A4NH / Article / Communications / East Africa / Finland / FSZ / ILRI / Kenya / Knowledge and Information / Participation / Policy / Research / Tanzania

On more rigorous informed consent in One Health cross-cultural livestock research

ILRI poster prepared by Tarni Cooper (concept and text), James Wakhungu (translation) and Timothy Hall (cartoons and design) as part of a What Is Killing My Cow? project in Tanzania. The poster was one of three communication tools used for seeking informed consent, which were tested and compared for participant comprehension (of project information) and engagement with the consent process.

English translations of Kiswahili captions: Box A: In the first part of the project, farmers said they want to know more about what is making their cattle sick. Box B: Farmer will choose 1–3 sick animals for sampling and the rest of the herd will only be examined at a distance. Box C: We will take milk samples in a clean, safe manner, to minimize risk. Box D: We will take blood samples in a clean, safe manner, to minimize risk. Box E: If necessary, we will restrain cattle on the ground using ropes. Box F: Participants will not receive any money or medicine for participating. However, farmers will receive advice about sick animals from a veterinarian, without having to pay.

‘Ethical compliance is becoming more and more important in agri-food research, but methods taken from Western systems are not always the most useful for our participants.

‘The International Livestock Research Institute (ILRI) is one of only two CGIAR centres with an Ethics Committee. ILRI and the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) are interested not just in statutory compliance but also in ensuring that research actually meets its obligations to participants.

‘In that light see our paper, just out, on understanding consent needs of dairy farmers in Tanzania and informal milk traders in Nairobi.’

‘Notably: a) none of the farmers comprehended all of the information content of a consent form; b) farmers better understood and comprehended pictorial consent forms; c) most traders preferred not to give signed consent (although all were literate).’

Delia Grace, leader of ILRI’s Food Safety and Zoonoses program

The following is excerpted from the paper’s abstract.

‘With the rise of the One Health paradigm, ethicists have called for new research approaches, considering the interdependent relationships of humans, animals, and their environment. These relationships can be particularly complex within resource-poor, smallholder livestock systems, necessitating a rigorous informed-consent process. Little has been published on informed consent beyond human-subject research. This paper outlines two studies on informed consent, for research identifying diseases of animal and human importance, within smallholder livestock value chains.

‘Firstly, a randomized independent-group study compared three communication tools (written, cartoons, and photographs) for informing 22 Tanzanian livestock-keepers before seeking their consent. A significant difference in comprehension and engagement in the informed-consent process was found between tools, and cartoons had the highest (i.e. best combined comprehension and engagement) scores. Most (21 out of 22) farmers answered half or more the questions correctly, but none were able to answer all questions. Comprehension testing allowed identification of common misunderstandings, such as immediate benefits the farmers would receive and the process to be used for relaying research results. Dialogue stimulated by cartoons and photographs allowed researchers to determine and respond to participants’ varied relationships with their livestock.

‘The second study assessed preferred methods for indicating consent among informal-sector milk vendors in Nairobi, Kenya. Of consenting participants, 61% (140/230) indicated consent verbally, 39% (90/230) signed consent and none chose thumbprint. There was a significant enumerator-effect on both overall consent and the methods chosen.

‘Several of these findings echo those published in human-medical research. Additionally, highlighted here is the importance of facilitating dialogue during the informed-consent process in One Health research, for a more nuanced understanding of relationships between humans, animals, and their environment. Also discussed is how a requirement to sign consent forms might limit consent among workers in informal markets, which are commonly studied in One Health research. We suggest expansion of these, and development of further, studies towards improving consent processes in One Health research. . . .’

The paper concludes:

. . . [S]tudy participants in those settings do not always comprehend all information provided in written consent forms and are not always comfortable with providing signatures on consent forms. Moreover, the fact that consent to participate in research is seldom refused by rural participants also raises questions about the validity of the consent process.

Read the whole paper, Towards better-informed consent: Research with livestock-keepers and informal traders in East Africa, by Tarni Cooper, Yumi Kirino, Silvia Alonso, Johanna Lindahl and Delia Grace, all of the International Livestock Research Institute (ILRI), in Preventive Veterinary Medicine, Vol 128, 1 Jun 2016.

The study in Tanzania was mainly funded by the German Federal Ministry of International Cooperation, GIZ. The study in Kenya was part of the FoodAfrica Programme, which is mainly financed by the Ministry for Foreign Affairs of Finland and the Japan International Research Center for Agricultural Sciences (JIRCAS). Both projects also received funding from, and contributed to the CGIAR Research Program on Agriculture for Nutrition and Health.

For more information view the slide presentations on Ethical practice in One Health research: Guest lecture by Tarni Cooper to Bachelor of Applied Science, ‘One Health’ students, University of Queensland, Australia, 6 Aug 2014; and Veterinary communication for development: Presentation by Tarni Cooper at the Veterinary Student Special Interest Group conference, University of Queensland, Gatton, Australia, 6 Aug 2014.

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