Deborah Nyirenda|Salla Sariola|Patricia Kingori|S. Bertel Squire|Chiwoza Bandawe|Michael Parker|Nicola Desmond
Structural coercion in the context of community engagement in global health research conducted in a low resource setting in Africa
Malawi-Liverpool-Wellcome Trust Clinical Research Programme|University of Liverpool|University of Helsinki|Wellcome Centre for Ethics and Humanities|University of Oxford|University of Helsinki|University of Malawi|Wellcome Centre for Ethics and Humanities|University of Oxford|Liverpool School of Tropical Medicine
community engagement increasingly promoted global health research improve ethical research practice sometimes coerce participation thereby compromise ethical research paper seeks discuss ethical issues arising community engagement low resource settinga qualitative study design focusing engagement activities three biomedical research projects ethnographic case studies used gain indepth understanding community engagement experienced multiple stakeholders malawi data collected participant observation 43 indepth interviews 17 focus group discussions community leaders research staff community members research participants thematic analysis used analyse interpret findingsthe results showed structural coercion arose due interplay factors pertaining socialeconomic context study design power relations among research stakeholders involvement community leaders government stakeholders power inequalities among research stakeholders affected participants ability make autonomous decisions research participation results presented themes perception research development research participants motivation access individual benefits power vernacular translations influence research participation coercive power leadersthe study identified ethical issues community engagement practices pertaining structural coercion conclude community engagement alone address underlying structural inequalities ensure adequate protection communities results raise important questions balance engaging communities improve research participation ensure informed consent voluntarily given