middle-income countries (LMIC) and provides recommendations for individuals who are planning to develop and implement a research project in a LMIC. Recommended planning should involve engagement of local stakeholders where the project will take place, researching and contacting an ethical review board prior to submission, and maintaining flexibility when considering issues that occur on the ground. Anecdotal information is provided to enlighten researchers about potential issues they may encounter. Using the suggested tips as a guide will help to ensure that a successful research project and positive learning experience occur. 

Author Biographies

Yardlee S Kauffman, Philadelphia College of Pharmacy, Pennsylvania

Assistant Professor of Clinical Pharmacy, Department of Pharmacy Practice and Administration

Lauren Jonkman, University of Pittsburgh

Assistant Professor of Pharmacy & Therapeutics, School of Pharmacy

Sharon E Connor, University of Pittsburgh

Assistant Professor of Pharmacy & Therapeutics, School of Pharmacy


AACP Global Pharmacy Report, (2011). American Association of Colleges of Pharmacy (AACP).

Angel, I.M. (1997). The ethics of clinical research in the third world. New England Journal of Medicine, 337, 847-849.

Bastida, E.M., Tung-Sung, T. & Jack, L. (2010). Ethics and community-based participatory research: perspectives from the field. Health Promotion Practice, 11, 16-20.

Benatar, S.R. & Fleischer, T.E. (2007). Ethical issues in research in low-income countries. International Journal of Tuberculosis and Lung Disease, 11, 617-623.

Butta, Z.A. (2002). Ethics in international health research: a perspective from the developing world. Bulletin of the World Health Organisation, 80, 114-120.

Cooke, J.G. (2009). Public Health in Africa: A report of the CSIS Global Health Policy Centre. Centre for Strategic and International Studies.

Emanuel, E.J., Wendler, D., Killen, J. & Grady, C. (2004). What makes clinical research in developing countries ethical? The benchmarks of ethical research. Journal of Infectious Diseases, 189, 930-936.

HIV/AIDS Twinning Centre, (2015). Addis Ababa University School of Pharmacy/ Howard University Pharmacist and Continuing Education Centre (online). Available at: HIVAIDSTwinningCenter-EthiopiaAAUHoward.html. Accessed 10th February, 2015.

Kass, N.E. (2001). An ethics framework for public health. American Journal of Public Health, 91, 1776-1782.

Kauffman, Y.S., Connor, S.E., Jonkman, L.J., Himisi, T., Kane-Gill, S.L., Gillespie, E.M. & Douglas, G.P. (2014). Retrospective evaluation of adverse drug reactions in a central hospital in Malawi. Enliven: Pharmacovigilance and Drug Safety, 004.

Lurie, P. & Wolfe, S.M. (1999). Science, ethics and future of research into maternal-infant transmission of HIV-1. The Lancet, 353, 1878-79.

McIntosh, S., Sierra, E., Dozier, A., Diaz, S., Quiñones, Z., Primack, A., Chadwick, G., Ossip-Klein, D.J. (2008). Ethical review issues in collaborative research between U.S. and low – middle income country partners: A case example. Bioethics, 22, 414–422.

Nuffield Council on Bioethics, (2002). The ethics of research related to health care in developing countries (pp. 1-205). London: Nuffield Council on Bioethics.

Oji, V., Weaver, S.B., Falade, D. & Fagbemi, B. (2013). Emerging roles of U.S. pharmacists in global health and Africa. Journal of Biosafety of Health Education, 1,1-8.




How to Cite

Kauffman, Y. S., Jonkman, L., & Connor, S. E. (2016). Navigating across international borders: a guide to research in low and middle-income countries for first- timers. Pharmacy Education, 16. Retrieved from



Research Article