The overall aim of health systems research is applied; to make a positive difference to policy and practice. This requires mutual understanding throughout the research process between researchers and implementers (governments, NGOs, and communities).
Strong respectful relationships – between investigators, between researchers and the communities and institutions that they work in, with policy makers, practitioners and other users of research – are key to research success and vital to ethical practice. In this section we have collected resources which illuminate how relationships can prompt ethical quandaries but also support identifying strategies to resolve them.
Some research projects are undertaken within collaborations or consortia which bring together implementing organisations from a number of countries or organisations. Parker and Kingori’s (2016) paper highlights for collaborative global health the importance of a series of factors that researchers see as essential in judging the merits of active participation in global health collaborations, including: respect for the needs, interests and agendas of partners; opportunities for discussion and disagreement; trust and confidence; and, justice and fairness in collaboration. This and other papers highlight that collaborations and consortia are shaped by a range of power dynamics and imbalances which researchers should be mindful of. Pratt and Hyder (2016) provide a checklist that can be used by trans-national research collaborations to determine where their governance practices strongly promote equity and where they may fall short.
The paper by Crane et al. (2017) addresses the issue of capacity building (which many donors demand as a component of research partnerships). Often the flow of resources, skills and knowledge is assumed to flow from high-income countries to low- and middle-income countries within these frameworks. The paper explores how one capacity development intervention led to new risks and the weakening of local ownership and room for manoeuvre. It offers lessons for how these negative outcomes can be avoided.
The paper by Hyder et al. (2012) outline some of the ethical issues that come to the fore when researchers engage with low-resource communities over the longer term. These include: “fair benefits and long-term beneficence; community autonomy, consultation and consent; impacts on local health systems; economic impacts of research participation; ethical review processes; and institutional processes and oversight within research organizations.”
We have also included literature on ‘community engagement’ which is a package of interventions employed by research programmes to ensure that local views and beliefs are taken into account and ideally shape priorities and practice.
Good and Bad Research Collaborations: Researchers’ Views on Science and Ethics in Global Health Research
Parker M. and Kingori P. (2016) Good and Bad Research Collaborations: Researchers’ Views on Science and Ethics in Global Health Research, PLoS ONE 11(10) There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much […]
Pratt B. and Hyder A.A. (2016) Governance of Transnational Global Health Research Consortia and Health Equity, Am J Bioeth. 2016 Oct;16(10):29-45 Global health research partnerships are increasingly taking the form of consortia of institutions from high-income countries and low- and middle-income countries that undertake programs of research. These partnerships differ from collaborations that carry out single […]
Crane J.T., Andia Biraro I., Fouad T.M., Boum Y. 2nd and R. Bangsberg D. (2017) The ‘indirect costs’ of underfunding foreign partners in global health research: A case study, Glob Public Health. 2017 Sep 16:1-8 This study of a global health research partnership assesses how U.S. fiscal administrative policies impact capacity building at foreign partner institutions. We conducted a […]
Exploring the Ethics of Long-Term Research Engagement With Communities in Low- and Middle-Income Countries
Hyder A.A. et al. (2012) Exploring the Ethics of Long-Term Research Engagement With Communities in Low- and Middle-Income Countries. Public Health Ethics (2012), 5 (3): 252-262 Over the past few decades, there has been increasing attention focused on the ethics of health research, particularly in low- and middle-income countries. Despite the increasing focus on the […]
Domecq J.P., Prutsky G., Elraiyah T., Wang Z., Nabhan M., Shippee N., Brito J.P., Boehmer K., Hasan R., Firwana B., Erwin P., Eton D., Sloan J., Montori V., Asi N., Abu Dabrh A.M. and Murad M.H (2014) Patient engagement in research: a systematic Review, BMC Health Services Research201414:89 A compelling ethical rationale supports patient engagement in […]
“The way the country has been carved up by researchers”: ethics and power in north–south public health research
Walsh A., Brugha R. and Byrne E. (2016) “The way the country has been carved up by researchers”: ethics and power in north–south public health research, International Journal for Equity in Health, 2016, 15:204 Despite the recognition of power as being central to health research collaborations between high-income countries and low- and middle-income countries, there has […]
Defining Health Research for Development: The perspective of stakeholders from an international health research partnership in Ghana and Tanzania
Ward C.L., Shaw D., Anane-Sarpong E., Sankoh O., Tanner M., Elger B. (2017) Defining Health Research for Development: The perspective of stakeholders from an international health research partnership in Ghana and Tanzania, Dev World Bioeth. 2017 May 3 The study uses a qualitative empirical method to define Health Research for Development. This project explores the perspectives of stakeholders in an international […]
Participants in the Community Engagement and Consent Workshop , Kilifi, Kenya , March 2011.(2013) Consent and community engagement in diverse research contexts, J Empir Res Hum Res Ethics. 2013 Oct;8(4):1-18 Consent and community engagement (CE) in health research are two aspects of a single concern-that research is carried out in a respectful manner where social value […]