Intended for healthcare professionals

Analysis Co-production of Knowledge

Effective engagement and involvement with community stakeholders in the co-production of global health research

BMJ 2021; 372 doi: (Published 16 February 2021) Cite this as: BMJ 2021;372:n178

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  1. Doreen Tembo, senior research manager patient and public involvement and external review1,
  2. Gary Hickey, senior public involvement manager1 2,
  3. Cristian Montenegro, assistant professor3,
  4. David Chandler, chief executive4,
  5. Erica Nelson, research fellow5,
  6. Katie Porter, assistant research manager, patient and public involvement1,
  7. Lisa Dikomitis, professor of anthropology and sociology of health6,
  8. Mary Chambers, head of public engagement with science7 8,
  9. Moses Chimbari, professor of public health9,
  10. Noni Mumba, head of community engagement10,
  11. Peter Beresford, emeritus professor of citizen participation11,
  12. Peter O Ekiikina, public contributor low and middle income countries12,
  13. Rosemary Musesengwa, senior researcher13,
  14. Sophie Staniszewska, professor of health research (patient and public involvement and experiences of care)14,
  15. Tina Coldham, public adviser and research fellow15 16,
  16. Una Rennard, public contributor to health and social care research17
  1. 1Wessex Institute, Faculty of Medicine, University of Southampton, Southampton, UK
  2. 2School of Health Sciences, University of Brighton, Brighton, UK
  3. 3School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile
  4. 4The Psoriasis and Psoriatic Arthritis Alliance, St Albans, Hertfordshire, UK
  5. 5London School of Hygiene and Tropical Medicine, London, UK
  6. 6School of Medicine, Keele University, Staffordshire, UK
  7. 7Oxford UniversityClinical Research Unit, Vietnam
  8. 8Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
  9. 9University of KwaZulu-Natal, School of Nursing and Public Health, South Africa
  10. 10KEMRI Wellcome Trust Research Programme, Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Kenya
  11. 11School of Health and Social Care, University of Essex, Colchester, UK
  12. 12Foundation for Open Development, Tororo, Uganda
  13. 13Department of Psychiatry, University of Oxford, Oxford, UK
  14. 14Warwick Medical School, Division of Health Sciences, University of Warwick, Coventry, UK
  15. 15National Institute for Health Research Centre for Engagement and Dissemination, London, UK
  16. 16School for Social Care Research, National Institute for Health Research, London, UK
  17. 17Oxfordshire, UK
  1. Correspondence to: D Tembo d.tembo{at}

Doreen Tembo and colleagues argue that small changes as well as larger system-wide changes can strengthen citizens’ contribution to knowledge in health research

Involving a broad range of individual and collective perspectives in global health research outside of academic research is gaining increasing recognition as a mechanism for achieving a greater impact. This activity goes by many names (box 1). In the global north or a high income country, it is commonly called “patient and public involvement,” “engagement,” or “participation.” In low and middle income countries or the global south, these participatory processes are termed “community engagement,” “participation,” and “community engagement and involvement.”123 Co-production, a core feature of community engagement and involvement, is common to health research in both the global north and south, with a range of potential benefits. It helps to ensure that health research contributes to building knowledge and generating innovations that benefit users of research.4 For research that drives change and reduces the waste of resources,5 co-production should start from the earliest stages, when problems are identified and priorities defined.6 Such an approach supports research that is ethical, specific, and appropriate to the local community.789101112 Involvement of end users in the design of projects has also been shown to improve recruitment of participants and research methods, making implementation and the impact of the research results more likely.913

Box 1

Terminology for partnering with communities

Many terms are used to describe how researchers form partnerships with non-academic communities. The lack of universally agreed and defined terms can lead to a lack of clarity about shared values and scope of activities, and relevance to other researchers and communities. It can also hamper discovery and synthesis of evidence from the literature.

The UK National Institute for Health Research (NIHR) distinguishes between terminologies …

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