The aim of this study is to apply theories of intersectionality and political economy to better understand how informal health service provision, utilization and governance is organised within informal urban settlements in Freetown, and how these impact on the health and healthcare access of people living with chronic health conditions. Download poster
Online research methods have risen in popularity over recent decades, particularly in the wake of COVID-19. We conducted five online workshops capturing the experiences of participatory health researchers in relation to power, as part of a collaborative project to develop global knowledge systems on power in participatory health research. These workshops included predominantly academic researchers […]
For the large population living in Nairobi’s informal settlements, the long-term effects of COVID-19 pose a threat to livelihood, health, and wellbeing. For those working in the informal sector, who are the lifeblood of the city, livelihoods have been severely supressed by COVID-19 restrictions such as curfews, pushing many into further poverty. This article draws […]
Freetown has over 1 million residents, many of whom live in about 68 crowded informal settlements. Residents of these settlements struggle daily to access basic services such as water, sanitation, and health-care services. We found that the government’s COVID-19 response measures (curfews, lockdowns, and travel restrictions) excluded informal residents from contributing to its design, and […]
One in three urban dwellers now live in precarious, marginalised areas, including informal spaces; this is an estimated 881 million people in low- and middle-income countries. People living and working in informal urban spaces face interconnected challenges, including multiple intersecting health risks and vulnerabilities, and complex, fluid governance arrangements, involving a mix of actors, with […]
Much of the current discussion on safeguarding comes from the perspective of the humanitarian sector, and direct service provision and implementation. Additionally, researchers working in global health also experience safeguarding challenges, and research funders and donors require assurance that safeguarding processes and policies are developed and implemented to protect participants and researchers, yet governance in […]
One of our core strategies to affect change is to support capacity strengthening of urban marginalised co-researchers to generate, collect, and use evidence as new localised knowledge to instigate change. Strengthening capabilities of urban marginalised people to engage with research processes is central to the principles of CBPR and meaningful participation of marginalised communities. ARISE […]
This paper applies an intersectional lens to health in informal urban settlements in Freetown, Sierra Leone. We explored how intersecting social characteristics including gender, age, wealth, occupation, and tenant status influence health and well-being outcomes. We found that hazardous environmental conditions, poor waste disposal, and waste burning contribute to health problems at a neighbourhood level. […]
COVID-19 presents a time to redefine vulnerability; however, in discussions of vulnerability, the health workforce, particularly in regard to their psychosocial well-being, is often forgotten. Healthcare workers (HCWs) in fragile settings are constantly exposed to health system shocks, including; conflict, disease outbreaks and natural disasters, which compound the everyday challenges of working in an under-resourced […]
COVID-19 has forced a reckoning about how we live, and in particular how exposure to disease risks are unevenly distributed. This contribution explores connections between the COVID-19 pandemic, chronic disease and conditions of chronic crisis among the urban poor. We suggest two issues in urgent need of attention in the long and short term are: […]
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