Ethics & Engagement across the Wellcome Trust Major Overseas Programmes
Every year Malawi Liverpool Wellcome Trust (MLW) recruits new staff to join the various projects within the programme, a good percentage of these staff is dominated by Fieldworkers (FWs). In 2015 MLW had about 87 FWs, over the years we have seen the number increasing up to 130. Principal Investigators (PI) manage their respective FWs. The increasing number drew our attention to embark on a small bursary project which aimed at exploring experiences of the FWs and how we can improve ethical practice within MLW. We also wanted to propose a strategy which can be used to provide systematic support to this group of staff.
We designed a qualitative study using Observations (targeting FWs) and in-depth interviews (targeting FWs Study Coordinators (SC) and Principal Investigators (PIs). 8 studies recruiting participants in multiple settings and designs; hospital and in the community, Rural and Urban, Observational and intervention studies were sampled out among numerous studies at MLW.
I joined the FWs in their day to day work, learning from their experience, we also did interviews to have an in-depth understanding of the ethical issues surrounding their work. The topics guides were drafted in line with the study objectives and interaction I had with respective FWs. We also interviewed PIs and Study Coordinators (SC) who managed them in the studies. Our interest was to find out how they support FWs to address ethical issues they face in their work, the existing communication channels between PIs/SC and FWs and how MLW can move forward to support FWs.
Some interesting issues came up, one overarching theme was the struggle the FWs face to translate ethical principles in to practice in their day work. The FWs faced dilemma to maintain privacy and confidentiality of participants, to achieve a thorough consenting process, discussing general information about MLW and its research work and handling refusals. The setting where studies were conducted paused a lot of challenges for the FWs to adhere to a standard practice, among them were illiteracy levels, knowledge about research, targets set by PIs contributed to the issues arising.
We plan to have a workshop with all the FWs who were involved to present our findings and also to let them have a say on the issues that came up. According to literature, FWs are not given a platform to comment on the dilemmas they face; we would therefore like to have their harmonized opinion on these findings and also how they think these issues can be dealt with.
We are currently drafting papers which will be published, we also aim at drafting a strategy which will be proposed to MLW to guide the support FWs need to eventually achieve standard practice within the institution.
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