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August 15, 2026PLOS Global Public HealthOpen Access

The precarious state of community engagement in African clinical trials: A systematic review of funding, workforce gaps, and the path to institutionalization

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Authors

LBLuchuo Engelbert BainSSSidney SangongOAOluwaseun Adebayo Adewunmi

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Overview

Systematic review reveals funding and workforce vulnerabilities in African clinical trial community engagement, highlighting the need for institutionalized models to support vaccine sovereignty.

Key Points

  • To synthesize evidence on community engagement approaches, funding mechanisms, and sustainability challenges within African clinical trials.
  • Conducted a systematic review following PRISMA 2020 guidelines across eight databases (including MEDLINE, EMBASE, Cochrane Library, and African Journals Online) for English and French studies published between January 2000 and February 2026.
  • Appraised study quality using the Mixed Methods Appraisal Tool (MMAT) and conducted spatial analyses using R.
  • Identified 30 eligible studies, revealing that approximately 90% of clinical trials in sub-Saharan Africa rely on external international donor funding, leading to the dissolution of community engagement and laboratory infrastructure upon grant completion.
  • Classified community engagement into instrumental, ethical, and collaborative typologies, demonstrating that reliance on indirect funding and uncompensated community labor threatens long-term trial viability.

Cite This Study

Bain et al. (2026) studied this question.

synapsesocial.com/papers/6a8019f175c2e31742c8625bhttps://doi.org/10.1371/journal.pgph.0006484
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