As Canadian investigators engaged in a qualitative project involving adults with and without disabilities in Uganda, we secured approval from four research ethics boards—two based in Canada and two located in Uganda. Ethical oversight in Canada is guided by the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS2), while Ugandan researchers adhere to the National Guidelines for Research Involving Humans as Research Participants (NGRU). Despite obtaining authorization from all committees, the planning and execution of this study surfaced distinct ethical challenges, particularly around safeguarding participant privacy and ensuring adequate financial resources to support ethical practice. Our experience in the field brought forward three core areas that merit attention. First, we show that global health research often demands ongoing methodological and logistical recalibration to protect the confidentiality of participants—especially individuals with disabilities—even when researchers comply with both Canadian and Ugandan ethical standards. Strategies for gathering and storing data had to be continually reshaped in response to the practical context on the ground. Second, we found that stable and sufficient funding played a decisive role in enabling privacy-protective, disability-responsive research procedures. Without proper financial backing, it would have been impossible to recruit participants by disability category, region, or sex, or to employ local sign language interpreters. Third, although both the TCPS2 and NGRU highlight the centrality of privacy, they provide little explicit guidance on how these concerns manifest in global health and disability-focused research, nor do they adequately address ethical questions linked to financial constraints and resource allocation.
Research conducted in settings with limited resources and among participants with diverse access needs requires a thoughtful, context-aware application of ethical frameworks. We propose that both the TCPS2 and NGRU incorporate more explicit attention to global health research, disability inclusion, and responsible research practices. Strengthening these guidelines should be accompanied by comprehensive training opportunities for researchers at all levels, as well as for funding bodies, to better support ethical global health scholarship.
