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practices in South Africa","volume":"85","author":"L Henley","year":"1995","journal-title":"S Afr Med J"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1177\/154510970200100202","article-title":"Justice and HIV care in Africa\u2014antiretrovirals in perspective","volume":"1","author":"S Houston","year":"2002","journal-title":"J Int Assoc Physicians AIDS Care (Chic)"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/154510970300200205","article-title":"Ethics and the AIDS pandemic in the developing world","volume":"2","author":"MJ Ahn","year":"2003","journal-title":"J Int Assoc Physicians AIDS Care (Chic)"},{"key":"ref9","first-page":"541","article-title":"Approaches to rationing antiretroviral treatment: ethical and equity implications","volume":"83","author":"S Bennett","year":"2005","journal-title":"Bull World Health Organ"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1136\/jme.2010.038570","article-title":"HIV priorities and health distributions in a rural region in Tanzania: a qualitative study","volume":"37","author":"KA Johansson","year":"2011","journal-title":"J Med Ethics"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1089\/jpm.2010.0440","article-title":"The perceptions of physicians in southeast Nigeria on truth-telling for cancer diagnosis and prognosis","volume":"14","author":"KC Nwankwo","year":"2011","journal-title":"J Palliat Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/S0277-9536(02)00090-4","article-title":"Disclosure of cancer diagnosis and prognosis in Northern Tanzania","volume":"56","author":"JJ Harris","year":"2003","journal-title":"Soc Sci Med"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/j.1471-8847.2006.00157.x","article-title":"Ethical and regulatory issues surrounding African traditional medicine in the context of HIV\/AIDS","volume":"7","author":"A Nyika","year":"2007","journal-title":"Developing World Bio"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.healthpol.2006.03.013","article-title":"Equity in resource allocation for health: a comparative study of the Ashanti and Northern Regions of Ghana","volume":"78","author":"AD Asante","year":"2006","journal-title":"Health Policy"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/1472-6963-6-127","article-title":"Priority setting in developing countries health care institutions: the case of a Ugandan hospital","volume":"6","author":"L Kapiriri","year":"2006","journal-title":"BMC Health Serv Res"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3402\/gha.v7.24121","article-title":"The right to traditional, complementary,\u2026 [Glob Health Action. 2014]\u2014PubMed\u2014NCBI","volume":"7","author":"M Stuttaford","year":"2014","journal-title":"Glob Health Action"},{"key":"ref17","article-title":"Could you have said no? A mixed-methods investigation of consent to HIV tests in four African countries","author":"CM Obermeyer","year":"2014","journal-title":"the International AIDS"},{"key":"ref18","first-page":"S3","article-title":"Evaluating the quality of informed consent an\u2026 [BMC Med Ethics. 2013]\u2014PubMed\u2014NCBI","volume":"14","author":"SC Chima","year":"2013","journal-title":"BMC medical ethics. BioMed Central Ltd"},{"key":"ref19","first-page":"S2","article-title":"Leadership and organizational ethics: the thr\u2026 [BMC Med Ethics. 2013]\u2014PubMed\u2014NCBI","volume":"14","author":"JM Mathooko","year":"2013","journal-title":"BMC medical ethics. BioMed Central Ltd"},{"key":"ref20","first-page":"48","article-title":"Ethics in occupational health: deliberations\u2026 [BMC Med Ethics. 2014]\u2014PubMed\u2014NCBI","volume":"15","author":"L London","year":"2014","journal-title":"BMC medical ethics"},{"issue":"Suppl 1","key":"ref21","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1080\/02664763.2012.755323","article-title":"Disclosure of HIV status between parents and children in Uganda in the context of greater access to treatment","volume":"10","author":"D Kyaddondo","year":"2013","journal-title":"SAHARA J"},{"key":"ref22","article-title":"Partager l&apos;information sur son statut s\u00e9rologique VIH dans un contexte de polygamie au S\u00e9n\u00e9gal: HIV disclosure in polygamous settings in Senegal","author":"K Sow","year":"2013","journal-title":"SAHARA-J: Journal of Social Aspects of HIV\/AIDS"},{"issue":"Suppl 1","key":"ref23","doi-asserted-by":"crossref","first-page":"S60","DOI":"10.1080\/02664763.2012.755339","article-title":"The duty to disclose in Kenyan health facilities: a qualitative investigation of HIV disclosure in everyday practice","volume":"10","author":"E Moyer","year":"2013","journal-title":"SAHARA J"},{"key":"ref24","article-title":"Improving resource allocation decisions for health and HIV programmes in South Africa: Bioethical, cost-effectiveness and health diplomacy considerations","author":"S Kevany","year":"2013","journal-title":"Glob Public Health"},{"key":"ref25","article-title":"Patients as consumers of health care in South Africa: the ethical and legal implications","author":"K Rowe","year":"2013","journal-title":"BMC medical ethics"},{"key":"ref26","article-title":"How informed are clients who consent? A mixed-method evaluation of comprehension among clients of male circumcision services in Zambia and Swaziland","author":"BA Friedland","year":"2013","journal-title":"AIDS Behav"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1472-698X-13-6","article-title":"HIV testing and care in Burkina Faso, Kenya, Malawi and Uganda: ethics on the ground","volume":"13","author":"CM Obermeyer","year":"2013","journal-title":"BMC Int Health Hum Rights"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1471-8847.2007.00198.x","article-title":"Local attitudes, moral obligation, customary obedience and other cultural practices: their influence on the process of gaining informed consent for surgery in a tertiary institution in a developing country","volume":"9","author":"DO Irabor","year":"2009","journal-title":"Developing World Bio"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1353\/ken.2006.0024","article-title":"The activities of UNESCO in the area of ethics","volume":"16","author":"H Have ten","year":"2006","journal-title":"Kennedy Inst Ethics J"},{"key":"ref30","unstructured":"United Nations Educational, Scientific and Cultural Organization (UNESCO). Medium Term Strategy 2008\u20132013. In: unesdoc.unesco.org. 28 Mar 2008. Available: <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/unesdoc.unesco.org\/images\/0014\/001499\/149999e.pdf\" xlink:type=\"simple\">http:\/\/unesdoc.unesco.org\/images\/0014\/001499\/149999e.pdf<\/ext-link>. Accessed 28 Mar 2013"},{"key":"ref31","unstructured":"United Nations Educational, Scientific and Cultural Organization (UNESCO). Global Ethics Observatory (GEObs) | United Nations Educational, Scientific and Cultural Organization. In: unesco.org. Available: <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.unesco.org\/shs\/ethics\/geobs\" xlink:type=\"simple\">http:\/\/www.unesco.org\/shs\/ethics\/geobs<\/ext-link>. Accessed 28 Mar 2013"},{"key":"ref32","unstructured":"United Nations Educational, Scientific and Cultural Organization (UNESCO). GEObs: Global network | United Nations Educational, Scientific and Cultural Organization. In: unesco.org. Available: <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.unesco.org\/new\/en\/social-and-human-sciences\/themes\/global-ethics-observatory\/about-the-geobs\/\" xlink:type=\"simple\">http:\/\/www.unesco.org\/new\/en\/social-and-human-sciences\/themes\/global-ethics-observatory\/about-the-geobs\/<\/ext-link>. Accessed 28 Mar 2013"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1017\/S0963180111000065","article-title":"Assisting countries in establishing national bioethics committees: UNESCO&apos;s Assisting Bioethics Committees project","volume":"20","author":"H Have ten","year":"2011","journal-title":"Camb Q Healthc Ethics"},{"key":"ref34","first-page":"534","article-title":"An evidence-based approach to benchmarking the fairness of health-sector reform in developing countries","volume":"83","author":"N Daniels","year":"2005","journal-title":"Bull World Health Organ"},{"key":"ref35","article-title":"An Introduction to Qualitative Research","author":"U Flick","year":"2009"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/j.1467-8519.1993.tb00292.x","article-title":"Bioethics and culture: an African perspective","volume":"7","author":"S Gbadegesin","year":"1993","journal-title":"Bioethics"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/j.1467-8519.1996.tb00118.x","article-title":"Bioethics: an African perspective","volume":"10","author":"GB Tangwa","year":"1996","journal-title":"Bioethics"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"ii","DOI":"10.1111\/j.1471-8847.2010.00291.x","article-title":"Bioethics and culture","volume":"10","author":"D Diniz","year":"2010","journal-title":"Developing World Bio"},{"key":"ref39","unstructured":"CIA. The World Factbook\u2014Gabon. In: cia.gov. Available: <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.cia.gov\/library\/publications\/the-world-factbook\/geos\/gb.html\" xlink:type=\"simple\">https:\/\/www.cia.gov\/library\/publications\/the-world-factbook\/geos\/gb.html<\/ext-link>. Accessed 28 Mar 2013"},{"key":"ref40","unstructured":"United Nations Development Reports. Human Development Report 2014. In: hdr.undp.org. Available: <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/hdr.undp.org\/en\/data\" xlink:type=\"simple\">http:\/\/hdr.undp.org\/en\/data<\/ext-link>. Accessed 14 February 2015."},{"key":"ref41","first-page":"179","article-title":"[Role of traditional medicine in the health care system of the cities of sub-Saharan Africa: Libreville in Gabon.]","volume":"20","author":"E Makita-Ikouaya","year":"2010","journal-title":"Sante"},{"key":"ref42","article-title":"Basics of Qualitative Research","author":"A Strauss","year":"1998"},{"key":"ref43","article-title":"Religions and Development Research Programme","author":"NA Alolo","year":"2007"},{"key":"ref44","article-title":"Principles of Biomedical Ethics","author":"TL Beauchamp","year":"2001"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/S0140-6736(02)07684-5","article-title":"Medical professionalism in the new millennium: a physicians&apos; charter","volume":"359","year":"2002","journal-title":"Lancet"},{"key":"ref46","first-page":"400","article-title":"The full spectrum of ethical issues in dementia care: systematic qualitative review. Br J Psychiatry","volume":"202","author":"D Strech","year":"2013","journal-title":"The Royal College of Psychiatrists"},{"key":"ref47","article-title":"Methods in Medical Ethics","author":"J Sugarman","year":"2010"},{"key":"ref48","first-page":"98","article-title":"What makes a problem an ethical problem? An empirical perspective on the nature of ethical problems in general practice. J Med Ethics","volume":"27","author":"AJ Braunack-Mayer","year":"2001","journal-title":"BMJ Publishing Group Ltd and Institute of Medical Ethics"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1136\/jme.2006.017681","article-title":"Clinical research with economically disadvantaged populations","volume":"33","author":"CG Colleen C Denny","year":"2007","journal-title":"J Med Ethics. BMJ Group"},{"key":"ref50","first-page":"11","article-title":"Honorarium or coercion: use of incentives for participants in clinical research","volume":"41","author":"SW Groth","year":"2010","journal-title":"The Journal of the New York State Nurses' Association. NIH Public Access"},{"key":"ref51","first-page":"801","article-title":"Empirical assessment of whether moderate payments are undue or unju\u2026\u2014PubMed\u2014NCBI. Arch Intern Med","volume":"164","author":"SD Halpern","year":"2004","journal-title":"American Medical Association"},{"key":"ref52","article-title":"Bioethics: an anthology","author":"H Kuhse","year":"2006","journal-title":"Bioethics: an anthology"},{"key":"ref53","article-title":"Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, Seventh Edition (LANGE Clinical Science)","author":"A Jonsen","year":"2010"},{"key":"ref54","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1136\/jme.2010.040121","article-title":"Quality of ethical guidelines and ethical content in clinical guidelines: the example of end-of-life decision-making","volume":"37","author":"DD Strech","year":"2011","journal-title":"J Med Ethics"},{"key":"ref55","doi-asserted-by":"crossref","DOI":"10.56021\/9780801871658","article-title":"Ethics consultation: from theory to practice","author":"MP Aulisio","year":"2003","journal-title":"Ethics consultation: from theory to practice"},{"key":"ref56","unstructured":"Mbatchou GA. \u00c9thique de la recherche biom\u00e9dicale au Gabon. Memoire. Available: <ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.memoireonline.com\/10\/12\/6306\/Ethique-de-la-recherche-biomedicale-au-Gabon.html\" xlink:type=\"simple\">http:\/\/www.memoireonline.com\/10\/12\/6306\/Ethique-de-la-recherche-biomedicale-au-Gabon.html<\/ext-link>"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pone.0132374","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,12]],"date-time":"2023-08-12T04:53:32Z","timestamp":1691816012000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0132374"}},"subtitle":[],"editor":[{"given":"Kenneth","family":"Bond","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2015,7,10]]},"references-count":56,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2015,7,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0132374","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,10]]}}}