Abstract
Although community engagement is increasingly promoted in global health research to improve ethical research practice, there is sometimes a disconnect between the broader moral ambitions for community engagement in the literature and guidelines on the one hand and its rather narrower practical application in health research on the other. In practice, less attention is paid to engaging communities for the 'intrinsic' value of showing respect and ensuring inclusive participation of community partners in research design. Rather, more attention is paid to the use of community engagement for 'instrumental' purposes to improve community understanding of research and ensure successful study implementation. Against this backdrop, we reviewed the literature and engaged various research stakeholders at a workshop to discuss ways of strengthening ethical engagement of communities and to develop context-relevant guidelines for community engagement in health research in Malawi.
Highlights
Guidelines and literature on community engagement emphasise participatory processes of engagement as a way of showing appropriate respect to communities and as a means of building sustainable community trust and equitable collaborative partnerships between researchers and community stakeholders
Strengthening ethical community engagement in Malawi Workshop participants agreed that community engagement should be incorporated in health research activities and that this should involve more than seeking letters of support from stakeholders such as hospital directors, District Health Officers or ‘informing’ communities about the research
Community engagement practices do not always reflect the ideals of participatory governance promoted in the literature in low literacy settings
Summary
Guidelines and literature on community engagement emphasise participatory processes of engagement as a way of showing appropriate respect to communities and as a means of building sustainable community trust and equitable collaborative partnerships between researchers and community stakeholders. 'researchers, sponsors, health authorities and relevant institutions should engage potential participants and communities in a meaningful participatory process that involves them in an early and sustained manner in the design, development and implementation, implementation of informed consent processes and monitoring of research and in the dissemination of its results’[1]. Ahmed and Palermo’s (2010) framework for reviewing applications for research involving communities includes values such as mutual understanding of the meaning of community engagement, strong partnerships, equitable sharing of power and responsibilities, inclusion of diverse perspectives, relevant research goals, ensuring mutual benefit for all partners, capacity building for both partners, equal respect, continuous communication, and transparent monitoring and evaluation.
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