Aligning Community Engagement With Traditional Authority Structures in Global Health Research: A Case Study From Northern Ghana

Tindana, Paulina; Rozmovits, Linda; Boulanger, Renaud; Bandewar, Sunita V S; Aborigo, Raymond; Hodgson, Abraham; Kolopack, Pamela A.; Lavery, James V.

doi:10.2105/ajph.2011.300203

Cited by 76 publications

(119 citation statements)

References 25 publications

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“…16,19,20,22 They believed that culturally appropriate strategies were necessary to educate the community about new interventions and encourage active participation in research. Community leaders in Ghana suggested using traditional community gatherings, which included cultural activities such as drumming and dancing.…”

Section: Centrality Of Community Engagementmentioning

confidence: 99%

“…Community leaders in Ghana suggested using traditional community gatherings, which included cultural activities such as drumming and dancing. 16 Many desired "genuine, fair, and effective" 24 dialogue with community members to improve trial design and conduct, strengthen ethical practice, and demonstrate respect for community values.…”

Section: Centrality Of Community Engagementmentioning

confidence: 99%

“…20,31 Endorsement by "chiefs" and understanding their role as "gatekeepers and mediators" was considered necessary to "allay suspicion, to nurture trust, and to establish the researchers' credibility." 16 Involving trusted "grassroot" 19 intermediaries such as community workers was deemed vital in "opening the way" 21 for researchers. Employing fieldworkers with knowledge of local customs was supported to facilitate recruitment of participants.…”

Section: Centrality Of Community Engagementmentioning

confidence: 99%

“…Employing fieldworkers with knowledge of local customs was supported to facilitate recruitment of participants. 16 Researchers recognized that community …”

Section: Centrality Of Community Engagementmentioning

confidence: 99%

“…So it is better to get them involved to be able to source some information from them, to be able to get their view about the project to move to the next stage, because they always have important contributions to make to the project, to improve on what you have." (NHRC research offi cer) 16 14 16 Recognizing the pivotal role of representatives and leaders "If one hadn't gone through the right procedure… that is, seeing the district authorities and the paramount chiefs and the subsection chiefs and so forth, there might have been a lot more suspicion about what was going on, why we were doing this, who we were, do we have permission to do this. Essentially, this study would not have been accepted."…”

Section: Tablementioning

confidence: 99%

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Stakeholder Views of Clinical Trials in Low- and Middle-Income Countries: A Systematic Review

et al. 2016

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CONTEXT: Clinical trials are necessary to improve the health care of children, but only onequarter are conducted in the low-to middle-income countries (LMICs) in which 98% of the global burden of disease resides. OBJECTIVE:To describe stakeholder beliefs and experiences of conducting trials in children in LMICs.DATA SOURCES: Electronic databases were searched to August 2014. Five themes were identified: centrality of community engagement (mobilizing community, representatives' pivotal role, managing expectations, and retaining involvement); cognizance of vulnerability and poverty (therapeutic opportunity and medical mistrust); contending with power differentials (exploitation, stigmatization, and disempowerment); translating research to local context (cultural beliefs, impoverishment constraints, and ethical pluralism); and advocating fair distribution of benefits (health care, sponsor obligation, and collateral community benefits). LIMITATIONS:Studies not published in English were excluded. CONCLUSIONS:Conducting trials in children in LMICs is complex due to social disadvantage, economic scarcity, idiosyncratic cultural beliefs, and historical disempowerment, all of which contribute to inequity, mistrust, and fears of exploitation. Effective community engagement in recruiting, building research capacities, and designing trials that are pragmatic, ethical, and relevant to the health care needs of children in LMICs may help to improve the equity and health outcomes of this vulnerable population.

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Section: Centrality Of Community Engagementmentioning

confidence: 99%

Section: Centrality Of Community Engagementmentioning

confidence: 99%

Section: Centrality Of Community Engagementmentioning

confidence: 99%

“…Employing fieldworkers with knowledge of local customs was supported to facilitate recruitment of participants. 16 Researchers recognized that community …”

Section: Centrality Of Community Engagementmentioning

confidence: 99%

Section: Tablementioning

confidence: 99%

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Stakeholder Views of Clinical Trials in Low- and Middle-Income Countries: A Systematic Review

et al. 2016

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The role of stakeholder structure in fostering community ownership: A case study of community‐based projects

Kobashi,

Goto,

Chi

2023

Health Planning & Management

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Community health projects have played a crucial role in improving health issues. Listening to communities' voices and achieving community ownership are essential for conducting effective health projects. However, there are limited studies on the frameworks for collecting, aggregating, and operationalizing community preferences and values. In this study, we selected two cases of community field surveys from Japan and Cambodia to discuss who may represent a community and propose a practical approach to achieving community ownership. Both cases involved various stakeholders. From the insights of these two cases, we suggested the following three key components in the community project: the community representative, the communicator, and the institute outside the community. Notably, the community representative's role as the community's direct voice should be properly recognized and institutionalised to establish community ownership. We proposed the following key terms of the qualifications of community representatives: they should be able to represent voices from the community, should have extensive experience to decide the project direction and manage the project, and should be independent of outside actors. Our theoretical model of the structure of different stakeholder groups in community‐based projects will be helpful to accelerate community capacity strengthening; moreover, it can help build the appropriate community institution and process, including multi‐stakeholder groups to promote community ownership in health programs.

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Developing organizational learning for scaling‐up community‐based primary health care in Ghana

Awoonor-Williams

Phillips

2021

Learning Health Systems

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Introduction: Achieving effective community-based primary health care requires evidence for guiding strategic decisions that must be made. However, research processes often limit data collection to particular organizational levels or disseminate results to specific audiences. Decision-making that emerges can fail to account for the contrasting perspectives and needs of managers at each organizational level. The Ghana Health Service (GHS) addressed this problem with a multilevel and sequential research and action approach that has provided two decades of implementation learning for guiding community-based primary health care development. Method:The GHS implementation research initiatives progressed from (i) a participatory pilot investigation to (ii) an experimental trial of strategies that emerged to (iii) replication research for testing scale-up, culminating in (iv) evidence-based scale-up of a national community-based primary health care program. A reform process subsequently repeated this sequence in a manner that involved stakeholders at the community, sub-district, district, and regional levels of the system. The conduct, interpretation, and dissemination of results that emerged comprised a strategy for achieving systems learning by conducting investigations in phases in conjunction with bottom-up knowledge capture, lateral exchanges for fostering peer learning at each system level, and top-down processes for communicating results as policy. Continuous accumulation of qualitative data on stakeholder reactions to operations at each organizational level was conducted in conjunction with quantitative monitoring of field operations.Results: Implementation policies were enhanced by results associated with each phase. A quasi-experiment for testing the reform process showed that scale-up of community-based primary health care was accelerated, leading to improvements in childhood survival and reduced fertility.Conclusion: Challenges to system learning were overcome despite severe resource constraints. The integration of knowledge generation with ongoing management processes institutionalized learning for achieving evidence-driven program action.

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Aligning Community Engagement With Traditional Authority Structures in Global Health Research: A Case Study From Northern Ghana

Cited by 76 publications

References 25 publications

Stakeholder Views of Clinical Trials in Low- and Middle-Income Countries: A Systematic Review

Stakeholder Views of Clinical Trials in Low- and Middle-Income Countries: A Systematic Review

The role of stakeholder structure in fostering community ownership: A case study of community‐based projects

Developing organizational learning for scaling‐up community‐based primary health care in Ghana

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