“People in villages and specific groups in developing countries do ‘participate’ in health research. But this is primarily as providers of data for studies or as participants in trials of new medicines and health interventions. What is not considered in the picture of community engagement in health research is how the power of communities to focus national research agendas on their priorities can be harnessed, especially in developing countries, and how  communities can better use and impact health research.” Council on Health Research for Development (COHRED) 2006¹

Involving the community and collaborating with its members are cornerstones of efforts to improve public health. As a result, community engagement is increasingly recognized as a vital component of efforts to expand access to quality care, prevent disease, and achieve health equity across several health systems in sub-Saharan Africa. But what does community engagement really mean and why is it important?

According to the Centers for Disease Control and Prevention (CDC), community engagement is “the process of working collaboratively with groups of people who are affiliated by geographic proximity, special interests, or similar situations with respect to issues affecting their well-being”.  The goals of CE are to build trust, enlist new resources and allies, create better communication, and improve overall health outcomes as successful projects evolve into lasting collaborations.

Community engagement in research may occur at different levels including co-option and compliance, consultation, cooperation, co-learning and collective action.

• Co-option and compliance - people participate by being dutiful subjects of research.
• Consultation - the community is invited to present the people’s perspective on matters of interest to researchers.
• Cooperation - members of the community are involved in the planning and execution of research.
• Co-learning - the community acquires new knowledge and skills from the research.
• Collective action - together, researchers the community and policy makers, take action to bring about change.

At the various levels of community engagement, there are vital partnerships that can help mobilize resources and influence systems, change relationships and serve as catalysts for changing policies, programs, and practices. A recent review of the literature on community engagement³ has identified key areas in which community engagement made a positive impact including;

1. Research Agenda setting—Engaging communities has been reported to influence the research agenda through its impact on: identifying topics for research, shaping research questions, initiating research projects and making decisions about which projects to fund.

2. Design and delivery—through community engagement, improvements to study designs, tools, interventions, representation/participation, data collection and analysis, communication, and dissemination can be implemented. Additionally new interventions or previously unappreciated causal links can be identified through the community’s knowledge of local circumstances.The speed and efficiency of the project can be enhanced by rapidly engaging partners and participants and identifying new sources of information

3. Ethics—Engagement creates opportunities to improve the consent process, identify ethical pitfalls, and create processes for resolving ethical problems when they arise

4. The public involved in the project—the knowledge and skills of the public involved in the project can be enhanced, and their contributions can be recognized (possibly through financial rewards). These efforts foster goodwill and help lay the groundwork for subsequent collaborations.

5. Community organizations—these organizations can gain enhanced knowledge, a higher profile in the community, more linkages with other community members and entities, and new organizational capacity. These benefits can create goodwill and help lay the groundwork for subsequent collaborations

6. The general public—the general public is likely to be more receptive to the research and reap greater benefits from it.

Community engagement can be associated with costs such as increased time and other resource needs, the need to develop new skill sets and increased expectations. However its positive impacts outweigh these costs.

1. Center for Disease Control and Prevention (CDC). (June 2011). Principles of community engagement. Second edition. http://www.atsdr.cdc.gov/communityengagement/pdf/PCE_Report_508_FINAL.pdf
2. Staley K.(2009) Exploring Impact: Public involvement in NHS, public health and social care research.INVOLVE, Eastleigh.
3.  Council on Health Research for Development (COHRED). 2006. Can communities influence national health research agendas? health research agendas? A learning process leading to a framework for community engagement in shaping health research policy
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