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Over the past two decades, Ghana has made significant strides in establishing research ethics systems aimed at safeguarding the rights and welfare of human research participants. These efforts have included capacity-building initiatives such as knowledge and skills transfer, infrastructure development, and the implementation of regulatory guidelines. While these interventions have supported a more effective and efficient transition toward ethical research conduct, a comprehensive needs gap assessment has yet to be conducted. Such an assessment is crucial for understanding existing challenges and guiding the development of targeted, context-specific capacity-building strategies. This paper presents the findings from a needs gap assessment undertaken by the Strengthening Regulatory and Ethics Capacity in Ghana (STREC-GH) project. The objective was to identify persistent capacity deficits and propose unified, contextually appropriate solutions to strengthen the country’s research ethics and regulatory landscape. This was a qualitative research which used a consultative and participatory approach to collect and analyse data. A two-day national workshop was convened, bringing together stakeholders from diverse institutions, including academia, research centres, regulatory authorities, and ethics review committees (RECs) from across Ghana. Data were generated through structured plenary discussions and breakout group sessions guided by standardized question prompts. Discussions were audio-recorded, transcribed verbatim, and analysed using thematic content analysis. An inductive coding framework was developed to identify recurrent categories and overarching themes, with independent coding by two researchers to enhance the reliability and credibility of the findings. Of the 35 stakeholders invited, 29 participated in the workshop. Several critical gaps were identified, including: Training: Inadequate access to both formal and ongoing training for REC members, administrators, and researchers, Capacity Building: Insufficient support mechanisms for continuous professional development, Human Resources and Logistics: Under-resourced and understaffed ethics secretariats, Regulatory Frameworks: Limited availability and implementation of localized guidelines and policies, Funding: A lack of sustained financial support from both institutional and governmental sources, Monitoring: Weak systems for tracking the activities of RECs/IRBs and for following up on approved research protocols, Governance: Absence of a national body with overarching responsibility for coordinating and overseeing research ethics in Ghana. Although notable progress has been made through various capacity-building efforts, this needs gap assessment highlights critical areas requiring urgent attention. The findings offer valuable insights for stakeholders seeking to strengthen research ethics systems in Ghana and serve as a guide for designing future interventions that are both strategic and impactful.