Perceptions of consent, permission structures and approaches to the community: a rapid ethical assessment performed in North West Cameroon

Abstract

BackgroundUnderstanding local contextual factors is important when conducting international collaborative studies in low-income country settings. Rapid ethical assessment (a brief qualitative intervention designed to map the ethical terrain of a research setting prior to recruitment of participants), has been used in a range of research-naïve settings. We used rapid ethical assessment to explore ethical issues and challenges associated with approaching communities and gaining informed consent in North West Cameroon.MethodsThis qualitative study was carried out in two health districts in the North West Region of Cameroon between February and April 2012. Eleven focus group discussions (with a total of 107 participants) were carried out among adult community members, while 72 in-depth interviews included health workers, non-government organisation staff and local community leaders. Data were collected in English and pidgin, translated where necessary into English, transcribed and coded following themes.ResultsMany community members had some understanding of informed consent, probably through exposure to agricultural research in the past. Participants described a centralised permission-giving structure in their communities, though there was evidence of some subversion of these structures by the educated young and by women. Several acceptable routes for approaching the communities were outlined, all including the health centre and the Fon (traditional leader). The importance of time spent in sensitizing the community and explaining information was stressed.ConclusionsRespondents held relatively sophisticated understanding of consent and were able to outline the structures of permission-giving in the community. Although the structures are unique to these communities, the role of certain trusted groups is common to several other communities in Kenya and Ethiopia explored using similar techniques. The information gained through Rapid Ethical Assessment will form an important guide for future studies in North West Cameroon.

Preparing for and Executing a Randomised Controlled Trial of Podoconiosis Treatment in Northern Ethiopia: The Utility of Rapid Ethical Assessment

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Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers

“…Participation was voluntary. The approach to the participants was made in accordance with the findings of rapid ethical assessment conducted by Kengne-Ouafo and colleagues [ 22 ]. This study was approved by the Cameroon Ethics Committee and the Ministry of Public Health.…”

Relationship between oral declaration on adherence to ivermectin treatment and parasitological indicators of onchocerciasis in an area of persistent transmission despite a decade of mass drug administration in Cameroon

“…Only those who indicated their consent by signing a consent or assent form were recruited for the study. Recruitment was done based on the approach described previously by Kengne-Ouafo et al [ 29 ] after a rapid ethical assessment undertaken in the North-West Cameroon to deteremine the level of individual and community knowledge of ethical issues related to biomedical research. All participants’ information collected during the course of the research were kept on a password protected database and were strictly confidential.…”