Ethical implications of obtaining voluntary informed consent on Kombewa health and demographic surveillance system in Western Kenya

Abstract

Background:. Several studies on informed consent in health research have been conducted, but few have focused on the three levels of obtaining informed consent on a Health Demographic and Surveillance System research, namely consenting the Community, Household, and Individual. Before consenting an individual participant in a Health Demographic Surveillance System, the researcher must obtain consent from two higher levels: The goal of this study was to describe how these three levels of consent, along with various socio-cultural factors, influenced the process of obtaining voluntary informed consent on the Kombewa Health Demographic Surveillance System. The study also looked into the difficulties that the researchers faced. on the Health Demographic Surveillance System and how they used best practices to solve presenting challenges to the consenting process. Objectives: The study addressed three specific objectives. (i) To describe the process of obtaining informed consent on Kombewa Health Demographic Surveillance System in Western Kenya. (2) To establish socio-cultural factors that influenced the ethical practice of obtaining informed consent on the Kombewa Health Demographic Surveillance System. (3) To explain the challenges and best practices of obtaining informed consent on the Kombewa Health Demographic Surveillance System. Method: A cross-sectional study, utilizing mixed methods. Simple random sampling was used to select 384 research participants for the questionnaire. In addition, purposive sampling was applied to enlist 12 researchers for key informant interviews. The analysis was done to evaluate consenting and its relationship with socio-cultural factors, with a focus on intrapersonal factors like gender influence, interpersonal factors like household head influence, and community factors like community gate keepers influence. In addition, thematic content analysis was applied to analyse qualitative data. Results: The three levels of consenting in the Health Demographic Surveillance System influenced the process of obtaining informed consent. Furthermore, the study discovered that researchers on the Health Demographic Surveillance System faced a variety of sociocultural challenges, such as reliance on authority, the influence of household heads, and individual and community expectations to consent to participate in research. Despite the difficulties participants faced and the monotony of re- consenting, researchers made every effort to overcome them. These best practices are presented as lessons for future health researchers to learn from, as well as solutions to challenges. Researchers overcame the challenges by using strategies to obtain voluntary informed consent on the Kombewa Health Demographic Surveillance System, which other health researchers should follow. Conclusion: The Health Demographic Surveillance System consenting process occurred at three levels, with consent from the top two levels, community and household, influencing individual consenting autonomy. Recommendation: Health researchers should strive to protect individual autonomy in the Health Demographic Surveillance System by obtaining individual informed consent.