Understanding the role of community advisory groups in Malawi

What is it about?

Community engagement to protect and empower participating individuals and com- munities is an ethical requirement in research. There is however limited evidence on effectiveness or relevance of some of the approaches used to improve ethical prac- tice. We conducted a study to understand the rationale, relevance and benefits of community engagement in health research. This paper draws from this wider study and focuses on factors that shaped Community Advisory Group (CAG) members’ selection processes and functions in Malawi. A qualitative research design was used; two participatory workshops were conducted with CAG members to understand their roles in research. Workshop findings were triangulated with insights from eth- nographic field notes, key informant interviews with stakeholders, focus group dis- cussions with community members and document reviews. Data were coded manually and thematic content analysis was used to identify main issues. Results have shown that democratic selection of CAG members presented challenges in both urban and rural settings. We also noted that CAG members perceived their role as a form of employment which potentially led to ineffective representation of com- munity interests. We conclude that democratic voting is not enough to ensure effec- tive representation of community’s interests of ethical relevance. CAG members’ abilities to understand research ethics, identify potential harms to community and communicate feedback to researchers is critical to optimise engagement of lay com- munity and avoid tokenistic engagement.

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Why is it important?

The paper critiques the roles of community advisory boards as a mechanism for improving community participation in research design and implementation