Expectations, Experiences and Impact of Engagement Between Health Researchers and Schools in Kenya

Abstract

Community engagement is increasingly recognized as essential for the ethical conduct of health research, particularly in international settings where wealth, educational and cultural differences between host communities and researchers are often stark. Engagement approaches are diverse, addressing a wide range of goals. The School Engagement Programme (SEP) forms part of a wider platform of community engagement activities at the KEMRI-Wellcome Trust Research Programme (KWTRP) in Kilifi, Kenya. Key SEP goals include raising mutual understanding between researchers and community members, nurturing secondary school students’ interest in science, and raising educational aspirations. In this thesis, I address the paucity of careful evaluations of community engagement in low and middle-income countries (LMICs), and of school engagement specifically. I consider the potential contribution of school engagement to the ethical goals of research, and contribute to the identification of key elements to use in the evaluation of school engagement programmes in the region. Drawing on a novel combination of methods including participatory video, baseline and post-intervention surveys, interviews and group discussions I found that the SEP benefitted students through nurturing an interest in science and promoting confidence in speaking to researchers, laying a foundation for future interactions. Researchers benefitted through strengthened ties with the community which gave them a better understanding of the context of their work and more of a sense of being part of the community. There were also unintended outcomes and mismatches between programme goals and community expectations however, which highlight the need for broad inclusion in planning and implementing school engagement programmes, and the monitoring of perverse outcomes. The thesis draws from the SEP evaluation findings to synthesise a theory of change and a framework to guide the evaluation of school engagement programmes.