This paper is a welcome addition to the literature on Community Engagement in Health Research. While welcoming the much needed articulation of possible frameworks to evaluate such engagement, three points come to my mind:
One is that the whole approach is seen as one of protecting the community, respecting the community etc., this paints the picture of a community that is vulnerable. However while the various principles and guidelines do address how research processes should engage with 'vulnerable' communities, there does not seem to be any responsibility of the researchers or the research process of addressing the source of this vulnerabilities. This will come about only when research itself is seen as a 'liberatory' process. Addressing the vulnerability rather than compensating for it means that research processes and researchers need to engage with communities and groups working with communities even before the conceptualization of the research protocol. Thus one finds enshrined in the Research Encounter of the Second People's Health Assembly the following, "It is important to understand that research is a tool for social transformation. Advantage should be taken of its potential for exposing and fighting for equity in health, for the empowerment of the community using political, psychological, cultural, and social means" (1). This was published in 2005 and thus predates almost all of the quoted literature. It is important that discourses on community engagement go beyond the acknowledgment of vulnerability (which in itself is a great step forward) to actually engaging with the sources of such vulnerability. That many processes of community engagement in the present framework still lead to such transformational processes, does not reduce the need to bring to the fore this alternative and 'liberatory' discourse.
As noted above such a transformation would mean that "community engagement" is not seen merely as a specific component of the research protocol, but a "way of life" it is equally important to ensure community engagement, 'between' research projects, and not merely 'during' research projects. Community engagement then becomes an imperative in the education of all researchers.
Finally it is important to question why while demanding community engagement for research processes, the authors stops at suggesting theory of change or realist approaches to evaluating such processes. One would have expected a foregrounding of participatory methods (2) in such evaluations.
I am chairperson of the Community Advisory Board of the National Institute of Resaerch on Tuberculosis, and a member of the Patient Advisory Panel & Editorial Advisory Board of the BMJ.
Taking the discussion forward
13 July 2015
This paper is a welcome addition to the literature on Community Engagement in Health Research. While welcoming the much needed articulation of possible frameworks to evaluate such engagement, three points come to my mind:
References
(1) Peoples Health Movement (2005). Research for People's Health. People's Health Movement, Bangalore http://sochara.org/sites/default/files/2.%20Research%20for%20Peoples%20Health.pdf
(2) Loewenson R, Laurell AC, Hogstedt C, D’Ambruoso L, Shroff Z (2014) Participatory action research in health systems: a methods reader, TARSC, AHPSR, WHO, IDRC Canada, EQUINET, Harare.
http://www.equinetafrica.org/bibl/docs/PAR%20Methods%20Reader2014%20for%20web.pdf
Competing interests
I am chairperson of the Community Advisory Board of the National Institute of Resaerch on Tuberculosis, and a member of the Patient Advisory Panel & Editorial Advisory Board of the BMJ.