The impetus to conduct trials of major public health interventions will often be from re- search centres or universities, in collaboration with the Ministry of Health (MOH). The intervention trial team will usually select the communities which they consider are most suitable for the conduct of a trial. The active and continued engagement with people within these communities is essential for the successful execution of the field trial. This chapter aims to provide practical guidance to researchers on ways of approaching com- munity engagement in trials in LMICs, including identifying some common pitfalls.
The terms ‘community’ and ‘engagement’ attract debate and controversy around their meanings and the social, ethical, and political implications of their application in development and biomedical research practice. These aspects will not be explored in detail in this chapter but are discussed elsewhere (Participants in the Community Engagement Consent Workshop, 2013). The present chapter should also be read in conjunction with Chapters 6 and 15, as understanding of the ethical responsibilities of researchers working in LMICs underpins the overall importance of community en- gagement and the planning of its components (see Chapter 6), and community engage- ment is essentially a social endeavour, with many overlaps with social and behavioural research approaches and methods (see Chapter 15).
For the purposes of this chapter, community engagement will be defined as the pro- cess of the trial team working collaboratively with the community on all aspects of the study which affect the community and its well-being. Overall, engagement should typically involve continuous mutual learning and communication between researchers and a range of community members before and during a trial and after a trial ends.