The Republic of Sudan

Federal Ministry of Health

Health Research Council

National Health Research Ethics Committee

NATIONAL APPLICATION FORM FOR ETHICAL APPROVAL OF A RESEARCH PROJECT

The application technical and ethical guidelines format are to be read before completing this form to ensure that the questions are answered appropriately.

You may find it helpful to read both national technical and ethical guidelines and then fill the format. You can add extra pages.

Before requesting an individual's consent to participate in research, the investigator must read chapter three in the Guidelines for Ethical Conduct of Research Involving Human Subjects.

The Arabic version of the informed consent is the form to be used to take the consent from the Sudanese research participants, so you should fill it in details and in a language or another form of communication that the individual can understand the research subject.

Ministry of Health

Health Research Council

2007

Do not include this page with your application form

Federal Ministry of Health

Health Research Council

Health Research Ethics Committee

For office use only

Proposal No.:

Date Received:

Please read the technical and ethical guidelines thoroughly before filling the form

Part 1: Technical proposal form

1. Principal investigator (PI) / Applicant

2. Co-investigator (2)

2. Co-investigator (3)

ý For more co- investigators use separate paper

3. Title of Proposal:

4. Purpose (tick where appropriate)

• For a grant

• For a postgraduate degree

• Other, specify

5. Introduction/ Background (Including rationale, problem statement and hypothesis)

ý You can use extra paper.

6. Objectives

8. Methodology

9. Data analysis

9. Work plan:

10. Budget: :(Personnel/ consumable items/ transportation/ field expenses…..etc.)

11. References:

12. Annexes