Kim:

Welcome to the Connecting Citizens to Science Podcast.

Kim:

We're here at HSR 2022 and I have another great participant here at

Kim:

the conference to share some of her experiences of community engagement.

Kim:

I have Lathadevi from the Institute of Public Health in India.

Kim:

Welcome, Latha so tell me a little bit about yourself and why you really

Kim:

are passionate about community.

Lathadevi:

Hi, I'm Latathdevi Chilgod.

Lathadevi:

I'm a public health researcher from my Institute of Public

Lathadevi:

Health, Bengaluru, India.

Lathadevi:

I am very much interested in community health because we have

Lathadevi:

been working with community health workers for the past two and a half

Lathadevi:

years during the times of Covid.

Lathadevi:

We learned a lot actually from that engagement.

Lathadevi:

So, uh, that really interests me.

Kim:

You learned a lot from that engagement; two years with community

Kim:

health workers is quite some time.

Kim:

Tell us a bit about what you learnt.

Lathadevi:

The project that we worked on started right in the Covid pandemic.

Lathadevi:

We did not have avenues of communication with community health workers, so

Lathadevi:

we explored the digital platforms.

Lathadevi:

We made a way that Zoom can be used because Covid brought in that

Lathadevi:

opportunity so that everyone with a phone can be reached everywhere.

Lathadevi:

We made sure that we engaged community health workers through

Lathadevi:

these sessions every week.

Lathadevi:

We would, uh, engage with them and then empower them with the new guidelines,

Lathadevi:

the new things that were just pouring in.

Lathadevi:

We made sure that we used to send them the reminders to join in

Lathadevi:

and they were so enthusiastic.

Lathadevi:

It is not only in the urban area, I'm talking, I'm talking about the

Lathadevi:

rural areas where I'm talking about the tribal areas and urban areas.

Lathadevi:

We had the avenues to engage people on that platform.

Lathadevi:

Based on that experience, we curated a course for community health

Lathadevi:

workers, which was case based blended pure learning approach.

Lathadevi:

What we did was, during all this interaction, we realised that the

Lathadevi:

concepts are a little unclear for them and they were just given these things

Lathadevi:

that you have to do XYZ, but then they don't know why I have to do that because

Lathadevi:

they are community health because they're not formally trained in health.

Kim:

Mm-hmm.

Lathadevi:

We understood that there is a gap there and we took that and

Lathadevi:

then we went on with this case based learning wherein, me as a community

Lathadevi:

health worker, I will see a problem, I will see how I will solve that problem

Lathadevi:

and I'll present it in my peer group.

Lathadevi:

Another community health worker will relate to that.

Lathadevi:

Then she will come up with another example that how she'll tackled

Lathadevi:

another problem with a similar context or a different context.

Lathadevi:

That was very engaging and empowering for them.

Kim:

Mm.

Lathadevi:

Yeah.

Kim:

That's really interesting that it evolved like that.

Kim:

Can you tell me the online communication you had, and you said there was enthusiasm

Kim:

for that, did you have to provide any equipment or strengthen capacity to use

Kim:

Zoom or did they just do it automatically?

Lathadevi:

The times that we live in right now,

Kim:

Yeah

Lathadevi:

everyone has smartphones.

Lathadevi:

Many a times they used to sit in a health centre where the admin would

Lathadevi:

be there and then they would, uh, switch on the Zoom and then all of them

Lathadevi:

would sit together and listen to us.

Lathadevi:

Many a times they were on fields.

Lathadevi:

They were on sides of the roads.

Lathadevi:

They were on somebody's houses.

Lathadevi:

They would sit there and put their headphones on and

Lathadevi:

listen to what we are telling.

Lathadevi:

They would come up with questions; "we want to talk to a paediatrician",

Lathadevi:

"we want to talk to a gynaecologist

Lathadevi:

". We facilitated that so that

Lathadevi:

and they were accessing that knowledge from nooks and corners.

Lathadevi:

That was heartening to see and that was empowering.

Lathadevi:

You feel good that, that times that we live in is amazing.

Kim:

The times we live in that different ways of communicating really can be

Kim:

drawn on, and you just said you're very lucky to live in these times

Kim:

where you can draw on those assets.

Kim:

That peer learning that could come from that sounds, uh, like it only could have

Kim:

been possible through online connections?

Lathadevi:

Definitely.

Lathadevi:

Having said that, that was Covid time.

Lathadevi:

There was no other way, but, uh, nothing compares to face to face.

Lathadevi:

We, uh, we found a balance, a blended program wherein a six week course will

Lathadevi:

be there, wherein every week they would come in, engage and do everything,

Lathadevi:

then come back for a offline workshop.

Lathadevi:

So we, if we have missed on something, come, let's just catch up on all

Lathadevi:

of that, then you are done with it.

Kim:

Amazing.

Kim:

That sounds great.

Kim:

How are you finding the sessions in relation to learning

Kim:

about community engagement?

Lathadevi:

Wonderful, wonderful.

Lathadevi:

I just attended the session, uh, that, uh, you facilitated and it was wonderful.

Lathadevi:

Wonderful.

Kim:

Any key points you'd like to share?

Lathadevi:

About reflexivity?

Lathadevi:

That just caught on.

Lathadevi:

Then I think, uh, the colonisation; the impact of it is, maybe, we have to take a

Lathadevi:

step back irrespective of whatever field you are in, whatever, whatever you are

Lathadevi:

doing, you have to take a step back and then reflect on whatever is happening.

Lathadevi:

Why is it happening?

Lathadevi:

What can I do about it?

Kim:

Mm, interesting.

Lathadevi:

Whoever you are, you, you don't have to be a researcher.

Lathadevi:

You can do any smallest thing also will, you know, will help.

Kim:

Thank you very much.

Kim:

So that was the equitable partnerships session that you were taking part of.

Kim:

So we like to finish with any advice that you have for others that are

Kim:

working in community engagement.

Lathadevi:

I think building rapport is must, and for that

Lathadevi:

you have to have the trust.

Lathadevi:

Everything that we talk about, all big, big words, all based on simple things

Lathadevi:

that you have to engage one on one.

Lathadevi:

Then you have to have that relationship with whoever you are engaging, be it a

Lathadevi:

policy maker or a community health worker.

Lathadevi:

You have to have the trust and that relationship; it matters.

Kim:

Thank you so much.

Kim:

That is a wonderful way to finish.

Kim:

Thank you to you and thank you to our listeners.

Kim:

Bye for now.

Bea:

Hello, this is the Connecting Citizens to Science Podcast, and

Bea:

we're here on the second day of the HSR Conference in Bogota.

Bea:

Today we have a speaker, German Alarcon, who is from Bogota, and

Bea:

he's going to be telling us about his work, his reflections on the

Bea:

conference, and how communities, can be engaged and what he's learned so far.

Bea:

So German please, can you introduce yourself, tell us a bit about what you do.

German:

Hello everyone.

German:

So I'm German Alacron I'm from Bogota, Columbia.

German:

I'm a research assistant at University College London, and also at the

German:

Universidad de los Andes which is here in Bogota Colombia as well.

Bea:

What kind of projects do you work on?

Bea:

What kind of work do you do?

German:

These days I'm working mainly within the Universidad de los Andes

German:

in a local project here in Colombia.

German:

The project is mental health is training in communities, so it's community mental

German:

health in Caqueta, rural communities.

German:

These communities were especially affected by the arms conflict here in Colombia.

German:

I work doing policy review, contrasting information with stakeholders and other

German:

experts, but also with the communities.

Bea:

OK, really interesting.

Bea:

So can you tell us a bit about what kind of stakeholders you're

Bea:

engaging with in this work?

German:

Yeah, so far we have engaged with people from the Ministry of

German:

Health, representative from the academia, many universities and experts.

German:

We are aimed in the next weeks to engage also with, uh, patients,

German:

representatives, and community leaders.

Bea:

Really, really interesting.

Bea:

Thank you so much.

Bea:

Can you tell us about anything that you've found particularly

Bea:

interesting in the conference so far?

Bea:

Anything that you've really enjoyed?

German:

I think that there is a lot of people from many places of the world here.

German:

The perspectives are, they're really, um, important to us because you can

German:

see how other countries with the same kind of situations are handling it

German:

in general, like the mental health problems of the world, I can say.

German:

So I found that encouraging.

German:

The other thing is that the main reason I'm here is because I'm part

German:

of the Emerging Voices programme.

German:

Many of my fellows of the programme are from the Global South, and we have

German:

talked a lot about this, like the mental health crisis in the world and how just

German:

to give more power to the communities in the sense that what they really

German:

need in terms of mental health and know what the government thinks that

German:

they need in terms of mental health.

Bea:

Absolutely.

Bea:

That's really, really interesting and so important that communities are at the

Bea:

centre of how those decisions are made.

Bea:

Are you presenting anything at this conference or are you here as a visitor?

German:

I'm more like visiting at this now.

German:

I was presenting our Emerging Voices pre-conference, a couple of days

German:

ago in Medellin, Colombia as well, but no, I'm here just like getting

German:

more knowledge and sharing with my fellows and supporting them.

Bea:

That's great.

Bea:

And we're also going to have an Emerging Voices special on this programme,

Bea:

so watch out for that as well.

Bea:

German and his colleagues will be talking on that.

Bea:

Thank you so much for joining us today.

German:

Thank you very much for the opportunity and always

German:

welcome to Bogota and to Colombia

German:

Great.

German:

Thank you so much.

Bea:

I'm here on the afternoon of the second day of the HSR Conference

Bea:

in Bogota, and I'm here with Meena Putturaj, who's going to be talking to

Bea:

us about her work in PAR and also her reflections on the session that we've

Bea:

just attended on equitable partnerships.

Bea:

Meena please, can you tell us a bit about your background and

Bea:

where you work at the moment?

Meena:

Hi I am Meena from India.

Meena:

I'm a PhD student who's working in the area of patient rights as a

Meena:

health policy and systems researcher, I strongly believe in the ideas of,

Meena:

uh, justice, equity, human rights.

Meena:

That's why I'm here, uh, attending this session on equitable

Meena:

partnerships in research.

Meena:

I learned a big deal in this session.

Meena:

I came to know about a lot of frameworks and toolkits that are available to

Meena:

operationalise equitable partnerships.

Meena:

As a researcher, I also have some experience engaging in

Meena:

participatory reaction research.

Meena:

What I have seen is that the two factors that are crucial in

Meena:

participatory action research is the time factor and the trust factor.

Meena:

The time factor is definitely important.

Meena:

It can't be a small project bound activity for sustainability purpose.

Meena:

To really make an impact on the ground, time is so crucial.

Meena:

You need to give that space for the communities to understand and come up and

Meena:

mobilise and drive towards social change.

Meena:

The other factor is trust factor.

Meena:

That's the bedrock of all these equitable partnerships.

Meena:

How do we build this, uh, trust is a big challenge and we should not take

Meena:

it very lightly because the trust has to be reflected both symbolically

Meena:

as well as materialistically.

Meena:

How do we do that is something we need to think through and should be very careful.

Meena:

As a researcher, some of the challenges with the participatory action research

Meena:

is there are not many toolkits available to deal with data ownership.

Meena:

All other research steps are kind of defined, we have toolkits, how to

Meena:

engage with the communities, how to do participatory reaction research,

Meena:

but when it comes to data ownership, it's, uh, again, the data that is

Meena:

generated out of participatory action research is still under the control

Meena:

of the powerful academicians or the researchers or the institutions.

Meena:

How do we ensure equity in this?

Meena:

That is something challenging and there are hardly any toolkits

Meena:

available to realise this.

Meena:

The other challenge, what I felt is, uh, how do we take the evidence

Meena:

that is generated from participatory action research to the policy makers?

Meena:

The policy makers, they themselves are coming from a different worldview,

Meena:

often from quantitative world.

Meena:

They even question whether a qualitative study is a study at all.

Meena:

So how do we sensitise them?

Meena:

Participatory action research is something that doesn't sync with them.

Meena:

The other thing I've observed in the literature is that there are so much the

Meena:

about participatory action research, so many empirical studies that are published,

Meena:

left, right, and centre What I miss is that, uh, the processes of participation,

Meena:

the pathways for participation that is kind of missing in the literature.

Meena:

That's a huge gap.

Meena:

If you don't know that it's not going to be helpful.

Meena:

How do we replicate these studies, other contexts, and that is a huge critique

Meena:

of participatory action research, right?

Meena:

It generates a lot of local data, which cannot be generalisable to other contexts

Meena:

because we are missing on the processes.

Meena:

We are not capturing the processes and the pathways and the mechanisms,

Meena:

and that's why we are getting this critique to address this, I think,

Meena:

it's important to focus on the pathways to capture adequately and also to

Meena:

disseminate in the field of science.

Meena:

Thank you.

Bea:

Thank you so much.

Bea:

That's a really interesting call for further action on this topic.

Bea:

Thank you for highlighting that.

Bea:

Just to finish up for our listeners, could you give us a little bit of

Bea:

detail about the kind of themes that you work on in your participatory

Bea:

action research projects?

Bea:

So what are the topics that you've done your projects focused on?

Meena:

I'm focusing on health governance.

Meena:

It's that the local level, how do we engage the forest dwelling

Meena:

indigenous communities, uh, to participate in the planning and

Meena:

implementation of healthcare services.

Meena:

That has been a tough job.

Meena:

Hardly they get representation in the policy tables.

Meena:

So how do we build the capacity of these community led platforms?

Meena:

How do we create a safer space for this indigenous communities to voice

Meena:

out, to articulate their problems?

Meena:

How do we strengthen their capacity even to understand their need?

Meena:

So that is the focus of this project.

Meena:

We are focusing on the capacity building of the indigenous communities health

Meena:

governance processes at the local level.

Meena:

I mean at the district and the sub-district level.

Bea:

Really fascinating.

Bea:

Thank you so much Meena.

Bea:

Can you give any reflections on the conference in general?

Bea:

Are you enjoying it?

Bea:

Anything that you found particularly interesting?

Meena:

Since my focus, my career, I'm going to build in the area of social

Meena:

participation, equity, and justice, I'm attending all the sessions that

Meena:

is about community participation.

Meena:

It's very interesting for me.

Meena:

Bogota city is the ideal place to discuss issues about social participation

Meena:

because I feel that it is there in the atmosphere, the ideas of liberty.

Meena:

I love it.

Meena:

I love the atmosphere.

Bea:

I completely agree.

Bea:

Yeah.

Bea:

Social engagement is really an air here, isn't it?

Bea:

Wonderful.

Bea:

Thank you so much for coming to talk to us and enjoy the rest of the conference.

Meena:

Thank you.

Bea:

This is Connecting Citizens to Science Podcast and we're here at the

Bea:

Health Systems Research Conference in Bogota with Daniela Da Costsa Franco who's

Bea:

going to tell me about her work and her reflections on the conference so far.

Bea:

Daniela, please tell us about yourself.

Daniela:

Well, hello, I am from Guatemala.

Daniela:

I am an epidemiologist and I do a lot of community intervention at primary

Daniela:

healthcare level, mostly in health promotion, health communication,

Daniela:

and digital health intervention.

Bea:

Thank you.

Bea:

What kind of communities are you working with at the moment?

Daniela:

We're working with indigenous communities in the Highlands of

Daniela:

Guatemala, and they speak three indigenous Mayan languages.

Daniela:

We also work with another community, which is Hispanic and indigenous community

Daniela:

in the northern part of the country.

Daniela:

The digital intervention has been conducted in this northern part of the

Daniela:

country, mostly with the healthcare workers and the health promotion and

Daniela:

health communication interventions have been conducted in the Highlands

Daniela:

with this different young community researchers, that's how we call them,

Daniela:

local community researchers, that are part of our team, and they have engaged

Daniela:

a lot in the communication interventions.

Bea:

Really, really great.

Bea:

Love that; work with co-researchers and strengthening capacity in that way.

Bea:

Could you tell us a bit about working with community researchers,

Bea:

how that process has gone?

Bea:

Any challenges that you've faced?

Daniela:

Well, the process has been a learning curve.

Bea:

Mm-hmm.

Daniela:

It's a learning curve first of all, because you need to understand the

Daniela:

context of the community because not all the communities have a good relationship

Daniela:

with the healthcare system in general.

Daniela:

That's been a challenge; how to address this or how to fix this relationship.

Daniela:

Secondly, I would say I have learned to be more academically humble.

Daniela:

We as academics tend to think we have the solutions or we need to

Daniela:

have the solutions for everything.

Daniela:

In terms of community wise approaches, it is important to acknowledge that you're

Daniela:

a foreigner, you're not from there.

Daniela:

You need to create more horizontal relationships with the people

Daniela:

we are collaborating with.

Daniela:

That's been a great learning.

Daniela:

Also these people that are part of our team, they feel like their voices are

Daniela:

being heard and their inputs and their feedback is incorporated into all the

Daniela:

interventions were being carried out.

Daniela:

And that has been challenging in terms of the programmatic activities of the

Daniela:

project and budget wise because you need to have certain flexibility to adjust

Daniela:

that context settings, you know, with the community and with the local researchers

Daniela:

to have a better and proper impact in terms of the intervention to be conducted

Daniela:

with culturally pertinent approaches.

Daniela:

It is important to take that into consideration.

Bea:

Absolutely.

Bea:

Really insightful.

Bea:

Thank you so much for that.

Bea:

Can I just ask, are you working on general health promotion or is there

Bea:

specific areas of health promotion that your projects focus on?

Daniela:

So far we have been focusing mostly in Covid health

Daniela:

promotion, everything related with, uh, providing information.

Daniela:

If you had any doubts, we had this call centre that it was installed

Daniela:

inside the healthcare facility.

Daniela:

We were promoting it in case people had any questions regarding Covid, the follow

Daniela:

up, the symptoms, a triage, et cetera.

Daniela:

Right now we were conducting promotions of the Covid vaccination.

Daniela:

And lastly, uh, rabies.

Daniela:

We conducted a rabies promotion recently because, well, rabies is still an issue.

Daniela:

They're not cases of rabies in people, but it's still very

Daniela:

highly active in Guatemala.

Daniela:

We try to do a different communication approach to have it more like

Daniela:

bottom up instead of top down.

Bea:

Interesting.

Bea:

Thank you.

Bea:

How are you finding the conference so far?

Bea:

Anything that you've really enjoyed?

Bea:

Any reflections that you have?

Daniela:

Well, I have to say that I agree with a colleague that mentioned

Daniela:

that it was very interesting to get to know all the different interventions

Daniela:

and research that has been conducted from colleagues from all over the world.

Daniela:

I found it very interesting also, the health systems that's being

Daniela:

showed because it's important to change our health systems in certain

Daniela:

countries that are vertical and to have a more patient centre.

Daniela:

So I found it quite interesting.

Daniela:

There's a lot of interesting topics.

Bea:

Yes, Agreed.

Bea:

Agreed.

Bea:

I think definitely that focus towards shifting to

Bea:

horizontality is really important.

Bea:

So thank you so much for coming to talk to us, um, and enjoy

Bea:

the rest of the conference.