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We are running a community based trials in the semi-urban communities in India. This study requires us to travel out daily to a district health facility spend the working day there and then return to the main research centre within the Hospital. As many of the trial running in India are within cities I thought it would be helpful to others to consider the many challenges faced by working out in the community outside the main urban area. These are partly logistical and partly social. Managing these studies is difficult at almost every level. As a medical doctor I have not been trained to plan the complexities of getting staff to and fro’, whilst making sure the vehicles work and that the samples get back to the lab within a specific time. In the wet season the roads are very bad and our transport has a terrible time getting through the washed away roads and making up for lost time in the chaotic traffic. Once we are there we need to make sure we have done a good job of talking to the local health centre staff and involving them right from the start. We could not work without their support and this can on occasion be difficult to achieve as research is not part of their job and outside of normal activities so our even being in their centre can be seen as an issue. Time is well spent avoiding such difficulties and talking the all the plans through with all the government staff, not just getting approval at the top level. The local communities must also to be carefully involved or suspicions will be raised and people will not want to take part in the studies. We advise others to talk to the community leaders and then to all the groups about what is being planned and what is involved. This takes time and thought but is essential to get quite right. This is not really the same in the cities where trials are conducted hospitals or health centres – but so important in rural or semi-urban studies.
did you get the community representatives involved also in the design of the informed consent tools, for instance to check the level of comprehension in relation to local language and background? If yes, was this experience positive/useful? Thanks,