Initiating community engagement in an ecohealth research project in Southern Africa

Background: Community Engagement (CE) in health research ensures that research is consistent with the sociocultural, political and economic contexts where the research is conducted. The greatest challenges for researchers are the practical aspects of CE in multicentre health research. This study describes the CE in an ecohealth community-based research project focusing on two vulnerable and research naive rural communities. Methods: A qualitative, longitudinal multiple case study approach was used. Data was collected through Participatory Rural Appraisals, Focus Group Discussions, In-depth Interviews, and observations. Results: The two sites had different cultural values, research literacy levels, and political and administrative structures. The engagement process included 1) introductions to the administrative and political leaders of the area; 2) establishing a community advisory mechanism; 3) community empowerment and 4) initiating sustainable post-study activities. In both sites the study employed community liaison officers to facilitate the community entry and obtaining letters of permission. Both sites opted to form Community Advisory Boards as their main advisory mechanism together with direct advice from community leaders. Empowerment was achieved through the education of ordinary community members at biannual meetings, employment of community research assistants and utilising citizen science. Through the research assistants and the citizen science group, the study has managed to initiate activities that the community will continue to utilise after the study ends. General strategies developed are similar in principle, but implementation and emphasis of various aspects differed in the two communities. Conclusions: We conclude that it is critical that community engagement be consistent with community values and attitudes, and considers community resources and capacity. A CE strategy fully involving the community is constrained by community research literacy levels, time and resources, but creates a conducive research environment.