Negotiating Research Participation in Community-Based Studies on the Kenyan Coast: Fieldworkers' Roles, and Implications for Ethical Practice

Kamuya, Dorcas Mwikali (2013). Negotiating Research Participation in Community-Based Studies on the Kenyan Coast: Fieldworkers' Roles, and Implications for Ethical Practice. PhD thesis The Open University.



In this thesis, I explore the nature of research interactions between fieldworkers (FWs) and research participants in a large, long-term international collaborative centre on the Kenyan Coast. Fieldworkers are members of local communities employed in research with the main responsibilities of communicating about studies, and carrying out biomedically simple, non-invasive procedures. Being socially embedded in the communities in which research is conducted, fieldworkers can potentially strengthen studies and research ethics through their insider knowledge of local norms, and of hard-to-reach populations. Being socially embedded can also present problems on how to respond to questions and demands in a context of wealth and health inequalities. I designed a mixed methodology study, primarily qualitative, to unpack the issues that fieldworkers at the frontline of research implementation face, how they resolve these, and the implications for policy and practice.

I found that fieldworkers and other research staff working in communities face considerable dilemmas including those related to household decision-making dynamics for research; and those related to types, levels and scope of research benefits given to participants and communities. The nature of pre-existing relationships within households, and of relationships developed between FWs and household members, apparently strongly influenced discussions and research participation choices. Relationships were often built and nurtured by both fieldworkers and participants. ‘Silent refusals’- a situation of inconsistent participation and reluctance to openly refuse or withdraw from research - emerged as a key challenge for fieldworkers. Negotiations were often imbued with subtle power relations across different sets of interactions; within households, between FWs and participants, and between FWs and supervisors, with potential to shift and shape the research implementation processes. There were often no easy answers to these and other issues fieldworkers faced; they appeared to draw on study guidelines, formal and informal supervision, peers and their own judgements in making choices.

Drawing on these findings, I suggest that understanding and responding to the issues that fieldworkers face throughout their fieldwork is important in supporting the practical application of ethics guidelines including those related to community engagement and consent; and in contributing to normative debates.

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