Bridging Trust and Collaborative Research in Low-Income Contexts During Public Health Emergencies: A Sierra Leone Case Study

Abstract

Background/aims: The COVID-19 pandemic has highlighted the critical role of community-centered research in addressing public health challenges, particularly in low-income settings. This study examines the experiences of conducting a mixed-methods COVID-19 vaccine uptake study among healthcare workers in Sierra Leone-a country with a history of infectious disease outbreaks and a fragile healthcare system.

Methods: Twenty-four (24) in-depth qualitative interviews and 1,001 healthcare workers across six districts completed a 109-item quantitative survey. Thematic analysis was conducted for the qualitative data, while the online survey data were analyzed in Stata for descriptive and inferential statistics.

Results: The qualitative results showcased how direct researcher-community interactions encouraged participation, even without financial incentives. Conversely, the quantitative results uncovered mistrust and limited engagement, mitigated primarily through financial incentives and active stakeholder involvement. Integrating these research methods provided a comprehensive understanding of the factors influencing vaccine uptake and the broader research process.

Conclusion: The paper yields practical insights into navigating community-based research's complexities amid a global pandemic. The results offer critical insights into pandemic preparedness and equity-informed methodologies for global health researchers and public health practitioners working in low-income settings. Community engagement and trust-building were core elements of vaccine uptake research. This case study contributes to the global health research discourse by emphasizing the need for locally adaptable research methodologies amid a public health emergency.

Keywords: COVID‐19; Sierra Leone; community engagement; healthcare workers; mixed‐methods; trust.