Poor health care infrastructure—materials, manpower, political will |
Limited financial resources—government priorities lie elsewhere in education, defence, general health care delivery, or debt repayment |
Poor training in research methods, epidemiology and statistics in general medical training |
Little incentive for a busy practitioner, overwhelmed by the system |
Reluctance of international journals to publish papers from developing world9 |
Research is not a priority of health system |
Employment systems where only service is rewarded |