Stakeholder engagement in research projects during a pandemic
Stakeholder Engagement Champion, Himangi Lubree from the King Edward Memorial Hospital Research Centre, Pune, India, describes the experience of conducting a massive stakeholder engagement exercise for RESPIRE during COVID-19
The COVID-19 pandemic has hit India severely, with a steep surge in cases in the months of February to May 2021. During this period, Pune district has reported the highest number of cases as well as deaths due to COVID-19 among all districts in India. While initially, urban areas in the district contributed to most of the case-load, rural areas in Pune district have witnessed an increase too with a reported 250,000 cases up to May 2021. The government, both state and local, has responded by enforcing administrative ‘lockdowns’ and restriction of routine activities that are deemed not essential to tackle the COVID-19 crisis or basic sustenance, as well as focusing on strengthening the health system in rural areas.
COVID-19 Sero-surveillance study
While the most serious impact of this has been a disruption in the daily lives of almost all individuals in the district and unfortunately, considerable mortality and morbidity, a less serious but important impact has been on the potential interruption in the conduct of RESPIRE research projects in Pune district. KEM Hospital Research Centre (KEMHRC) Pune, a RESPIRE partner, began field work in February 2021 for a RESPIRE-funded study to determine Covid-19 seropositivity (the presence of antibodies in blood serum) in rural communities in Pune district. Up to the third week of May 2021, the study completed data collection from about 11,000 individuals residing in 120 villages and plans to collect data from 30 more villages in June 2021. This work, while impressive in itself, becomes all the more remarkable, considering the fact that data collection coincided with the surge in COVID-19 cases in Pune. The study field team, led by Dr Makarand Ghorpade and supported by Mr Arun Dhongade, worked through the lockdowns, negotiated with local government officials to allow the study teams to travel in the field for data collection, explained the study objectives and their importance to community members and counselled them regarding the benefits and risks of participating in the study.
While the primary credit goes to the study field team for their dedication, even though the team members were at a constant risk of themselves getting infected by SARS-CoV-2, a crucial factor for this success has been a massive stakeholder engagement exercise that the study team conducted in the said villages. Between February and May 2021, the team members held 120 different meetings with community representatives such as heads of village (Sarpanch), administrative heads (Gram Sevak), public health nurses (Auxiliary nurse midwife), community health workers (ASHA) and local government (Gram Panchayat) members in the study area. At these meetings the purpose, significance and expected outcomes of the study were discussed and inputs were asked from the community regarding study conduct. There was an initial hesitancy expressed by these stakeholders to allow the study team to collect data, with many of them sceptical about the importance and need of the study while others were apprehensive about villagers coming in contact with study team members. However, all these queries were patiently addressed by the team members through scientific explanations regarding the importance of the study and assurances regarding precautions taken by team members while collecting data. Examples of similar studies in other parts of India were provided and whenever required, the Principal Investigator and Co-Investigator spoke directly with community representatives to answer their queries. Ultimately, all community members in the 120 villages agreed to participate in the study and also provided support to the field team when they faced local challenges. For example, allowing the study teams special access to villages even during a lockdown, community health workers arranging space in the villages for data collection, etc.
Stakeholder engagement to enhance research
We believe that the fact that these stakeholders were consulted prior to data collection conveyed a sense of ownership of the study by the stakeholders, which greatly facilitated the study conduct. Crucially, the study team was able to build trust with the community initially through these stakeholder engagement meetings and then during field work. Continuing stakeholder engagement reinforced this trust. Community members are also being provided feedback, in terms of providing sero-testing results to individual study participants, as well as providing seroprevalence rates to communities at large. This feedback is important in ensuring that our engagement with the community is not a one-time activity and will continue in the future.
We conclude by stating that while this is an example of how appropriate stakeholder engagement can help research studies even in times of an extra-ordinary public health crisis, this has been a valuable learning experience for KEMHRC Pune and emphasizes the importance of stakeholder engagement.