Community engagement in IR

Invariably, most if not all health care interventions are targeted at community members – engaging them throughout the IR process is critical. Engagement is a process that involves consultation, education, communication, participation, extension work and partnerships. For example, by:

Informing the community of policy directions of the government.
Consulting the community as part of a process to develop government policy, or build community awareness and understanding.
Involving the community through a range of mechanisms to ensure that issues and concerns are understood and considered as part of the decision-making process.
Collaborating with the community by developing partnerships to formulate options and provide recommendations.
Empowering the community to make decisions and to implement and manage change.

Engagement allows the IR team to draw on the collective contextual knowledge of the community, as well as their understanding of existing strengths and resources within the intervention area. Community engagement should therefore be facilitated throughout the entire IR cycle – from pre-intervention, to intervention and continuous monitoring to the final evaluation – and not only during the IR design or conceptualization process (Figure 6).

Too often, unfortunately, researchers simply present an idea or approach to the community that they think will work and expect them to ‘buy in’. In engaging the community, it is best to first discuss the problem at hand, as well as strengths and resources existing within the community, and then seek their opinions on the optimal interventions and IR approaches that will address the problem.

‘Gatekeepers’ in the communities where IR will be conducted are particularly important research stakeholders. They can be considered de facto experts in the field, and an invaluable source or conduit of local information and knowledge, as well as of innovative solutions.

A frequent barrier to effective community engagement is the use of complicated informed consent forms, typically employed in a bid to follow principles of good research ethics. Complicated material with a lot of research jargon and fragmented information leaves the community wondering if they are safe or not. All materials provided to community members should be presented simply, with the critical information designed to make the community comfortable and to reassure them of their safety. Complex technical language – and the confusion and mistrust it can potentially generate – are critical barriers that should not be overlooked.