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Topic
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1) What is your experience with stakeholder mapping? How do you use stakeholder maps at your site? Discuss how you (and your colleagues) determine the importance of involving one stakeholder versus another. For example, how do you determine who constitutes your CAB?
2) Stakeholder engagement is not easy and multiple partnerships can be hard to manage. How can you partner with stakeholders to create a community of sustained engagement? How can you get members of your research team to “buy-in” to sustained or longer-term stakeholder partnerships?
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Replies
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1) What is your experience with stakeholder mapping? How do you use stakeholder maps at your site? Discuss how you (and your colleagues) determine the importance of involving one stakeholder versus another. For example, how do you determine who constitutes your CAB?
We as a company did mapping workshops at each of the study sites to map what they already have in place in their community engagement programs. This mapping tool is based on the “onion” graph and then lists all possible types of stakeholders from study team to participants to national stakeholders. At site we would discuss each type of stakeholder at site and the type of relationship (ie. healthy relationship with frequent contact or currently unhealthy relationship with negative or no contact) between the site contact and stakeholder. Usually from these meetings it became clearer where some more work or follow-up was required and why.
2) Stakeholder engagement is not easy and multiple partnerships can be hard to manage. How can you partner with stakeholders to create a community of sustained engagement? How can you get members of your research team to “buy-in” to sustained or longer-term stakeholder partnerships?
It is always important to show some interest in the stakeholders’ activities too, for instance if your stakeholder is a CAB member who is also involved in a community project, to try and be involved and supportive of non-trial-related activities and to try to collaborate on projects where both parties/causes benefit from it. This should get the research team more involved in partnerships too.
Research Training for CAB members are also a very good idea. This keeps members engaged and part of the cause instead of the relationship being only about giving feedback in one direction at a time. Once someone feels equipped to deal with a concept or situation, they will automatically feel more part of it and responsible for it.
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Stakeholder mapping has not been taking place in our site. We do involve the CAB members where updates of the upcoming protocols are discussed and their recruitment strategies discussed. The CAB members involve various community representatives though not all are represented.Mapping applies on the recruitment sites e.g. the bar owners.
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I was just at a combined community engagement forum that brought together TB and HIV CLOs and community engagement managers. One of the suggestions that came up about CAB management was CAB empowerment through literacy. If you challenge CABs to research topics they want to learn more about it motivates them to attend meetings and events. I thought this was a really interesting approach to managing a specific stakeholders engagement.I sit on a CAB and don’t think this would be a useful stratagy for us (empowering through specific challenges) I was wondering if others thought this could work in their CABs or with other stakeholders?
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As the community engagement prepares for each study a CAB is created. Member of the CAB representative or have extensive knowledge of the priority population being addressed in the protocol. My team feels it is important to formulate CAB that can provide informative feedback to the research team as they gear for study design and implementation.
I agree stakeholder engagement can be challenging however an effective plan must be upheld to foster the appropriate deliverable. Additionally, it is important to know when stakeholders should be included in the research and when their presence can be omitted.
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Managing stakeholder engagement and multiple partnerships is definitely difficult, but it is also critical to the success of much (if not all) of the work I am involved in with my organization. My colleagues and I work to do extensive stakeholder mapping at the beginning of any new project/initiative and work to outline which different roles (e.g., partners, collaborators, advisers, working group members) for stakeholders. Those we identify as potential partners or collaborators include other groups with parallel efforts and/or missions–this allows sharing and pooling of resources and expertise. Those we identify as advisers include prominent individuals with influence in the various stakeholder groups they represent–this helps to ensure the needs of different stakeholders is reflected in our work, and also helps with communicating progress/results from our work back to those stakeholder communities. Early engagement is key to ensuring sustained “buy-in” and prolonged partnerships–stakeholders are more likely to be committed to an effort when they have played an active role in helping to shape a project/program, and as such would be more invested in the long run to success of the effort.
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At our site we realised that it is not possible for the CAB to represent all the stakeholders in the community, which is why we have identified other stakeholders that we have partnered with. eg We have the District Aids Council and the Local Aids Council. These comprises of all government departments, NGO’s and other stakeholders. We usually engage with these stakeholders quarterly and we meet with the CAB monthly. We then contact individual stakeholders when there is a need to do so. We motivate our stakeholders by attending their meetings and giving presentations to them so that they can be updated about the progress of the study. We also partner with them when having community events. We also distribute educational material to the community. We maintain our relationship with them throughout the trials.
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At our site we realised that it is not possible for the CAB to represent all the stakeholders in the community, which is why we have identified other stakeholders that we have partnered with. eg We have the District Aids Council and the Local Aids Council. These comprises of all government departments, NGO’s and other stakeholders. We usually engage with these stakeholders quarterly and we meet with the CAB monthly. We then contact individual stakeholders when there is a need to do so.
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how do you sustain the motivation of the stakeholders ?
thats a tough one.
depends on the stakeholder expectation and that the trial did not change.
-keeping the stakeholder informed and the progress of the trial can help.
-conferences to show there is a need statistically
-stakeholder audits is allowed
-feedback
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– As per previous study. depends on the area she/he will represent the community but has to be part of the community for a long time and has been involved in the community before in a positive way.
– multiple partners is hard to manage, depending on area of expertise that conflicts.i feel dealing with with partners individually is more clear and then review both sides together and come to a conclusion.
people often see things differently also personalities
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MRC/UVRI generates a list of stakeholders. Discussion on CAB composition basing on location and expertise is done.Our CAB representative constitutes of people with diverse expertise and influence in community and each of them serves on the CAB for a period of 4 years.
Having this CAB in place is not our ultimate stakeholder engagement plan, other stakeholders are engaged on several occassions in study activities since not all key stakeholder can be hosted as CAB.
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The strategies that we use to ensure that stakeholder motivation remains constant and sustainable even in-between trials is that we make sure that we support their plans for community engagement for example at the beginning of every year at the NGO forum meetings we exchange event calendars for each organisation. we also offer support where needed in regards to their scheduled health campaigns. this year we partnered up with brothers for life and the Centre for Creative leadership (CCL), Chaps, The centre for HIV and AIDS Prevention Studies (CHAPS) and New start. the purpose of the event was to promote Medical male circumcision (MMC) and also to get the community to know their HIV status by voluntarily testing for HIV. SRCs contribution was to educate about HIV and co infections and clinical trials and also the distribution of condoms and education about condom use.
This also helps when we conduct our own community engagement campaigns e.g WAVD the above mentioned organizations gave us support by adding value to our event and also assisting in the marketing of the event.
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For the additional question of sustaining stakeholders interest; Every May 18th the The World AIDS Vaccines Awareness Day (WAVD) we work with star athletes to stage competitive race and fun run. This being a region where most of the international athletic champions come from it attracts community interest. We also host talent shows and body building events as build up activities for WAD every December and involve stakeholders in these plans.
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1) What is your experience with stakeholder mapping? How do you use stakeholder maps at your site? Discuss how you (and your colleagues) determine the importance of involving one stakeholder versus another. For example, how do you determine who constitutes your CAB?
In the beginning of FEM-PrEP study, we identified community stakeholders who would be relevant to engage for the purpose of the study. The study population was women who exchange sex for money/goods. During mapping, we conducted questionnaires with community members and stakeholders for more information to aid our recruitment strategies, CAB selection, and other aspects of the study we were about to conduct (FEM-PrEP).
As mentioned above, stakeholder maps assist the site to understand the target population for the study before implementation. Information such as where the target population may be found for recruitment purposes, what aspects to consider during recruitment and during study procedures. We also identified and communicated with the stakeholders that work with the target population.
To determine which stakeholder to choose against the other, we looked at the diversity of CAB that existed that time and identified the gaps. In doing so, we learnt that we also needed, for example, a CAB member who represents the target population, we did this in order to learn more about the population. Current CAB members in recent studies constitutes of various representatives such as gay and lesbians, priest, health professionals, politicians, taxi associations, etc. However, we identified a gap, we need to find a CAB member who will represent traditional healers.
2) Stakeholder engagement is not easy and multiple partnerships can be hard to manage. How can you partner with stakeholders to create a community of sustained engagement? How can you get members of your research team to “buy-in” to sustained or longer-term stakeholder partnerships?
Strategical partnerships are key to stakeholder engagement. Each partners should fulfil a specific function in order to meet our community engagement objectives
Treatment Action Campaign (TAC):
This is an advocacy group that can influence the decision making process by public sector in regards to human rights and health issues (HIV and TB treatment etc.) our partnership with this group brings us closer to various population within our community such as LGBTI, youth and disadvantaged people. We gain insight into possible barriers that can stop the communities buy in into clinical research. With that information we can create appropriate strategies on how to engage and educate those publics
NGO forums:
These forums are created by and governed by the respective NGOs register and not registered and also the local district. These assists the site and other organisations to communicate with a broad audience at the same time when monthly forum meetings are in session. Each organisation is given a slot to present s or inform the group should a need arise.
We use this opportunity to inform/update our stakeholder about recent developments at site, studies: upcoming studies, result dissemination, campaigns and educational programs. This also helps us not to duplicate other organisations activities such HIV, TB, Contraceptives and campaigns. As a result we end up partnering and sharing programs with stakeholders instead of competing.
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I start by admitting that in our site we have not engage in stakeholder mapping as described in this course, though I have some experience to share, that makes the case for the need for stakeholder engagement before trials.
1. Our first study was a HIV vaccine cohort targeting mainly Tea plantation workers and their adult dependents to establish HIV prevalence, incidence and viral diversity in this community which fairly represented the general population in the region. The tea plantation was chosen because it had a stable population of migrant workers residing in the plantation who would be easy to follow up. Scientists went population and explained to the workers that they aimed to recruit participants who would be tested for HIV and the results would be confidential, among the information to be used would be their employment numbers. Plantation workers declined because they thought their employer was working with the research to find out people who were infected so that they could be fired. During that time care and treatment was not available and knowing one was infected was like a death sentence. All attempts by management to convince workers to attend information sessions failed, since workers and their adult dependents had been assured that participation was voluntary.
Scientist took a back seat and engaged community outreach team to establish what the issues that generated hostile reception of the study were. This when it was decided after learning from sites that had done similar work, that it was important to form a community advisory group. A scientist, plantation executive and some plantation union representatives were picked and the scientist became the group chair. When meeting were called, participation was very poor. To improve community dynamics, the scientist, and Tea plantation executive stepped down, and in their place a local teacher, health care worker, and grass root government administrator were picked and information on community fears and concerns started flowing in, which were gradually addressed
The local administrator, Pastors and teachers had received all manner of myths from the community indicating that they trusted them and hence their membership. Workers were being represented by their union and they had to be included. Members were therefore picked based on the trust the target community had on them.
To engage various stakeholders of diverse backgrounds was initially a challenge, however they were informed in capacity building forums that HIV was wrecking havoc in the community and has leaders they have to lead the fight from the front and that research was critical in knowing the extend of the problem, so that a solution the search for a vaccine could begin. They were eventually brought together in support of research by the common threat they all faced.
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) What is your experience with stakeholder mapping? How do you use stakeholder maps at your site? Discuss how you (and your colleagues) determine the importance of involving one stakeholder versus another. For example, how do you determine who constitutes your CAB?
I have minimum experience with mapping and have used the techniques of conducting a situational analysis and community profile to understand the community. We have used information from various resources to understand the community and develop our referral structures and network contacts. We ensure that all health and social development members are part of the stakeholders and that the CAB is made up of volunteers from our recruitment areas, health services, traditional leaders and social development services. I like the idea of critical thinking of developing CABs and using the mapping techniques explained in this module. We have used a system of asking members to complete biosketches and we assessed their eligibility to be CAB members using a few criteria indicators such as willingness to be part of HIV prevention, experience in an organisation, ability to participate and contribute to discussions, have had health education and outreach exposure. This has helped to a limited extent.
2) Stakeholder engagement is not easy and multiple partnerships can be hard to manage. How can you partner with stakeholders to create a community of sustained engagement? How can you get members of your research team to “buy-in” to sustained or longer-term stakeholder partnerships?
Sustainability is not easy in an environment with high unemployment and high expectations for monetary rewards or compensation. But we have now been working with our communities for over a decade and built trust as we have always been open and honest to our stakeholders of the research process, outcomes and study closures. We have also provided support for capacity development of community members who have attended conferences and scientific events sharing their voice about final results. Long term partnerships may be achieved using the GPP principles and applying this in partnership with the community. Developing capacity of the community members to access employment and improve technical skills like using a computer, chairing sessions, presenting at meetings, writing minutes has helped with sustainability to a limited extent. This is work in progress for me personally but very important to strengthen my skills in sustaining CABS.
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1. Stakeholder mapping is an important step to understand who your key stakeholders are, where they come from, and what they are looking for in the relationship to your organisation. In our Research centre when doing stakeholder mapping, we list all relevant groups, organisations and that is regarded as identifying stakeholders and in that process we try to understand what is going to be their main interest in the research. stakeholders are engaged according to their levels and their roles in the community but all stakeholders are very important because they all have influence in the community.
2. Engaging with stakeholders to create a community sustained engagement is very important that also including understanding their roles in the community and their understanding of the research. by attending community events and letting community understand what is really happening in research centre.
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1. During the Ebola trial planning stage, the team identified the target population, based on this, we identified individual that can link us to the targeted study population. Advocacy visit was paid. Usually during these visit we prioritize the people we met based on their influence. We engaged them separate by educating them about the trial especially when we perceive an opposition. The CAB members were essentially made up of community member and opinion leaders. Religious leader representing the two major religion in Nigeria Islam and Christianity were selected, media experts, representative of the community that was picked out for recruiting volunteers as well as legal expert.
2. For the CAB members, weekly updates are sent to them. They also hold their meeting quarterly which is funded by the research. But from the planning stage, all the stakeholders engaged are mostly people who a member of the team know or the stakeholders engaged recommended. So to some extent they are people who are ready to volunteer their time and resources without expecting anything. Because they are not expecting any incentive they work with an open mind. This encourages sustainability as there is constant updates of what is happening. They usually nominate a member to visit the site.
As a research team, adequate plans has to be made to at least make a difference in the life of the stakeholders, it could be inform of education, information or provision of some facilities. For instance,a community that was engaged during a previous research is so eager to volunteer for this study because the research team was able to sink a borehole where the community can fetch water from. This has made that community research conscious.
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1. at our site we used have stakeholders that were mainly worked with TB and HIV patients and that worked because they were trusted by the community and their work was voluntary. however we had to adapt because most people who worked in these sector were now employed by the government. one other thing during this time we realized that our CAG was one sector based. we stated to introduce other sectors that worked with the community and now our CAG has people work in government, trade unions, activist, Traditional healers, LGBTI and NGO’s working with TB and HIV patients.
2. one of the things we did at our side is to show our CAG members that, as people who are involved in community work and want to bring change. being part of the CAG is part of the change they are pursuing and they can incorporate their daily work and their role as the bridge between the side and the community.
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Hi Erica and Heidi– I agree that managing personalities, motivations, and expectations is tricky. Balancing these different perspectives and also on sustaining the ‘dialog’ between trials can be challenging! How do you determine which relationships are more relevant in the long-term? Is there a specific way you analyze and prioritize each relationship and determine your own investment?
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1. In my site what determines the importance of involving a stakeholder in research activities, first is the nature of study (i.e. vaccine trial or HIV cohort with out much intervention), we sometime check the location/ geographical area where we recruit participants , also the area or the aspect from which she/he will represent the community e.g from women groups or youths or religion just to make sure that we have a wide range of stake holders who can contribute , advice or comment on the study procedures or design in connection to the target population.
2. I agree with you sometimes managing multiple partners is difficult especially when you have people with difficult personalities among the stakeholders. However in my experience if we have to deal with two groups that might not agree on some easily we normally conduct discussion in two separate groups and when we have an agreement that is okay with both side then we tell the to choose one or two representatives from the groups who will participate either in a bigger group discussion or in a seminar or meeting.However in most cases we have managed to sustain partnership with out much strain.
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In preparation of an international HIV prevention study, we have to map which stakeholders should review the protocol. With this have to take into account relationships between different groups, as well as ensuring that country-specific feedbacks are incorporated. I learned today that priority setting can be helpful in reaching out to protocol reviewers.
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