Abstract
Background: Sixteen RECs were randomly selected from various institutions across Kazakhstan, representing both public and private sectors and covering biomedical and socio-behavioral research reviews. Objective: This research addresses a critical knowledge gap by providing empirical data on REC operations in Kazakhstan, facilitating a better understanding of how these committees align with international ethical standards and best practices. Furthermore, by situating our findings within the broader context of REC performance in LMICs, we aim to highlight specific challenges unique to Kazakhstan and propose evidence-based recommendations. Methods: Data were collected using a culturally adapted, semi-structured questionnaire based on a validated self-assessment tool. Descriptive statistics were used to analyze the data. Results: The overall average score for the RECs was 71.9% out of a possible 100%, indicating generally effective functioning but highlighting significant areas needing improvement. Strengths included well-established organizational aspects, diverse membership, and adequate educational training. However, weaknesses were identified in the thoroughness of protocol evaluations and resource allocation, with low scores in "Review of Specific Protocol Items" (33.7%) and "REC Resources" (56.2%). Additionally, 38.5% of RECs were not registered with national authorities, underscoring the need for improved regulatory oversight. Conclusion: While RECs in Kazakhstan demonstrate strengths in organizational structure and member training, critical gaps exist in protocol review processes and resource support. Targeted interventions - such as enhancing training programs for REC members, increasing funding and resources, and establishing a national accreditation system - are recommended to improve the quality of ethical oversight in research. Strengthening these areas will ensure comprehensive protocol reviews and better protection of research participants.