Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia.

Urban dwellers’ food and nutritional wellbeing are both dependent on infrastructure and can be indicative of wider wellbeing in urban contexts and societal health. This paper focuses on the multiple relationships that exist between food and infrastructure to provide a thorough theoretical and empirical grounding to urgent work on urban food security and nutrition in the context of rapid urban and nutrition transitions in the South. We argue that urban systems and food systems thinking have not been well aligned, but (...) that such alignment is not only timely and overdue but also fruitful for both thematic areas of research and policy. We draw in particular on work within wider urban political economy and political ecology that can be classified as part of the ‘infrastructural turn’ that is influential with urban studies but little acknowledged within food studies. Drawing on these literatures helps us to better understand the interrelationships between people, things and ideas that make up both infrastructure and food systems. Policy, planning and research relating to both food and urban systems cannot afford to ignore such interlinkages, though much policy still operates on the neat assumptions of progressive connectivity to ‘the grid’ and formal food retail. Instead we argue how in many urban governance systems, a variety of hybrid mechanisms—on and off the grid, public and private formal and informal—better represent how urban residents, particularly the most marginalised, meet their everyday food and infrastructural needs along a continuum of gridded and off-grid access. (shrink)

This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can result in unpredictable outcomes. We focus on situations where ‘country ownership’ of HSR is relatively well established and where there is significant involvement of local researchers (...) and close ties and relationships with policy makers are often present. We frame our discussion around two country case studies with which we are familiar, namely China and South Africa and discuss the implications for conducting ‘embedded’ research. We suggest that reflexivity is an important concept for health system researchers who need to think carefully about positionality and their normative stance and to use such reflection to ensure that they can negotiate to retain autonomy, whilst also contributing evidence for health system change. A research process informed by the notion of reflexive practice and iterative learning will require a longitudinal review at key points in the research timeline. Such review should include the convening of a deliberative process and should involve a range of stakeholders, including those most likely to be affected by the intended and unintended consequences of change. (shrink)

Background Rapid Ethical Assessment is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia. Methods Mixed methods research using a sequential explanatory approach was conducted from July to September 2012, including 241 cross-sectional, self-administered and 19 qualitative, in-depth interviews among health (...) researchers and regulators including ethics committee members in Ethiopian health research institutions and universities. Results In their evaluation of the consent process, only 40.2% thought that the consent process and information given were adequately understood by study participants; 84.6% claimed they were not satisfied with the current consent process and 85.5% thought the best interests of study participants were not adequately considered. Commonly mentioned consent-related problems included lack of clarity, inadequate information, language barriers, cultural differences, undue expectations and power imbalances. About 95.4% believed that consent should be contextualized to the study setting and 39.4% thought REA would be an appropriate approach to improve the perceived problems. Qualitative findings helped to further explore the gaps identified in the quantitative findings and to map-out concerns related to the current research consent process in Ethiopia. Suggestions included, conducting REA during the pre-test phase of studies when applicable. The need for clear guidance for researchers on issues such as when and how to apply the REA tools was stressed. Conclusion The study findings clearly indicated that there are perceived to be correctable gaps in the consent process of medical research in Ethiopia. REA is considered relevant by researchers and stakeholders to address these gaps. Exploring further the feasibility and applicability of REA is recommended. (shrink)

In South Africa, disability grant allocation has been under review and tensions are evident in government rhetoric stressing welfare provision on the one hand, and encouraging on the other. This ambiguity is traced down to the level of grant negotiations between doctors and in a psychiatry clinic in Khayelitsha. Here embodies the distress associated with harsh circumstances and is deemed by supplicants as sufficient to secure a grant. The paper illustrates how national discourses influence the presentation and experience of suffering (...) and the way in which doctors mediate diagnoses. The implications of local understandings of for expectations of the post-apartheid state are explored. (shrink)