Consent to Research in Madagascar: Challenges, Strategies, and Priorities for Future Research

  • Elysee Nouvet School of Health Studies, Western University, London, Canada
  • Simon Grandjean Lapierre Institut Pasteur Madagascar; Centre de Recherche du Centre Hospitalier de l’Université de Montréal; Département de microbiologie, infectiologie et immunologie, Université de Montréal
  • Astrid Knoblauch Institut Pasteur Madagascar, Madagascar; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
  • Laurence Baril Institut Pasteur of Cambodia, Phnom Penh, Cambodia
  • Andry Andriamiadanarivo Global Health Institute, Stony Brook University, New York, USA
  • Mihaja Raberahona Centre Hospitalier Universitaire Joseph Raseta Befelatanana; Centre d’Infectiologie Charles Mérieux, Ankatso, Antananarivo, Madagascar
  • Chiarella Mattern Institut Pasteur Madagascar, Madagascar
  • Lorie Donelle School of Nursing, Western University, London, Canada
  • Jean Rubis Andriantsoa Comité d’Éthique à la Recherche Biomédicale auprès du Ministère de la Santé, Ambohidahy, Antananarivo, Madagascar
Keywords: Research Ethics, Consent, Madagascar, Global Health, Sub-Saharan Africa, research on research


The ethical conduct of research in any setting hinges on the voluntary and informed consent of research participants. Working towards consent that is truly voluntary and informed, however, is far from straightforward, and requires attention to contextual factors that may complicate achievement of this ideal in specific research settings. This paper is based on Madagascar’s first “Consent complexities in health research in Madagascar” workshop, held in Antananarivo, Madagascar, in October 2018. It identifies a number of challenges encountered by individuals responsible for the conduct or oversight of health research in Madagascar related to informed and voluntary consent. Key challenges identified included: adaptation of consent tools into local dialects and for limited literacy populations; perceived acquiescence of potential participants regardless of actual preference based on cultural norms; perceived time pressures within tight project timelines to collect data as quickly as possible, limited time for consent processes; fears and taboos related to specific research procedures or topics; and, uncertainty about how best to approach and verify the validity of individual consent in contexts where traditional leaders’ influence is conventionally sought out and respected. Potential strategies for responding to each of these challenges are proposed, as are key questions meriting further study.

How to Cite
Nouvet E, Grandjean Lapierre S, Knoblauch A, Baril L, Andriamiadanarivo A, Raberahona M, Mattern C, Donelle L, Andriantsoa JR. Consent to Research in Madagascar: Challenges, Strategies, and Priorities for Future Research. Can. J. Bioeth. 2022;5:33-44.