Mesh is an open-access web space for people involved in community engagement with health research in low and middle-income countries (LMICs). Mesh provides a neutral location for engagement practitioners, researchers, health workers and others to find resources, seek expertise, and share their questions and experiences.
Users of Mesh have access to a wide variety of resources including academic publications, informal project reports, guides and toolkits, plus, curated lists of funding opportunities, e-learning, events and networks that focus on engagement with global health research.
We have also mapped resources around specific themes, such as evaluation, to make it easy to navigate the wealth of resources. Our discussion forums and email discussion lists foster collaboration between the global community of over 6000 users from 157 countries.
What do we mean by engagement?
There are a number of terms used when we talk about engaging non-researchers with health research, including: public engagement, community engagement, public outreach, public and patient involvement, and participation. Organisations and individuals define each differently, and so the terms can cause confusion. Although we do not exclude any interpretation of engagement, we focus on engagement that moves beyond simple health promotion, formal education or research study recruitment.
We encourage activities that bridge the gap between medical researchers and community groups or the wider public and provide channels for these groups to understand one another better. Activities could involve policy influencers, school pupils, civil society groups, research participants, their families and neighbours, or wider public groups.
Engagement activity itself can come in many forms, ranging from community-led digital storytelling, collaborative theatre projects or café-style debates. The defining characteristic of any strong engagement project is the underpinning justification for the engagement first and foremost. By stimulating new perspectives and understanding for all involved the research can become better designed, targeted and accountable to the society in which it is taking place.
Different stakeholders often have contrasting, and at times conflicting, interests and agendas. Scientific researchers might want to use an engagement activity to inform their research agenda, methodology and protocols, and to strengthen the ethics of their research practice. For non-scientists, the activity could help them to make informed choices or incorporate concerns, such as a desire for personal development and gaining social status as well as broader concerns around social justice and community development.
Many projects are initiated or conducted through close partnership between global health research institutions and cultural and community organisations.
We host project reports for activities that encourage in depth dialogue in a variety of ways. Here, we share with you a handful of those projects that show the diversity, benefits and challenges of engagement.
Sacred Water: Engaging researchers with local beliefs and knowledge
Mixed media artist Lena Bui worked directly with women’s groups in Nepal, to support them express their memories, experiences and hopes linked to water and health through art.
The participants created a community exhibition of collage, clay objects and accompanying stories, which provided food for thought for medical researchers exploring water borne disease within the community, and some of the local customs and knowledge that they might encounter.
Genome Adventures: Engaging widely but also with a variety of stakeholders
Genome adventures used comic books alongside supplementary activities to promote deeper interactions and exchange between researchers and non-researchers. The comic book narratives introduced school age children and young people to genomics research in Botswana.
Scientists, industry and business professionals, the media, illustrators, NGOs and policy makers were involved in the development of the storylines capturing contemporary research and issues surrounding it. A community advisory board, advising on research studies at the Botswana-Baylor Children’s clinic (partners in the project), was consulted as the four comic books were developed.
Drawing upon the advice of various community representatives, such as church and faith leaders, human rights leaders and minority groups’ representatives, deepened engagement, ensuring the outputs produced were acceptable and applicable to the wider community.
Shoklo Malaria Research Unit: Unpredictability and the need for fluid project design
In Thailand, the Shoklo Malaria Research Unit (SMRU) are conducting large scale malaria elimination efforts at various locations along the Thai/Myanmar border. They are engaging with various community groups at each site, including community leaders, homemakers, religious groups, children and youth in order to promote community understanding of this largescale research.
Despite careful planning, complicated social interventions might arise from stakeholder groups and individuals with their own interests and drives. As such, engagement can take interesting and unpredictable directions and have unexpected outcomes, which was the case.
The team were working across language barriers and national borders, and needed to think carefully about seasonality and the timing of activities given the agricultural practices of the community.
They also found communicating concepts such as drug resistance and infection more difficult than first assumed, given that local language translations, even within the same ethnic group, could vary dramatically.
‘…‘malaria’ in Karen is ‘ta-nya-goh’ which translates to “fever with chilling”, but Karen people living in Thailand use specific term ‘pa-zo-su’ which means “poison from mosquito”’ (Kajeechiwa et al 2017 https://wellcomeopenresearch.org/articles/2-59/v1)
The solution was to develop educational materials with limited or no text, relying instead on photos, hand drawn pictures and diagrams:
‘There is no single set of operating procedures for community engagement…To be successful, community engagement teams must be flexible, mature and experienced, supportive of each other and resilient to work in difficult settings.’
The results of this work were published and peer reviewed as a research article on Wellcome Open Research.
Community and public engagement is increasingly seen as an area that deserves its own critical reflection and is growing as an area of multi and interdisciplinary research. There is increasing recognition of the unique skills and knowledge that engagement practitioners develop.
Our editorial team is always interested in finding new ways to host the knowledge produced by engagement practitioners and academics in various formats. We are also on hand to help you to develop project reports to host on the site. We encourage anyone to share their own engagement experiences with us on our add resources page, or email us at Mesh, and for any Wellcome-funded researchers to publish the results on Wellcome Open Research.