Conducting health‐related social science research in low income settings: ethical dilemmas faced in Kenya and South Africa

Abstract

The value of the social sciences is increasingly recognised in health services and clinical research, contributing to an increasing number of multi-disciplinary, multi-method studies. Such studies offer numerous advantages, but also pose particular challenges, including different approaches to or foci in research ethics across disciplines. Drawing on two similar studies conducted in coastal Kenya and in rural South Africa, we share the ethical challenges we faced in relation to several key principles, the responses we adopted, and the new dilemmas that resulted from our actions. Given that multi-disciplinary, multi-method studies are often reviewed by committees with greater familiarity with biomedical than social science research, we conclude by drawing on our experiences, and the wider literature and guidelines around conducting social science research, to make suggestions of additional considerations for social science elements of multi-disciplinary research. We also emphasise that in practice it is the social relationships that are established between researchers and field-teams, and between field-teams and community members, that are critical to fulfilling the moral (as opposed to the legal) aspects of ethics guidelines. These essential elements of ethical practice, and of producing quality data, are not easily tested and checked by ethics committees. Rather they are linked to the insight and integrity of the principle investigators and their research teams. Copyright © 2009 John Wiley & Sons, Ltd.

Towards a political economy of the use of research assistants: reflections from fieldwork in Tanzania and Mozambique

“…Our analysis supports the need for attention to a range of practical tasks that can help to facilitate the smooth running of qualitative fieldwork, and that are well documented in Molyneux et al (2009). These include building in enough time for comprehensive training and education on the project aims, relevant literature, and the techniques to be used, as well as opportunities for pilot and practice.…”

“…This is a delicate point because ensuring the good functioning of the professional relationship between researcher and research assistant may need to be based on engaging more, not less, the research assistant in the process of data collection. In both cases, then, it is clear that the establishment of this relationship was a vital element of the research process, without which any research activities conducted may have been of limited scientific value (Molyneux et al, 2009). It also emphasises that any issues that researchers have with managing research assistants may be rooted in questions of ownership and control, relations that can sometimes be obscured, with tensions put down to clashes in personalities, not interests.…”

Research Ethics Governance in Times of Ebola

“…Such an approach can underestimate the potential harms that can affect respondents and communities that take part in qualitative studies (Townsend et al , 2010);Most ECs/IRBs are not equipped to examine such research protocols as they have limited experience reviewing them, little social science and anthropological expertise, and because of the ‘low risk’ perception they tend not to seek external advice (Molyneux et al , 2009). …”

The Challenges of Maintaining Social Work Ethics in Kenya

“…For example, Nyambedha (2008) stresses the importance of using and adding to local knowledge through research with vulnerable groups (including for instance, communities affected by HIV/AIDS in Kenya) and using the knowledge gained to guide and inform their advocacy work. Recognising the way socio-cultural issues affect, for example, public health, and the importance of creating positive relationships with individuals and communities in social research, are important ethical aspects in engaging vulnerable communities in Africa (Molyneux et al 2009). In other words, working with respect with people includes respecting their history and culture.…”