1
|
Kumar R, Khosla R, McCoy D. Decolonising global health research: Shifting power for transformative change. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003141. [PMID: 38656955 PMCID: PMC11042701 DOI: 10.1371/journal.pgph.0003141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Recent debates on decolonizing global health have spurred interest in addressing the power asymmetries and knowledge hierarchies that sustain colonial ideas and relationships in global health research. This paper applies three intersecting dimensions of colonialism (colonialism within global health; colonisation of global health; and colonialism through global health) to develop a broader and more structural understanding of the policies and actions needed to decolonise global health research. It argues that existing guidelines and checklists designed to make global health research more equitable do not adequately address the underlying power asymmetries and biases that prevail across the global health research ecosystem. Beyond encouraging fairer partnerships within individual research projects, this paper calls for more emphasis on shifting the balance of decision-making power, redistributing resources, and holding research funders and other power-holders accountable to the places and peoples involved in and impacted by global health research.
Collapse
Affiliation(s)
- Ramya Kumar
- United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Rajat Khosla
- United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia
| | - David McCoy
- United Nations University-International Institute for Global Health, Kuala Lumpur, Malaysia
| |
Collapse
|
2
|
Lee TL, Sawai T. Navigating equity in global access to genome therapy expanding access to potentially transformative therapies and benefiting those in need requires global policy changes. Front Genet 2024; 15:1381172. [PMID: 38638119 PMCID: PMC11024294 DOI: 10.3389/fgene.2024.1381172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
In December 2023, the US Food and Drug Administration and the UK Medicines and Healthcare Products Regulatory Agency granted the first regulatory approval for genome therapy for sickle cell disease. This approval brings hope to those suffering from this debilitating genetic disease. However, several barriers may hinder global patient access, including high treatment costs, obtaining informed consent for minors, inadequate public health infrastructure, and insufficient regulatory oversight. These barriers reflect the structural inequalities inherent in global health governance, where patient access often depends on social and institutional arrangements. This article addresses concerns around informed consent, treatment costs, and patient access, and proposes corresponding policy reforms. We argue that these discussions should be framed within a broader global context that considers social and institutional structures, global research priorities, and a commitment to health equity.
Collapse
Affiliation(s)
- Tsung-Ling Lee
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan
| | - Tsutomu Sawai
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
3
|
Suchman L, Gitome S, Nyando M, Kwena ZA, Wekesa P, Okumu S, Ndunyu L, Okoli C, Tijani A, Jegede A, Idiodi I, Nmadu G, Dimowo S, Maluwa A, Atuyambe L, Birabwa C, Alitubeera P, Kaudha B, Kayego A, Jumbe T, Mtalimanja I, Vallin J, Sinha E, Phillips BS, Amongin D, Bukusi E, Holt K, Kamanga M, Liu J, Malata A, Omoluabi E, Waiswa P. Many Cooks in the Kitchen: Iterating a Qualitative Analysis Process Across Multiple Countries, Sites, and Teams. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2300143. [PMID: 38050043 PMCID: PMC10749643 DOI: 10.9745/ghsp-d-23-00143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/24/2023] [Indexed: 12/06/2023]
Abstract
Establishing and proving methodological rigor has long been a challenge for qualitative researchers where quantitative methods prevail, but much published literature on qualitative analysis assumes a relatively small number of researchers working in relative proximity. This is particularly true for research conducted with a grounded theory approach. Different versions of grounded theory are commonly used, but this methodology was originally developed for a single researcher collecting and analyzing data in isolation. Although grounded theory has evolved since its development, little has been done to reconcile this approach with the changing nature and composition of international research teams. Advances in technology and an increased emphasis on transnational collaboration have facilitated a shift wherein qualitative datasets have been getting larger and the teams collecting and analyzing them more diverse and diffuse. New processes and systems are therefore required to respond to these conditions. Data for this article are drawn from the experiences of the Innovations for Choice and Autonomy (ICAN) Research Consortium. ICAN aims to understand how self-injectable contraceptives can be implemented in ways that best meet women's needs in Kenya, Uganda, Malawi, and Nigeria. We found that taking a structured approach to analysis was important for maintaining consistency and making the process more manageable across countries. However, it was equally important to allow for flexibility within this structured approach so that teams could adapt more easily to local conditions, making data collection and accompanying analysis more feasible. Meaningfully including all interested researchers in the analysis process and providing support for learning also increased rigor. However, competing priorities in a complex study made it difficult to adhere to planned timelines. We conclude with recommendations for both funders and study teams to design and conduct global health studies that ensure more equitable contributions to analysis while remaining logistically feasible and methodologically sound.
Collapse
Affiliation(s)
- Lauren Suchman
- University of California San Francisco, San Francisco, CA, USA.
| | - Serah Gitome
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | | | - Sarah Okumu
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | | | | | | | | | | | | | - Alfred Maluwa
- Malawi University of Science and Technology, Limbe, Malawi
| | - Lynn Atuyambe
- Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Betty Kaudha
- Makerere University School of Public Health, Kampala, Uganda
| | - Agnes Kayego
- Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Janelli Vallin
- University of California San Francisco, San Francisco, CA, USA
| | - Elena Sinha
- University of California San Francisco, San Francisco, CA, USA
| | - Beth S Phillips
- University of California San Francisco, San Francisco, CA, USA
| | - Dinah Amongin
- Makerere University School of Public Health, Kampala, Uganda
| | | | - Kelsey Holt
- University of California San Francisco, San Francisco, CA, USA
| | | | - Jenny Liu
- University of California San Francisco, San Francisco, CA, USA
| | - Address Malata
- Malawi University of Science and Technology, Limbe, Malawi
| | | | - Peter Waiswa
- Makerere University School of Public Health, Kampala, Uganda
- Karolinska Institute, Stockholm, Sweden
- Busoga Health Forum, Jinja, Uganda
| |
Collapse
|
4
|
Leuche VT, Delgado-Zapata R, Umphrey L, Lam SK, Nunez KC, Musiime V, Rule A. Decolonizing Global Child Health Education for More Equitable and Culturally Safe Collaborations. Pediatr Ann 2023; 52:e467-e473. [PMID: 38049188 DOI: 10.3928/19382359-20231017-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Global health (GH) as an academic field is fraught with both historical and present systemic injustice, including unilateral partnerships, power asymmetry in grant funding and research agenda setting, lack of acknowledgment of low- and middle-income countries' contributions, and bias toward high-income countries' institutions. Reflecting on colonialism and White supremacy's legacy is vital for training pediatricians to actively work to create more bidirectional partnerships to improve the health of all children worldwide. In this review, we discuss the present challenges within academic GH and offer four key action steps to decolonize GH education: (1) reflecting on the history of global child health; (2) creating a new language framework; (3) reviewing cultural humility, antiracism, and decolonization curricula; and (4) discussing institutional action steps to decolonize and sustain culturally safe global child health education. [Pediatr Ann. 2023;52(12):e467-e473.].
Collapse
|
5
|
Tchonang Leuche V, Delgado-Zapata R, Umphrey L, Lam SK, Cardiel Nunez K, Musiime V, Rule A. Decolonizing Global Child Health Education for More Equitable and Culturally Safe Collaborations. Pediatr Ann 2023; 52:e344-e350. [PMID: 37695281 DOI: 10.3928/19382359-20230720-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Global health (GH) as an academic field is fraught with both historical and present systemic injustice, including unilateral partnerships; power asymmetry in grant funding and research agenda setting; lack of acknowledgment of contributions from low- and middle-income country collaborators; and disadvantageous bias toward low- and middle-income country institutions. Reflecting on the legacies of colonialism and White supremacy is vital for training pediatricians to actively work to improve the health of all children worldwide, within bidirectional and culturally safe partnerships in which power dynamics and ethnocentrism are dismantled. In this article, we discuss the present challenges within academic GH education (GHE) and offer four key action steps to decolonize GHE: (1) reflecting on the history of global child health; (2) creating a new language framework on pertinent concepts in GHE; (3) developing cultural humility, antiracism, and decolonization curricula; and (4) intentional institutional action steps to decolonize and sustain culturally safe global child health education. [Pediatr Ann. 2023;52(9):e344-e350.].
Collapse
|
6
|
Willows TM, Oliwa J, Onyango O, Mkumbo E, Maiba J, Schell CO, Baker T, McKnight J. COVID-19 and unintended steps towards further equity in global health research. BMJ Glob Health 2023; 8:e011888. [PMID: 37328283 PMCID: PMC10276961 DOI: 10.1136/bmjgh-2023-011888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/29/2023] [Indexed: 06/18/2023] Open
Abstract
There was, and possibly still is, potential for COVID-19 to disrupt power inequities and contribute to positive transformation in global health research that increases equity. While there is consensus about the need to decolonise by transforming global health, and a roadmap outlining how we could approach it, there are few examples of steps that could be taken to transform the mechanics of global health research. This paper contributes lessons learnt from experiences and reflections of our diverse multinational team of researchers involved in a multicountry research project. We demonstrate the positive impact on our research project of making further steps towards improving equity within our research practices. Some of the approaches adopted include redistributing power to researchers from the countries of interest at various stages in their career, by involving the whole team in decisions about the research; meaningfully involving the whole team in research data analysis; and providing opportunities for all researchers from the countries of interest to voice their perspectives as first authors in publications. Although this approach is consistent with how research guidance suggests research should be run, in reality it does not often happen in this way. The authors of this paper hope that by sharing our experience, we can contribute towards discussions about the processes required to continue developing a global health sector that is equitable and inclusive.
Collapse
Affiliation(s)
- Tamara Mulenga Willows
- Tropical Medicine and Global Health, University of Oxford Medical Sciences Division, Oxford, UK
| | - Jacquie Oliwa
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Onesmus Onyango
- Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Elibariki Mkumbo
- Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Ifakara, Tanzania
| | - John Maiba
- Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Ifakara, Tanzania
| | - Carl Otto Schell
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Tim Baker
- Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Ifakara, Tanzania
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Jacob McKnight
- Center for Tropical Medicine and Global Health, University of Oxford Centre for Tropical Medicine, Oxford, UK
| |
Collapse
|
7
|
Tang Y, Zhang F, Xu DR. The implications of decolonization on China's academic global health: a dialogue with Stephen Gloyd at the Luhu Global Health Salon. Glob Health Res Policy 2023; 8:14. [PMID: 37198704 PMCID: PMC10190061 DOI: 10.1186/s41256-023-00299-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/21/2023] [Indexed: 05/19/2023] Open
Abstract
The call for decolonization in global health is growing alongside China's increasing involvement in the field. This perspective paper presents and extends with a further literature review of a dialogue with Stephen Gloyd, a global health professor from the University of Washington, conducted in July 2022 at the Luhu Global Health Salon. Drawing from Gloyd's four decades of experiences in low- and middle-income countries, as well as his role in creating the University of Washington's global health department, the doctoral program in implementation science, and the non-governmental organization, Health Alliance International, this paper delves into the concept of decolonization in global health and explores how Chinese universities can expand their participation in global health while striving for equity and justice. Focusing on China's academic global health research, education, and practice, the paper proposes specific recommendations for building an equity-focused global health curriculum, addressing power imbalances and inequalities in university-affiliated organizations, and strengthening South-South cooperation in practice. The paper offers implications for Chinese universities on expanding future global health cooperation, promoting global health governance, and avoiding recolonization.
Collapse
Affiliation(s)
- Yu Tang
- Acacia Lab for Implementation Science, School of Health Management and Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Feifei Zhang
- Southern Medical University Institute for Global Health (SIGHT), Dermatology Hospital of Southern Medical University (SMU), Guangzhou, China
| | - Dong Roman Xu
- Acacia Lab for Implementation Science, School of Health Management and Dermatology Hospital, Southern Medical University, Guangzhou, China.
- Center for World Health Organization Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China.
- Southern Medical University Institute for Global Health (SIGHT), Dermatology Hospital of Southern Medical University (SMU), Guangzhou, China.
| |
Collapse
|
8
|
Hodson DZ, Etoundi YM, Parikh S, Boum Y. Striving towards true equity in global health: A checklist for bilateral research partnerships. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001418. [PMID: 36963065 PMCID: PMC10021183 DOI: 10.1371/journal.pgph.0001418] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Interest in "global health" among schools of medicine, public health, and other health disciplines in high-income countries (HIC) continues to rise. Persistent power imbalances, racism, and maintenance of colonialism/neocolonialism plague global health efforts, including global health scholarship. Scholarly projects conducted in low- and middle-income countries (LMIC) by trainees at these schools in HIC often exacerbate these problems. Drawing on published literature and shared experiences, we review key inequalities within each phase of research, from design through implementation and analysis/dissemination, and make concrete and practical recommendations to improve equity at each stage. Key problems facing global health scholarship include HIC-centric nature of global health organizations, paucity of funding directly available for LMIC investigators and trainees, misplaced emphasis on HIC selected issues rather than local solutions to local problems, the dominance of English language in the scientific literature, and exploitation of LMIC team members. Four key principles lie at the foundation of all our recommendations: 1) seek locally derived and relevant solutions to global health issues, 2) create paired collaborations between HIC and LMIC institutions at all levels of training, 3) provide funding for both HIC and LMIC team members, 4) assign clear roles and responsibilities to value, leverage, and share the strengths of all team members. When funding for global health research is predicated upon more ethical and equitable collaborations, the nature of global health collaborations will evolve to be more ethical and equitable. Therefore, we propose the Douala Equity Checklist as a 20-item tool HIC and LMIC institutions can use throughout the conduct of global health projects to ensure more equitable collaborations.
Collapse
Affiliation(s)
- Daniel Z. Hodson
- Yale School of Medicine, New Haven, CT, United States of America
| | - Yannick Mbarga Etoundi
- Douala Military Hospital, Douala, Cameroon
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Sunil Parikh
- Yale School of Medicine, New Haven, CT, United States of America
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States of America
| | - Yap Boum
- Epicentre, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Science, University of Yaoundé I, Yaoundé, Cameroon
- Institut Pasteur of Bangui, Bangui, Central African Republic
| |
Collapse
|
9
|
Kaplan L, Kuhnt J, Picot LE, Grasham CF. Safeguarding research staff “in the field”: a blind spot in ethics guidelines. RESEARCH ETHICS 2022. [DOI: 10.1177/17470161221131494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Across disciplines there is a large and increasing number of research projects that rely on data collection activities in low- and middle-income countries (LMICs). However, these are accompanied by an extensive range of ethical challenges. While the safeguarding of study participants is the primary aim of existing ethics guidelines, this paper argues that this “do no harm” principle should be extended to include research staff. This study is a comprehensive review of more than 80 existing ethics guidelines and protocols that reveals a lack of safeguarding research staff regarding the ethical challenges faced during data collection activities in LMICs. This is particularly the case when it comes to issues such as power imbalances, political risk, staff’s emotional wellbeing or dealing with feelings of guilt. Lead organizations are called upon to develop guiding principles that encompass the safeguarding of research staff, which are then to be adapted and translated into specific protocols and tools by institutions.
Collapse
Affiliation(s)
| | - Jana Kuhnt
- German Institute of Development and Sustainability, Germany
| | | | | |
Collapse
|
10
|
Jaeger L, Devi T, Barbazza E, Neufeld M, Franz C, Marten R, Tello JE. Describing and mapping scientific articles on alcohol globally for the period 2010-2021: a bibliometric analysis. BMJ Open 2022; 12:e063365. [PMID: 36127108 PMCID: PMC9490636 DOI: 10.1136/bmjopen-2022-063365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To describe and map scientific literature related to alcohol consumption, its determinants, governance, harm and control policies by publication output, author affiliations, funding, countries of study and research themes. DESIGN Bibliometric analysis using performance analysis and science mapping techniques. DATA SOURCES Scientific articles. ELIGIBILITY CRITERIA Indexed scientific articles published between 1 January 2010 and 31 December 2021 with an English abstract focused on alcohol consumption, its determinants, harms, governance and control policies. DATA EXTRACTION AND SYNTHESIS Searches were run in Web of Science and PubMed. Performance metrics were analysed using descriptive statistics. Keywords were used for science mapping in a deductive approach to cluster articles by five main research themes. The 'policy response' theme was further analysed by six subthemes. RESULTS 4553 articles were included in the analysis. Three out of four articles (3479/4553, 76.4%) were authored solely by authors affiliated with HIC institutions. One in five articles (906/4553, 19.9%) had at least one author affiliated to an institution from an upper-middle-income, middle-income or low-income country context. Governments, followed by research institutions, were the predominant funding source. Half (53.1%) studied a single country and, of these, 77.0% were high-income countries (HICs). Australia, USA and UK were the most studied countries, together accounting for 44.9% (975/2172) of country-specific articles. Thematically, 'consumption' was most studied, and 'alcohol determinants', least. 'Policy response' articles were predominately conducted in HIC contexts. CONCLUSIONS Although the attributable harm of alcohol is known to affect more significantly lower-income and middle-income countries, scientific publications primarily report on HIC contexts by authors from HICs. Research themes reflect known cost-effective policy actions, though skewed towards HICs and a focus on consumption. The implementation of context-specific alcohol control policies requires addressing the determinants of the uneven geographical and thematic distribution of research.
Collapse
Affiliation(s)
| | - Tanmay Devi
- Data Analysis, CPC Analytics, Berlin, Germany
| | - Erica Barbazza
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam, Netherlands
| | - Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | | | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneve, Switzerland
| | - Juan E Tello
- Department of Health Promotion, World Health Organization, Geneve, Switzerland
| |
Collapse
|
11
|
Rutherford C, Boehnke JR. Introduction to the special section "Reducing research waste in (health-related) quality of life research". Qual Life Res 2022; 31:2881-2887. [PMID: 35907111 DOI: 10.1007/s11136-022-03194-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Claudia Rutherford
- Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Cancer Care Research Unit (CCRU), The University of Sydney, Sydney, Australia. .,Faculty of Science, School of Psychology, Sydney Quality of Life Office, The University of Sydney, Sydney, Australia. .,The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia.
| | - Jan R Boehnke
- School of Health Sciences, University of Dundee, Dundee, UK
| |
Collapse
|
12
|
Kumar M, Atwoli L, Burgess RA, Gaddour N, Huang KY, Kola L, Mendenhall E, Mugo C, Mutamba BB, Nakasujja N, Njuguna I, Obasi A, Petersen I, Shidhaye R. What should equity in global health research look like? Lancet 2022; 400:145-147. [PMID: 35597247 DOI: 10.1016/s0140-6736(22)00888-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/10/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Manasi Kumar
- Brain and Mind Institute, Aga Khan University, Nairobi 00100, Kenya.
| | - Lukoye Atwoli
- Brain and Mind Institute, Aga Khan University, Nairobi 00100, Kenya; School of Medicine, Aga Khan University, Nairobi 00100, Kenya
| | | | - Naoufel Gaddour
- Department of Psychiatry, University of Monastir, Monastir, Tunisia
| | - Keng Yen Huang
- Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA
| | - Lola Kola
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Emily Mendenhall
- Edmund A Walsh School of Foreign Service, Georgetown University, Washington DC, USA
| | - Cyrus Mugo
- Research Department, Kenyatta National Hospital, Nairobi, Kenya
| | | | | | - Irene Njuguna
- Research Department, Kenyatta National Hospital, Nairobi, Kenya
| | - Angela Obasi
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Inge Petersen
- Center for Rural Health, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Rahul Shidhaye
- Department of Psychiatry, Pravara Institute of Medical Sciences, Loni, Ahmednagar, Maharashtra, India
| |
Collapse
|
13
|
Polidano K, Parton L, Agampodi SB, Agampodi TC, Haileselassie BH, Lalani JMG, Mota C, Price HP, Rodrigues S, Tafere GR, Trad LAB, Zerihun Z, Dikomitis L. Community Engagement in Cutaneous Leishmaniasis Research in Brazil, Ethiopia, and Sri Lanka: A Decolonial Approach for Global Health. Front Public Health 2022; 10:823844. [PMID: 35242734 PMCID: PMC8885625 DOI: 10.3389/fpubh.2022.823844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a parasitic skin disease endemic in at least 88 countries where it presents an urgent, albeit often “neglected” public health problem. In this paper, we discuss our model of decolonial community engagement in the ECLIPSE global health research program, which aims to improve physical and mental health outcomes for people with CL. The ECLIPSE program has four interlinked phases and underpinning each of these phases is sustained and robust community engagement and involvement that guides and informs all activities in ECLIPSE. Our decolonial approach implies that the model for community engagement will be different in Brazil, Ethiopia and Sri Lanka. Indeed, we adopt a critical anthropological approach to engaging with community members and it is precisely this approach we evaluate in this paper. The data and material we draw on were collected through qualitative research methods during community engagement activities. We established 13 Community Advisory Groups (CAGs): in Brazil (n = 4), Ethiopia (n = 6), and Sri Lanka (n = 3). We identified four overarching themes during a thematic analysis of the data set: (1) Establishing community advisory groups, (2) CAG membership and community representation, (3) Culturally appropriate and context-bespoke engagement, and (4) Relationships between researchers and community members. During our first period of ECLIPSE community engagement, we have debunked myths (for instance about communities being “disempowered”), critiqued our own practices (changing approaches in bringing together CAG members) and celebrated successes (notably fruitful online engagement during a challenging COVID-19 pandemic context). Our evaluation revealed a gap between the exemplary community engagement frameworks available in the literature and the messy, everyday reality of working in communities. In the ECLIPSE program, we have translated ideal(istic) principles espoused by such community engagement guidance into the practical realities of “doing engagement” in low-resourced communities. Our community engagement was underpinned by such ideal principles, but adapted to local sociocultural contexts, working within certain funding and regulatory constraints imposed on researchers. We conclude with a set of lessons learned and recommendations for the conduct of decolonial community engagement in global health research.
Collapse
Affiliation(s)
- Kay Polidano
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Linda Parton
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Suneth B. Agampodi
- Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Thilini C. Agampodi
- Department of Community Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | | | | | - Clarice Mota
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Helen P. Price
- School of Life Sciences, Keele University, Newcastle-under-Lyme, United Kingdom
| | - Steffane Rodrigues
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | | | - Leny A. B. Trad
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Zenawi Zerihun
- Department of Psychology, Mekelle University, Mekelle, Ethiopia
| | - Lisa Dikomitis
- School of Medicine, Keele University, Newcastle-under-Lyme, United Kingdom
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, United Kingdom
- *Correspondence: Lisa Dikomitis
| |
Collapse
|
14
|
Rasheed MA. Navigating the violent process of decolonisation in global health research: a guideline. THE LANCET GLOBAL HEALTH 2021; 9:e1640-e1641. [DOI: 10.1016/s2214-109x(21)00440-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/10/2021] [Indexed: 12/14/2022] Open
|