ABSTRACTBuilding trust between researchers and communities involved in research is one goal of community engagement. This paper examines the implications of community engagement for trust within communities, including trust among community volunteers who assist with research and between these volunteers and other community members. We describe the experiences of two groups of community volunteers recruited as part of an HIV and TB intervention trial in Malawi: cluster representatives, recruited both to act as key informants for TB suspects and mortality reporting (...) and to identify and report community concerns, and community counsellors, recruited to provide semi-supervised HIV self-testing. We examine tensions experienced due to playing multiple roles, and the implications of volunteer responsibilities for short- and long-term community relationships. Data was collected through a workshop, in-depth interviews and focus group discussions with volunteers and community members. While the volunteer system init... (shrink)

Community engagement to protect and empower participating individuals and communities is an ethical requirement in research. There is however limited evidence on effectiveness or relevance of some of the approaches used to improve ethical practice. We conducted a study to understand the rationale, relevance and benefits of community engagement in health research. This paper draws from this wider study and focuses on factors that shaped Community Advisory Group members’ selection processes and functions in Malawi. A qualitative research design was used; (...) two participatory workshops were conducted with CAG members to understand their roles in research. Workshop findings were triangulated with insights from ethnographic field notes, key informant interviews with stakeholders, focus group discussions with community members and document reviews. Data were coded manually and thematic content analysis was used to identify main issues. Results have shown that democratic selection of CAG members presented challenges in both urban and rural settings. We also noted that CAG members perceived their role as a form of employment which potentially led to ineffective representation of community interests. We conclude that democratic voting is not enough to ensure effective representation of community's interests of ethical relevance. CAG members’ abilities to understand research ethics, identify potential harms to community and communicate feedback to researchers is critical to optimise engagement of lay community and avoid tokenistic engagement. (shrink)

This volume probes the interdisciplinary relationships between African literature and African philosophy within the context of epistemological decolonization and the (South) African scholarly transformation project. The contributors map out how philosophy and literature can be viewed as mutually enriching disciplines within and for Africa.

BackgroundThe participant recruitment process is a key ethical pivot point when conducting robust research. There is a need to continuously review and improve recruitment processes in research trials and to build fair and effective partnerships between researchers and participants as an important core element in ensuring the ethical delivery of high-quality research. When participants make a fair, informed, and voluntary decision to enroll in a study, they agree to fulfill their roles. However, supporting study participants to fulfill study requirements is (...) an important ethical obligation for researchers, yet evidenced as challenging to achieve. This paper reports on participants’ motivations to volunteer and remain part of a dietary study conducted in Kasungu District, Malawi.MethodsWe conducted twenty in-depth interviews (with chiefs, religious leaders, trial participants, and health surveillance assistants), five systematic ethnographic observations, and fourteen focus group discussions with trial participants and their partners. Interviews were audio-recorded and transcribed verbatim. We used a grounded theory methodology to analyse data that included coding, detailed memo writing, and data interpretation.FindingsThe findings reveal that many participants had concerns during the trial. Thematically, experiences included anxieties, mistrust of researchers, rumours, fears of exploitation, and misconceptions. Anonymous concerns collected from the participants were reported to the trial team which enabled the researchers to appropriately support participants. Despite initial concerns, participants described being supported and expressed motivation to take up their role.ConclusionThese findings highlight a diverse map of multiple notions of what is ethically relevant and what can impact participation and retention within a study. The study has revealed how embedding a responsive approach to address participants’ concerns and ethical issues can support trust relationships. We argue for the need to employ embedded ethics strategies that enhance informed consent, focus on participants’ needs and positive experiences, and support researchers to fulfill their roles. This work highlights the need for research ethics committees to focus on the risks of undue influence and prevent exploitation especially in settings with a high asymmetry in resources and power between researcher and participant groups.Trial Registration: The Addressing Hidden Hunger with Agronomy (Malawi) trial was registered on 5th March 2019 (ISCRTN85899451). (shrink)

Health workers and support staff at Malawi’s major referral hospital, the Queen Elizabeth Central Hospital, Blantyre, were on strike between 5th and 19th October 2001. The health workers’ grievances included: lack of risk allowances; poor professional allowances; low salaries; and low housing allowances. The strike resulted in almost total closure of the 1500-bed hospital; only the burns and orthopaedic wards continued to serve patients. Volunteer staff, comprising the Red Cross, and nursing and medical students provided services. Verbal and written threats (...) by the authorities had minimal effect on terminating the strike; rather, they encouraged the resolve to continue with the industrial action. We report aspects of the genesis, progress and resolution of the strike. Although not much seems to have been achieved, both the employer and the workers need to draw lessons from the experience. (shrink)

How well the Sustainable Development Goals (SDGs) are achieved will greatly influence the lives of today’s children and decisively shape the rest of the 21st century. Yet, children were largely excluded from opportunities to influence the selection of SDGs and their associated targets and indicators, and major barriers to meaningful child engagement remain. However, child-focused agencies have found that when children are intentionally enabled to participate in seeking accountability, they can influence their families, communities and governments to value their contributions (...) and increase their well-being. In furthering its strategy of building brighter futures for children, World Vision implements Citizen Voice and Action (CV&A), a strategic social accountability approach, into communities where children are severely impoverished. Drawing on empirical evidence from children’s CV&A experiences, this paper enquires into the circumstances under which children are empowered to seek accountability for SDGs. This article identifies shared processes which they and others use to strengthen children’s participation in seeking social justice through social accountability. This paper argues that children possess under-recognised research capabilities to think and reflect systemically, critique, understand, and pursue socially just and equitable outcomes conducive to the SDGs, which under the right circumstances, can influence practices, policies, laws and systems. (shrink)

The 2015–2016 South African higher education student movements evoked critical conversations regarding the extent to which institutions of higher learning have transformed into democratic and inclusive spaces. One of the key gaps in this field is the paucity of research that explores the potential role of theology in steering the direction of transformation in South African higher education system. Through a Wesleyan approach, the paper argues that the four quadrilaterals of the Wesleyn approach, scripture, tradition, reason and experience will be (...) used as a theological tool to weight beliefs in the levels of dogma and doctrine, opinion and so as not to confuse critical reflection with negativity and judgmentalism in critically reflecting on the South African higher education struggles for transformation and decolonization. In our attempt to contribute meaningfully to the broader debates, started by scholars such as Nadar and Reddy and more recently, Phiri and Nadar, who locate their work in theology to think through gender, curriculum and African feminism differently, counter-hegemonically. In this paper, we aim to contribute to this emerging body of work by arguing that theology has a critical role to play in helping us to imagine what a transformed, inclusive and socially just higher education could look like. (shrink)