Table 2 Thematic and sub thematic presentation of barriers for conducting clinical trials

1

Lack of financial and human capacity

Lack of funding

[40,41,42,43,44,45,46,47,48,49,50,51]

Lack of skilled personnel

[40, 42, 44, 45, 48,49,50, 52, 53]

Lack of awareness and motivation

[43, 45, 48, 49, 52, 53]

2

Ethical and regulatory system obstacles

Delay of approval decisions

[40, 42, 45, 46, 48, 49, 52, 53]

Unskilled authorities

[42, 45, 48, 49]

Complex and strict ethical and regulatory system

[48, 49, 51].

4

Lack of research environment

Lack of infrastructure

[45, 47,48,49,50]

Lack of research materials/facilities

[40, 46, 47]

Lack of conducive scientific atmosphere

[43, 45, 50]

5

Operational barriers

Unsupportive administrative system

[43, 45, 47, 48, 51, 52]

Lack of/difficult patient recruitment

[40, 44, 47]

6

Competing demands

Lack of time

[40, 48, 51, 53]

Other competing priorities

[40, 43, 45, 46, 48, 51, 53]