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HSR2022 Special - Conversations in the Halls (Episode 2)

Our team of podcasters are roaming the halls of HSR2022 to bring you the thoughts and takeways of the presenters and delegates after the sessions, with a focus on community engagement. 

In today’s special episode we have: 

Dr. Lathadevi Chilgod – Public Health Researcher , Institute of Public Health, Bengaluru, India 

Germań Alaracoń – Research Assistant, University College London & Universidad de los Andes 

Meena Putturaj – PhD Scholar, Institute of Public Health, Bengaluru, India 

Daniela DaCosta – Epidemiologist, the Unit of Medical Anthropology    

More conference coverage coming your way throughout the week! 

Follow Connecting Citizens to Science on your usual podcast platform to hear our equitable global health research podcast connect discussing how researchers connect with communities and people to co-develop solutions to global health challenges. The series covers wide ranging topics such as TB, NTD’s, antenatal and postnatal care, mental wellbeing and climate change linked to health. 

Transcript
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.

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Researchers and scientists join with communities and people to address global challenges

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Kim Ozano

Research and Development Director at SCL and co-founder and host of the ‘Connecting Citizens to Science’ (CCS) podcast. Kim is a health policy and systems researcher with over 15 years’ experience of designing, delivering and evaluating health and development projects in the Global South and UK. She is an implementation health research specialist, as can be seen from her publications and work at the Liverpool School of Tropical Medicine, where she remains an Honorary lecturer.
Kim creates space in Connecting Citizens to Science for researchers and communities to share their experience of co-production to shape policy and lasting positive change.