Inclusion of Gender and Vulnerable Groups

Author: Sofia Muyemayema (ACACIA researcher, Registered Nurse, University of Zimbabwe)

22/06/2023

I am Sofia Muyemayema a Registered Nurse and ACACIA researcher from Zimbabwe. In the following paragraphs I will talk about gender and vulnerable groups’ inclusion in ACACIA study across all ACACIA sites.

Asthma is a chronic respiratory disease that affects millions of children worldwide and Inclusive research is crucial to improve the lives of those who suffer from it. The ACACIA study ensured that all individuals, including vulnerable groups who may be at higher risk of developing asthma or experiencing worse outcomes, were included. Recruiting a diverse sample of participants and considering the unique needs and experiences of different subgroups was vital to ensuring that the ACACIA study was representative of the population.

Gender inclusion

In this project, gender inclusion was essential to avoid exacerbating existing health disparities and to ensure that the findings and recommendations are applicable to everyone. Inclusive sampling and recruitment strategies were employed in the ACACIA study, ensuring that all genders were included equally. The study involved individuals from different genders, from the technical to administrative part, part and thus was having an equal chance of person to get involved regardless of the gender. The selection process of participants was random and based on the symptoms presented and did not involve direct picking of the participants.

Inclusion of vulnerable groups

Vulnerable groups, such as those from low-income families, racial and ethnic minorities, and those with limited access to healthcare, were also involved. By doing so, researchers hoped to better understand the unique challenges faced by different subgroups and develop more effective interventions to improve their health outcomes. During sampling of the involved schools it was ensured that all categories of schools in urban settings were represented (e.g., day and boarding schools, girls only, boys only and mixed schools, public and private schools). Study sites generally found private schools more reluctant to participate. Engaging with them was particularly difficult in Nigeria, the Nigerian PI says: ‘There was poor participation by the privately owned schools who persistently refused to complete the school agreement form and we could do nothing about it’.

How we dealt with barriers to involvement

Language barriers can be a significant obstacle to participation in research. The ACACIA study considered this issue by communicating in preferred languages and respecting individual views, encouraging participation. Parents who were unable to read and write were able to have a witness of their choice to complete consent forms. Communicating in preferred languages and respecting individual views gave participants a sense of importance and boosted their confidence, encouraging participation. In Zimbabwe, Focus Group Discussions were conducted in Shona, a local language so that everyone could participant well. Understanding reasons why individuals did not want to participate helped to start conversations about participation and provided the possibility to overcome any barriers. To ensure inclusion of parents and children from marginalized groups, adequate compensation was provided to cover travel costs to the schools for qualitative data collection and for participation in the study. The field team also visited homes where parents could not be available during working hours to sign consent forms, ensuring that no one was left behind due to working parents or lack of transport funds.

By implementing these strategies, the ACACIA study ensured that the findings were representative of the population and could lead to meaningful improvements in asthma management for all individuals, regardless of their background or circumstances. This ACACIA study involving school children was crucial to improving our understanding of this condition and developing effective interventions and policies to manage it.