Rethinking our Rigor Mortis: Creating space for more adaptive and inclusive truth-seeking in community-based global health research in Kenya

ABSTRACT

As global health researchers, we have long embraced the conviction that the answers to complex problems of poverty and disease will reveal themselves if only we apply enough scientific rigor. Yet, at the community level, our group of American and Kenyan investigators has begun to question whether our veneration of rigor is itself contributing to the intractability of certain types of global health problems. Here, we illustrate examples from our experience among the remote island communities of Lake Victoria, Kenya, and join a chorus of emerging voices, to examine how our culture of control as global health scientists may marginalise truth-seekers and change-makers within communities we seek to serve. More broadly, we seek to acknowledge the limitations of control over truth that rigorous academic research affords. We suggest that by relinquishing this pervasive illusion of control, we can more fully appreciate complementary modes of answering important questions that rely upon the intrinsic resourcefulness and creativity of community-based enterprises taking place across sub-Saharan Africa. While such inquiries may never solve all problems facing the diverse populations of the continent, we advocate for a deeper appreciation of the inherent capacity of adaptive, locally contextualised investigations to identify meaningful and enduring solutions.

KEYWORDS:

• Community-based research
• global health ethics
• slow research
• inclusivity
• Kenya

Acknowledgements

The authors would like to thank our international and local partners who have contributed to the realisation of the Mfangano Community Health Field Station. We want to thank the Ekialo Kiona Center and Research Department staff and volunteers, the Organic Health Response Board of Directors and Staff, University of Minnesota Dept. of Family Medicine and Community Health, UMN Center for Global Health and Social Responsibility, Maseno University Dept. of Public Health, the Community Health Workers of Mfangano, our Community Advisory Groups, Mbita District Ministry of Health providers and staff, and the people of Mfangano Island. We would like to recognise the MIHNIS, RECH, KANYAKLA, and MOMENTUM study teams, and all our collaborators at UCSF/Berkeley, FACES, KEMRI, Maseno, and UMN who have supported our efforts in cultivating trust, capacity, and health on Mfangano. We would like to acknowledge Dr. Vincanne Adams for ‘slow research’ insights and thoughtful comments on an early draft. Finally, we would like to acknowledge Dr. Mandisa Mbali, and Dr. Jessica Rucell for editing this manuscript as part of the Special Issue— ‘African Voices in Global Health: Knowledge, Creativity and Accountability’.

Disclosure statement

No potential conflict of interest was reported by the authors.