Abstract
Contemporary research practices link to colonial and imperialist knowledge creation and production and may promote harmful perspectives on marginalized and oppressed groups. We present a framework for a decolonial approach to research in global health and health promotion applicable across research settings. This framework is aimed at anticipating and alleviating potentially harmful practices inherent in dominant research methods. The framework focuses from a macro- and micro-level perspective on three critical dyads: ‘context’ and ‘accountability’; ‘researcher identity’ and ‘positionality’; and ‘procedural ethics’ and ‘ethics in practice’ considerations. We present guidance for how to consider reflexivity and positionality as they apply in this framework in global health and health promotion research practice.
Keywords
Introduction
From the vantage point of the colonized, the term ‘research’ is inextricably linked to European imperialism and colonialism. The ways in which scientific research is implicated, in the worst excesses of colonialism, remains a powerful remembered history for many of the world’s colonized peoples (1).
An emerging initiative within global health and health promotion research questions Euro-America imperialism and coloniality within the field (1–3). Deeply entrenched discriminatory practices exist because coloniality is intertwined with dominant models of research, which dislocate and silence epistemic diversity (4). Researchers are trained to believe and reproduce assumptions that the social and material world is structured and functions based on Euro-American epistemic dominance (5–7). Globally, researchers adopt methods and approaches based on colonial knowledge systems in lieu of situated or contextual knowledges (8–10). These assumptions may ignore or deny the humanity of research participants and disregard their ability agency in their own lives and contexts (11). Knowledge production emanating from this approach to research is complicit with the oppressive practices of sorting, labeling, and controlling the lives of everyday people. Oppressive research practices position people inaccurately as these practices use external lenses for research purposes that serve to create evidence for externally developed research questions and hypotheses.
Decoloniality encompasses theory and debate around sociohistorical, geopolitical, and economic perspectives on gender, race, and heteropaternalism (heterosexual, male, paternalistic ways of thinking, viewing, acting, and controlling contexts, identities, and relationships) (12,13). Decolonial perspectives see the long-lasting effects of colonial power; the ‘coloniality of power’, expressed through oppression, as intersectional, multidimensional, multisystemic, institutional, historical, and self-perpetuating (13).
In research projects that aim for contextually reflexive research practice, researcher identity and positionality, ethical considerations and researcher accountability are critical components for iterative interrogation (14). This decolonial framework aims to offer global health and health promotion research ways to examine epistemic positioning, and research methodology to promote decolonial research praxis (Figure 1).
Decolonial research framework.
This decolonial framework for approaching research comprises macro- and micro-level elements that influence the research process. At the macro-level are three elements: context, identity, and procedural ethics. At the research/micro-level, three elements (accountability, positionality, ethics-in-practice) are important. Throughout the research process researchers use reflexive questioning to orient and position themselves towards participants and contextual perspectives. Reflexive questioning may occur within teams (dialogical reflexivity) or at an individual level (reflexivity) (15).
Author positionality
TN is a is a cis-gendered, displaced woman of color, of ethnic minority background, and a clinical psychologist and researcher practicing in a public health setting in South Africa. ZZ is a cis-gender, straight, woman of color, first-generation immigrant in the US of an ethnic minority background, whose research focuses on the intersection of critical race theory, educational power dynamics, and social justice. GG’s experiences as a biracial (Black and White), gay, cis-gendered man in the Southern United States shape his focus as a medical education researcher.
Macro-level: the high-level vantage point framework
The macro-level in the framework addresses context, identity, and ethical approval. These are the broader environments in which research is conducted (i.e. contexts); how people view themselves in these contexts (e.g. do they view themselves as part of the Global South vs. Global North; developing country vs. developed, identifying with a racial, gender, sexual, ethnic, linguistic, group); and how this identification impacts the ethical considerations Global North university review boards required of researchers.
Micro-level: the study/project-level framework
The micro-level is the study or fieldwork level, and comprises accountability, positionality, and ethics-in-context. This refers to the daily variability and activity of the project, including how researchers account for various activities and outcomes as they report to relevant stakeholders (e.g. funders, participants, etc.), the researchers’ positionality, and what identity elements may shift in the research process (e.g. physician, principal investigator (PI), thesis advisor, community advocate, etc.), and ethics in practice (e.g. what decisions are made in the course of the project which conform to or contravene procedural ethics and how these are negotiated or managed).
The next section explains how elements of the framework may be used together.
Context and accountability
Context is the broader social and political milieu, and the sociohistorical context of colonialism in the world. At this level, researchers may describe local contexts in detail, including how they impact and intersect with each other. This may be as large as global regions and countries (e.g. members of the Global South interacting with the Global North), or as narrow as a single community of health workers in a clinic. Context may refer to the political environment at the time when the research was conducted (e.g. dictatorship, democracy) or social environmental events that influence the everyday research context (e.g. war, natural disaster). In considering the context, researchers must note the dynamic cultural practices that shape that time and community space, and describe how those practices shape and intersect with the research process in that context. Questions for reflection include:
How would I describe the physical location of the research?
How does the contemporary and historical social and political milieu impact on the study?
What other rules, laws, and conventions are operational in this context that might be pertinent to and/or impact the study?
Accountability refers to researchers’ obligations to the various stakeholders in the research process, such as the research participants, the funding body, and the researcher’s employing organization (16). Accountability takes many forms, including member checking as an imperative rather than an optional addendum. Reciprocity is an ethical requirement holding researchers accountable to reflexively engage with emergent data regardless of the level of community engagement in other aspects of the research (5). In dominant contexts, accountability to power (funding institutions, North in North–South collaborations) may overshadow accountability to participants. As such, researchers may ask: what are the implications of prioritizing funders over participants and communities in accountability checks? How does accountability to structures and systems over participants and communities affect/inform the research and its outcomes? Here it is important to consider community intellectual property rights and access to and publication of cultural and personal information, for example, using community or traditional folklore, art or music to illustrate research findings without proper permission and possibly compensation or presenting a patient’s artwork or journal writing without acknowledgment. Participatory forms of knowledge include knowledge developed and gained in collaboration with participants. Community members and leaders should understand and agree to a research engagement that is mutually beneficial and in ways that make sense from their perspectives. Community rights, interests, and cultural governance must be central to accountability.
Identity and positionality
Identity refers to social constructed and externally conferred identities which then dictate expectations of roles and behaviors of researchers (8). Decolonial theory poses that one of the major projects of colonialism was to categorize and define identity relative to White male colonizers so that the colonizers’ identity would form the dominant norm and stand as a referent through which the world is understood and constructed (10,14,17). These can range from professional identity to racial, gender, or sexual identity, and are important to consider in view of structural power controls, both subtly and overtly, on what constitutes legitimate identities, and how they should be performed. Identities cannot be accounted for as single categories, such as gender, race, sexuality, socio-economic status; rather they are multidimensional and complex categories which are impacted by overlapping matrices of oppression. As a result, the default identity became self-referential – that of the colonizer, the White, male, heterosexual, cis-gender. Thus, researchers should reflect on their personal identity as well as the research team’s identity. The following questions might be useful to explore identity in the broader research context: what are the socially-constructed and externally conferred identities that might be salient in this study? How do these socially constructed identities and externally conferred identities differ and/or impact on how participants view themselves? What is the composition of my research team and how might that influence their own and participants’ identity perspectives? Does the team have representation from the community?
Positionality refers to the concept that the social–historical–political location of a researcher influences their orientations (i.e. the idea that researchers are not separate from the social processes they study). It also influences the importance given to, the extent of belief in, and their understanding of the concept of positionality (8,11,12,18). Positionality here refers to the ‘stance or positioning of researchers in relation to the social and political context of the study, the community, the organization or the participant group. (19)’ This designation has roots in the traditions of action-based and critical research in the sense of researchers’ views and interaction with the study participants. Researchers’ positionality, including the personal and philosophical perspectives (e.g. worldview), influences the assumptions, research design, and methods of a study. The components of research design, methods, and worldview are interconnected and therefore influenced by the positionality of the researcher. Researchers’ active interrogation of their own positionality is critical as the primary investigators’ perspectives influence and shape all aspects of the study design, data collection and interpretation, including where, why, and how data is written up and presented. Positionality consciously or unconsciously shifts depending on whether we are training field workers, talking to a senior, or presenting proposals to funders. How we assert or hold back on different aspects of our identity depends on with whom we interact and for what purpose, and must be made explicit. Questions researchers could consider asking themselves are: what are my beliefs about race culture and education in society and how do those beliefs impact my choice of research question, methods, and analysis? What are some racialized experiences that I have had that shaped my research decisions? What is the impact of my identity as a researcher in the global context? What power and privileges does my own identity afford me in this particular research work?
Positionality and identity example
In a collaborative study in which a research project was funded in the Global North but located in the Global South, all the PIs barring one were White, male English speakers. The junior researchers, fieldworkers, and graduate students were all women of color from the Global South. The PIs controlled the research process and funding while those researchers in the Global South handled the administration and fieldwork under their direction. The PIs did not intentionally silence or oppress junior members; however, they may in fact have silenced themselves, believing their opinions were not worthy of consideration. In situations where asymmetrical power dynamics are at play, some questions pertinent to this study could include: what effects can unequal identity dynamics have on the research process? Are these dynamics likely to impact how the process is conducted, how it is designed, how meetings are conducted and controlled, what research questions take priority, how data is interpreted, et cetera? What advantages can we offer to the junior researchers in this study to mitigate some of the skewed power dynamics?
Procedural ethics and ethics in practice
Procedural ethics are the processes outlined and governed by academic conventions (20). In a process dominated by procedural ethics, researchers seek prior ethical approval for research through institutional review boards (IRBs). An IRB located in a previously colonizing country might provide ethical oversight for a study conducted in a country where people continue to live with the effects of colonization (21,22); this is procedural ethics being informed and enforced by dominant power structures. However, in some countries practices have moved on considerably, for example, Australia, where Indigenous ethics cooperatives such as the Aboriginal Health Research Ethics Committee (AHREC), established in the 1980s, is a formally registered ethics forum where anyone wishing to conduct research matters with or about Aboriginal or Torres Strait Island People’s priorities must consult this committee for approval. There are other contexts where no formal ethics committees exist. Then it is crucial for researchers to employ contextual reflexivity and consult within their teams, with participants and with relevant community stakeholders about how they will maintain ethical and respectful practice in the research process (15).
Ethics in practice are the everyday, situational, and unanticipated ethical issues that occur when doing research with others (11). A decolonial reading of ethics in research in modern institutions would see procedural ethics as essentially colonial in origin. For example, the notion that IRBs typically hold a zero-point perspective on confidentiality and informed consent in ethics; these standards are based on individual decision making and personal autonomy created and propagated for colonializers’ purposes. These may be contrary to ethical, social, and moral practice in contexts where community and family consultation and group interdependence are important. Essentially the procedures and processes of IRBs are situated within a Euro-American Western epistemology and therefore do not and cannot morally be applied to all groups of people in all contexts and all parts of the world (1,3,22).
IRB approval should be obtained from the institutions of all international researchers. Researchers may want to ask themselves the following questions: if the research is being conducted in a Global South context, does the local institution have a formalized IRB? Is the concept of IRB approval considered foreign in the country of research? What tools will be used to ensure ethical research conduct? Am I making assumptions about ethics that are not aligned with the lived reality of the participants, researchers, or community in the study setting? Are there additional steps that I must take to ensure respectful relationships with stakeholders in the research project that are not specified by the IRB? Specifications need to be extended so that it is clear that additional steps are necessary when IRB specifications counter local community and contextual ethics. Some communities have begun established community-based ethics foundations and cooperatives to elevate contextually resonant ethical practices. Where these foundations do not yet exist because community ethics are considered embodied knowledge or communities have not yet deployed conscious agency to counterbalance externally introduced ethics systems, researchers must constantly reflect on whether IRB rules are consistent or in conflict with community ethics, in collaboration with research teams and community members.
In line with the iterative practices in qualitative research, researchers must question and challenge IRB decisions or imperatives that counter local and contextual conventions, norms, and accepted ways of engaging. Some communities may have begun established community-based ethics foundations and cooperatives to elevate contextually resonant ethical practices. Where these foundations do not yet exist because community ethics are considered embodied knowledge or communities have not yet deployed conscious agency to counterbalance externally introduced ethics systems, researchers must constantly reflect, in collaboration with research teams and community members, on whether IRB rules are consistent or in conflict with community ethics.
‘Global health research ethics should be premised not upon passive accordance with existing guidelines on ethical conduct, but on tactile modes of knowing that rely upon being engaged with, and responsive to, research participants (23, p.29)’. We suggest that researchers must be accountable first to the ethics and expectations of local communities before IRBs. Often IRB knowledge of communities and contexts that researchers work in, especially when those are novel and foreign contexts, comes from those researchers themselves. Researchers in the field must engage iteratively and reflectively with community and contextual ethics in relation to IRB requirements (14).
Procedural ethics versus ethics in practice example
In a Global North–South collaboration exploring the lived experience of home-based caregivers, the Global North-based IRB approved financial compensation for participants being interviewed in the study. However, cultural convention in the local community expected that the researcher (seen as the host) provide a meal at the meeting. If the IRB specification was strictly followed, word would quickly spread around the community and participants would not turn up for the meeting once they realized that they would not receive a meal to sustain them on the long journey home. The ethics-in-practice decision made by researchers was to offer participants a meal, which was respectful of local expectation, and to overlook IRB specifications made by a committee located miles away or in a different country.
Discussion
Researchers in global health promotion have a responsibility to be disruptive, to look critically at the kind of research we do, and how we implement and situate our research within the broader world. This is the basis of generating new knowledge and perspectives in the context of global social justice in research practice. This framework aims to scaffold efforts at reflexive positioning at both the macro- and micro-level research contexts by using a decolonial lens to meaningfully disrupt entrenched hegemonic discrimination.
Whilst there are frameworks and interventions that address Equity, Diversity and Inclusion (EDI), cultural safety, and social accountability in Global Health research, our framework departs from these in some fundamental ways; we take a decolonial perspective which challenges the structural basis on which knowledge that underpins research is predicated. Conventional approaches hold tacit assumptions that have the sanction to include others in structures and institutions from which the researchers themselves draw power. This includes the assumption that researchers should create safety for others within the precepts of how safety is defined by power structures and to be accountable to structures from which they gain their legitimacy or credibility. In contrast, our decolonial approach encourages researchers to question where power in these structures originates and whether they have the right to control inclusion, govern accountability rules and determine what safety is for people from diverse cultures in diverse contexts.
The framework will not apply to all research projects in the same way. Some elements will be dominant or foregrounded, while others will not be directly relevant. Counterintuitively, the framework may be most applicable when a research project does not address race, equity, social justice, or other obvious forms of discrimination. In projects that are not considered socially controversial, issues of discrimination tend to be veiled and most salient. For example, in a study investigating how to teach residents about assessing cardiac patients, researchers need to ask themselves about the assumptions they make as they construct research questions, how the larger context might influence data, and who benefits from their research.
This framework represents a methodological contribution through which researchers may begin to look more critically at epistemological and ontological assumptions. It offers ways to access unconscious attitudes underpinned by (colonized) ways of seeing and doing research. Given that coloniality in research implies the perpetuation of research methods and approaches that emanate from colonially founded bases of knowledge, we propose that questioning these methods, guided by this framework, will challenge coloniality in research. The framework offers the opportunity to step back and notice and acknowledge embodied and taken for granted research practices, and to consider that what may be true for us as researchers may not apply in the same way to the people with whom we teach, study, and work.
This framework may align in part with EDI concepts, attitudes and recommendations; however, we pose that EDI is peculiar to North American literature on antiracism and discrimination in research. Therefore, the literature relates to ‘equity, diversity, and inclusion’ within existing systems based on Global North colonially based epistemologies. We question approaches that aim to change actions within existing systems and structures by specifically adopting an approach based in Decolonial theory. We take a position that interrogates and dismantles existing systems and structures from the perspective that their basis in Global North ideology rejects against those who do not fit the norm of the zero-point White male perspective.
For those of us who come from marginalized, oppressed and neglected groups, contexts, locations, and identities, this framework can alert us to how we may have been co-opted or colluded into participating in oppressive work. It may also alert us to our unquestioning acceptance of the universality of ontological and epistemological notions inherited from a single dominant colonial mindset. The framework may provide means to acknowledge, reflect on, and constantly adjust our embodied presence in a research situation.
