ArticleBMC medical ethics2020
Structural coercion in the context of community engagement in global health research conducted in a low resource setting in Africa.
Article in BMC medical ethics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Community engagement in research in sub-Saharan Africa: current practices, barriers, facilitators, ethical considerations and the role of gender - a systematic review.The Pan African medical journal · 2022Pooled it
- Examining study participants' decision-making and ethics-related experiences in a dietary community randomized controlled trial in Malawi.BMC medical ethics · 2021Trial
- Parental motivations, facilitators, and barriers to participating in a pediatric vaccine trial in Kathmandu, Nepal: A qualitative study.Human vaccines & immunotherapeutics · 2026Article
- Engaging communities in public health practice: lived experience or lived expertise?International journal for equity in health · 2026Article
- Conflicting perspectives on what constitutes fair compensation and benefits among research stakeholders in Malawi.BMC medical ethics · 2025Article
- "If I am here, it is because the system failed": a critical qualitative study of global commercial clinical trials for advanced cancer in Chile.Globalization and health · 2025Article
- Can anonymisation become disempowering? Rethinking ethics for low-risk global health research.Journal of global health · 2025Article
- Using dataflow diagrams to support research informed consent data management communications: participant perspectives.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Article
- Balancing Ethics and Culture: A Scoping Review of Ethico-Cultural and Implementation Challenges of the Individual-Based Consent Model in African Research.Journal of empirical research on human research ethics : JERHRE · 2024Article
- Community engagement and the centrality of 'working relationships' in health research.BMJ global health · 2024Article
- Enhanced or hindered research benefits? A realist review of community engagement and participatory research practices for non-communicable disease prevention in low- and middle-income countries.BMJ global health · 2024Review
- Assembling a global health image: Ethical and pragmatic tensions through the lenses of photographers.PLOS global public health · 2024Article
- Maternal mental health research in Malawi: Community and healthcare provider perspectives on acceptability and ethicality.SSM. Mental health · 2023Article
- Mistrust: Community engagement in global health research in coastal Kenya.Social studies of science · 2023Article
- 'Guidance should have been there 15 years ago' research stakeholders' perspectives on ancillary care in the global south: a case study of Malawi.BMC medical ethics · 2023Article
- Making districts functional for universal health coverage attainment: lessons from Ghana.Frontiers in public health · 2023Article
- Doing 'reciprocity work': The role of fieldworkers in a mass drug administration trial in the Gambia.Global public health · 2022Article
- A critical examination of research narratives 'rumours' and passive community resistance in medical research.BMJ global health · 2022Article
- Clinical research on COVID-19: perceptions and barriers to participation in The Gambia.BMJ global health · 2022Article
Corrections and comments
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7 authors.
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Abstract
backgroundWhile community engagement is increasingly promoted in global health research to improve ethical research practice, it can sometimes coerce participation and thereby compromise ethical research. This paper seeks to discuss some of the ethical issues arising from community engagement in a low resource setting.
methodsA qualitative study design focusing on the engagement activities of three biomedical research projects as ethnographic case studies was used to gain in-depth understanding of community engagement as experienced by multiple stakeholders in Malawi. Data was collected through participant observation, 43 In-depth interviews and 17 focus group discussions with community leaders, research staff, community members and research participants. Thematic analysis was used to analyse and interpret the findings.
resultsThe results showed that structural coercion arose due to an interplay of factors pertaining to social-economic context, study design and power relations among research stakeholders. The involvement of community leaders, government stakeholders, and power inequalities among research stakeholders affected some participants' ability to make autonomous decisions about research participation. These results have been presented under the themes of perception of research as development, research participants' motivation to access individual benefits, the power of vernacular translations to influence research participation, and coercive power of leaders.
conclusionThe study identified ethical issues in community engagement practices pertaining to structural coercion. We conclude that community engagement alone did not address underlying structural inequalities to ensure adequate protection of communities. These results raise important questions on how to balance between engaging communities to improve research participation and ensure that informed consent is voluntarily given.
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