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The ethical‐legal requirements for adolescent self‐consent to research in sub‐Saharan Africa

A scoping review

Bibliographic Data

ID21504700
AuthorsBusisiwe Nkosi (0000-0002-7084-3252, Africa Health Research Institute KwaZulu‐Natal South Africa, corresponding author), Brian C Zanoni (0000-0002-8640-7703, School of Medicine Emory University Atlanta Georgia USA), Janet Seeley (0000-0002-0583-5272, Africa Health Research Institute KwaZulu‐Natal South Africa), Ann Strode (0000-0001-6354-189X, School of Law University of KwaZulu‐Natal Durban South Africa)
Year2022
Volume36
Issue5
Pages576-586
Publication date2022-06-01
Open AccessYes
TypeARTICLE
VenueBioethics (JOURNAL)
Journal identifiersISSN: 0269-9702 • E-ISSN: 1467-8519
PublisherWiley (PUBLISHER • GB)
DOI10.1111/bioe.12988
PMID34942033
OpenAlexW4200361698
LanguageEN
Citations received3
References cited4

Support for the enrolment of adolescents in research has been constrained by uncertainties in parental involvement, and the lack of clarity in the ethical and legal frameworks. We conducted a scoping review to examine articles that explored the opinion of scholars on the question of adolescent consent and conditions for parental waivers in research in sub‐Saharan Africa (SSA). Guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) tool, we searched electronic databases (PubMed, EMBASSE, EBSCOHOST) and also reviewed the references of articles identified for additional relevant literature. We included full text English articles focusing on adolescent consent and parental waivers in SSA that were published between 2004 and 2020. We excluded studies focusing on healthcare, theses, and reviews. We reviewed a total of 21 publications from South Africa ( n = 12), Kenya ( n = 4) and Botswana, Malawi, Nigeria, Uganda and Zimbabwe ( n = 1 each). We identified four broad thematic issues: the current position regarding parental waivers and self‐consent; parental involvement in the consent process; the role of community approval or consent when adolescent self‐consent approaches were used; and complexities and ambiguities in legal requirements and ethical guidelines on adolescent consent. Our findings show inconsistencies and ambiguities in the existing legal and ethical frameworks within and across different countries, and underscore the need for consistent and clearer guidance on parental waivers and adolescent self‐consent. Harmonization of the legal and ethical frameworks taking into account varying contexts is critically important to ensure research on adolescents in SSA meets adolescents' specific unmet needs

Alternative medicine · CLARITY · Family medicine · Harmonization · Informed consent · Legal guardian · Medical education · Parental consent · Political science · Qualitative research · Social science · Sociology · Thematic analysis · Adolescent and Pediatric Healthcare · Adolescent Sexual and Reproductive Health · Ethics and Legal Issues in Pediatric Healthcare · Law · Medicine · Psychology

  • The ethical‐legal requirements for adolescent self‐consent to research in sub‐Saharan Africa

    Open Access•Busisiwe Nkosi, Brian C Zanoni et al.•Bioethics•2022

  • ‘I feel that I should decide on my own….’

    Open Access•Ferdinand C Mukumbang, Kristen Beima-Sofie et al.•BMJ Global Health•2023

  • Comparing comprehension of consent document between adolescent girls and caregivers of adolescents in Siaya County, Kenya

    Open Access•Jacob Onyango, Gift-Noelle Wango et al.•Research Ethics•2025

  • The ethical‐legal requirements for adolescent self‐consent to research in sub‐Saharan Africa

    Open Access•Busisiwe Nkosi, Brian C Zanoni et al.•Bioethics•2022

  • Changes to the law on consent in South Africa

    Open Access•Melanie Zuch, Amanda J Mason‐Jones et al.•BMC International Health and…•2012

  • I think the parent should be there because no one was born alone”

    Allison K Groves, Denise Dion Hallfors et al.•African Journal of AIDS Research•2018

  • Written Parental Consent in School-Based HIV/Aids Prevention Research

    Catherine Mathews, Sally Guttmacher et al.•American Journal of Public Health•2005

Citations per year0.75
Citation span2022 - 2025 (4)
Highly citedNo

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