This brief on catastrophic health expenditure in Kenya’s rapidly growing urban areas look at how the rapid growth of urban populations poses significant challenges to healthcare access in cities in low and middle-income countries (LMICs), such as Kenya. A scoping review on the economic impact of accessing healthcare in urban populations indicates that residents across […]
Supported by the ARISE Responsive Challenge Fund, the African Population and Health Research Centre (APHRC) worked with Child Space Organization to reach out to children heading up households in the attempt to address the vulnerabilities and marginalities they face. Child headed households (CHHs) refer to families that have a minor as the head of the […]
Abstract This article critically reviews the literature on urban informality, inequity, health, well-being and accountability to identify key conceptual, methodological and empirical gaps in academic and policy discourses. We argue that critical attention to power dynamics is often a key missing element in these discourses and make the case for explicit attention to the operation […]
Abstract Safeguarding challenges in global health research include sexual abuse and exploitation, physical and psychological abuse, financial exploitation and neglect. Intersecting individual identities (such as gender and age) shape vulnerability to risk. Adolescents, who are widely included in sexual and reproductive health research, may be particularly vulnerable. Sensitive topics like teenage pregnancy may lead to […]
Abstract Poorly managed sanitation is degrading, unhealthy and far too dominant among the urban poor. The conventional solution to poorly managed onsite sanitation and/or open defecation is for governments to provide adequate sanitation at subsidised prices. Few governments in low and middle income countries can subsidise access to sanitation facilities for people living and working […]
Waste workers-otherwise known as sanitation workers-are often made invisible due to informal work arrangements. In India, as in other parts of the world, sanitation workers tend to be from the oppressed and marginalized communities with little access to healthcare and quality health services. This despite, their work being highly important to society and exposing them […]
Co-production requires dismantling existing power hierarchies. As such, it can support decolonising knowledge generation and fostering inclusive and equitable relationships with diverse (and at times) marginalised actors participating in health governance, research and decision-making. Decolonising knowledge production recognises that expertise lies with those communities directly affected by health inequities and challenges as well as other […]
Decolonising health research requires a shift to inclusive processes, and actively engaging with communities. Community-based participatory research (CBPR) fosters collaboration among communities, researchers, and implementers to produce contextual knowledge for action. Enhancing co-production skills and competencies has been shown to improve research quality and validity, while CBPR principles have been developed, limited guidance exists on […]
Waste pickers in India are extremely vulnerable to a range of health problems due to their poor living and unsafe working conditions, and struggle to access the health services they are entitled to. This research uses a community-based participatory research and focuses specifically on vector-borne diseases in two districts of Andhra Pradesh, exploring how they […]
In Kenya, the pregnancy rate of 15% among adolescents aged 15–19 years is alarmingly high. Adolescent girls living in informal urban settlements are exposed to rapid socio-economic transitions and multiple intersecting health risks and may be particularly disadvantaged in accessing sexual reproductive health services. Understanding vulnerabilities and service-seeking behaviours from different perspectives is important in order […]
Involving community researchers and the broader community in the development and validation of priorities, study tools, data collection processes, data analysis, interpretation and action planning is important to the quality of the CBPR process. Consistently engaging the community in monitoring the progress of community activities and gaining their reflexive accounts of the actions ensures rigour within the research process.
Capacities (competencies and conditions)
●Awareness of trustworthiness criteria that draw on critical epistemologies
●Ability to assess and develop contextualised code of research ethics including safeguarding
●Capacity to undertake validation exercises with stakeholders and the wider community to ensure the study is relevant, accepted and supported
●Ongoing learning, quality assessment and safeguarding assessment
●Capacity to contextualise research materials that value local ways of knowing and knowledge production
●Knowledge on how to engage in and apply reflexivity, considering positionality with regard to research findings, to strengthen rigour and trustworthiness
●Ability to triangulate different sources of information to determine research priorities, approach and actions
●Rigorous research findings which draw on trustworthiness criteria
●Generalisable research processes that can enhance CBPR techniques
●Community based research that is robust and adds value to communities, policies and practices
●Community members learn research skills, gain access to resources, and find ways to legitimate their knowledge, which have previously been limited by a history of exclusionary research practices
●After the research partnership has undertaken a process of prioritisation, and before conceptualising the research, validate the priorities and incorporate additional context to increase trustworthiness in the process
●Design research analysis and interpretation procedures that involve community researchers and associated stakeholders
●Have an outsider to help increase the rigour and real and perceived validity of the research
●Conduct data interpretation sessions to discuss interpretations, add context to information collected, and facilitate a better understanding of project documentation
●Triangulate data sources and add participant checking
●Undertake co-analysis activities with co-researchers and stakeholders
●Increase the reliability of the study by developing and using a case study protocol and a chain of evidence
●Design survey and interview questions that are culturally aligned enhancing the fit of the research with the implementing context
●Identify relational and situated ethical and safeguarding concepts and approaches that best fit the specific context and the process-oriented nature of CBPR (25)
●Constructive negotiation with gatekeeping bodies such as funders and research ethics committees to increase understanding of appropriate approaches
●Engage co-researchers and community members during the research tool preparation to cover all the essential aspects of the research including safeguarding risks
Utilise quality criteria to evaluate the CBPR process – see Springett, Atkey (26) and Sandoval, Lucero (27
●Documentation on the translation and adaptation of the materials and quality assurance processes through minutes and notes on discussions and engagement within the team and with stakeholders
●Documentation of research validation processes
●Documentation of discussion during triangulation of findings
●Case studies/stories/blogs that show reflexivity processes
●Peer reviewed publications
●Audio or notes from community validation processes
●NVivo or other screenshots showing quality checking processes
●Development and use of a case study protocol and the development of a database and a chain of evidence to improve reliability of the study
*Please note that some statements are adaptations or direct quotes from the papers listed in the reference section