Gender considerations for inclusive CEI

This is the second episode of our series, Spotlight on community engagement and involvement (CEI): Leaving no one behind. 

Heidi Surridge, NIHR Senior Research Manager for CEI, hosts this episode and is joined by Prince Tommy Williams, Executive Director of Lifeline Nehemiah Projects, Mangenda Kamara, Co-founder of 2YoungLives, and Sanjog Thakuri, Consultant on Child Participation, Governance and Professional and Organisational Development. 

The guests discuss what is meant by leaving no one behind, challenges of engaging gender groups in their research, the impact of their research on communities and provide tips for leaving no one behind in CEI. 

Prince and Mangenda are affiliated with the NIHR Global Health Research Group: Implementation of simple solutions to reduce maternal and neonatal mortality and build research capacity in Sierra Leone.

Get to know our speakers

Prince Tommy Williams has over 20 years of experience in CEI. His impactful leadership during the 2014 to 2015 Ebola outbreak in Sierra Leone saw him coordinate a vital response for the Kuntorloh, Wellington community, saving 20,000 lives providing messaging and essential support to 18,000 individuals in quarantine homes. Under his guidance, projects funded by Big Lottery, Comic Relief, Lifeline Network International and NIHR have successfully reached marginalised groups in deprived communities. Prince's unwavering commitment to improving lives, leaving no one behind, continues to inspire and empower those in need.

Mangenda Kamara is a research assistant for 2yL, a community engagement expert, a gender expert and a PhD student in the Department of Sociology and Social Work. With extensive experience in community engagement, Mangenda  specializes in guiding, coaching and mentoring people in the community, especially women, to drive positive change. Her work fosters inclusive educational environments and empowering local communities. 

In Mangenda's PhD research, she explored adolescent pregnancy in Sierra Leone through a womanist lens, focusing on the Tombo and Mattru Jong communities. This research strengthens her commitment to advocating for gender equity, youth empowerment and educational access. Her engagement spans policy advisory roles, grassroots initiatives and partnerships that create sustainable community-driven solutions. 

Sanjog Thakuri is an intersectional feminist with a special focus on Boyhood, Masculinity, and MenEngage. He has worked with and for the community for over 2 decades by engaging the community for the advocacy and transformation of harmful social norms. Sanjog's policy support for government and advocacy programming for and with development partners and UN agencies is mostly focused on empowering the community and listening to them. 

Heidi Surridge is a Senior Research Manager at the NIHR - Global Health Research, CEI and Research Inclusion. She has a nursing background, before gaining a BA (Hons) in Social Sciences and a Masters in Sociological Research in Health Care, then working as a health researcher in the UK.

Heidi has worked for the NIHR for 16 years, facilitating, supporting and advocating public and community involvement in research and the management of research funding. She is dedicated to enabling communities to have ethical, relevant and mutually beneficial involvement in health research worldwide, from research priority setting through to policy and service provider uptake.

This episode was recorded in late 2024. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect those of the NIHR or the Department of Health and Social Care.

Transcript

Spotlight on CEI: Leaving no one behind 

Episode 2 - Gender considerations for inclusive CEI

Host: Heidi Surridge

Guests: Prince Tommy Williams, Mangenda Kamara, Sanjog Thakuri

Heidi Surridge 00:00

Hello, listeners. My name is Heidi Surridge, and I work for the National Institute for Health and Care Research, an organisation based in the UK that funds research, both in the UK and globally. Welcome to our podcast series, ‘Spotlight on community engagement and involvement: Leaving no one behind’, exploring how we involve and engage people and communities in health and care research with particular focus on those who are marginalised and vulnerable.

This is the second episode in this series, and today we're going to focus on gender.

The topic of gender and sex is a very complex one, with sensitivities worldwide. So, whilst we acknowledge the breadth of this topic, this episode will focus on being inclusive when engaging women and men in different contexts and settings in global health research. This requires an understanding of the local culture and social systems to appropriately navigate any sensitivities and determine the most appropriate ways to engage. 

So, I am delighted to be joined by 3 people who have far more experience of these issues than I do. I would like to extend a warm welcome to Prince Tommy Williams and Mangenda Kamara. Mangenda and Prince are both undertaking community engagement and involvement on an NIHR, the National Institute for Health and Care Research award, in Sierra Leone.

And another warm welcome to Sanjok Thakuri in Nepal. Sanjog works as a freelance consultant, as a global health advocate and gender expert.

So, let's talk. Could you kindly introduce yourselves and tell us, what does community engagement and involvement that leaves no one behind mean to you? I'd like to invite Mangenda to speak first.

Mangenda Kamara 02:23

Good morning, everyone. Once again, I'm Mangenda Kamara, and I'm working for 2YoungLives as a research assistant. So, for me, community engagement and involvement and leaving out no one means to me the involvement of everybody in the community in the decision making and the implementation of the project, and also ensuring that you engage the marginalised people to have their voice within those decision making and the implementation in the project. Also, if using this strategy or this way of involvement helps to bring equity and seeks to address the needs of the marginalised people within that community, and it also fosters a solution to their problems because they are well involved and it's sustainable at the end of the day. So, and also it creates ownership amongst the marginalised people and the community itself. 

Heidi Surridge  03:52

Well, thank you, Mangenda, you've made some really great points. Prince, would you like to kindly introduce yourself.

Prince Tommy Williams 04:01

Well, thank you so much for having me. Yes, I am Prince Tommy Williams. I am the Executive Director of Lifeline Nehemiah Project. I'm also the community engagement and involvement lead in a fund we receive from the NIHR. 2YoungLives is also part of the CRIBS programme - CRIBS, it's an acronym that stands for Capacity Research Innovation Building Maternity Systems in Sierra Leone. So, 2YoungLives is part of that. And so yes, that's me.

Heidi Surridge  04:42

Thank you, Prince, and just to follow on with that, to ask you about what community engagement and involvement that leaves no one behind, what does that mean to you, Prince?

Prince Tommy Williams 04:54 

Leave no one behind to me means creating a safe space for marginalised people, including all girls, women, persons with disability. It also means to me, the [the] marginalised people should not just receive a piece of information, but they should be involved in discussion leading to solution(s) affecting them at community level.

Heidi Surridge  05:27

Thank you so much, thank you. And I'm very much hearing about ownership and two-way involvement and safe spaces, which is really all about that inclusivity isn't it.

So, Sanjog, the same question to yourself, and giving you the opportunity to introduce yourself and telling us what you think community engagement and involvement that leaves no one behind means.

Sanjog Thakuri 05:55

Hello everyone and Namaste. My name is Sanjog Thakuri and I'm from Nepal. I recently completed my tenure as an NIHR Global Health Community Engagement Network member, and I'm affiliated with an NGO called Hami DajuVai. I work in the area of gender justice through research, capacity building and community engagement, with particularly I focus my work on men and masculinities. To me, community engagement that truly leaves no one behind means giving power to the community, especially those who are historically marginalised and recognising their values. Because, you know, we don't do research for a library, we do research for people and the community. So, we [we] need to understand the context of their lived experiences, and often those in position of power based on gender, class, race, religion, you know, they often receive most of the opportunities, and while the marginalised and deprived are always excluded.

So, I think for me, the idea of community engagement, it's about the shifting (of) our biased mindset, and it's about not viewing them as a participant, but as an expert.

Heidi Surridge  07:07

Thank you. A very valid and important point about the power of knowledge. So, let's pose the next question, and I'd like to pose this question to Prince please. Can you tell us a bit about how you've worked with women in terms of your community engagement and involvement?

Prince Tommy Williams 07:27

Just to answer that question, I'll give you a little bit of background. Since 1996, the Lifeline Nehemiah Project has used community engagement and involvement across its activities. 2015, we had Ebola in Sierra Leone. That was a time that we really saw at higher level, the importance of community engagement and involvement during our intervention in the fight against Ebola, and we were able to mobilise over 30,217 people; empower them with the right information. We were able to support most of those people at quarantine homes with food and food items. Then with the community, in partnership with other international NGOs, we are able to also establish an Ebola treatment centre which we were able to reach out and save over 217 people from the Ebola. Fast forward, we did a research in 2016 at community level. Doing that research, we find out that girls were at risk, and women were at risk as well, especially pregnant girls and women. So, Lifeline Nehemiah Project leadership came together and decided we should start an intervention scheme after that research, that was how the team decided to introduce 2YoungLives. The 2YoungLives is a mentoring scheme for pregnant under 18 years old, with particular emphasis on the most vulnerable adults with disabilities, including learning disabilities.

So, the mentors, we ensure they support the girls to attend ANC and hospital bar, supports, rehabilitates, rehabilitation to family connections were saved, and appropriate need would be. So, in all this we were able to save 550 girls who delivered safe, and there was no maternal death.

Heidi Surridge  10:06 

Thank you, Prince. And Sanjog, can you share with us some of the gender-based issues you've experienced in your work?

Sanjog Thakuri 10:17

Sure. Heidi, I think that patriarchal mindset is everywhere. It exists globally in every setting, and Nepal is no exception. We also have our own cultural practices that include the harmful traditions, such as you know, control over women's sexuality, leadership, mobility, and we also have the caste system, because in Hindu religion there's a caste system. And during my community-based engagement, while doing the research of the project, what I've noticed is that even among the adolescents the boy dominates the girls largely within the school setting or within their romantic relationship. We do have  chhaupadi practices where the girl and women are forced to live in huts during their monthly cycle for 7 days. Girls and women are often denied to access the health facilities or healthy foods, even during the public health emergencies like COVID, like the dengue, you know, compared to men and boys. And why I'm bringing these issues, not other gross human rights violation is that often these are the issues (that) are not considered as a gender-based violence. You know, these are somehow we have normalised these things. Though we have other significant forms of oppression as well, for example, with Dalit women. Although women from the Flatland or the women of disability or LGBT, they also face multiple forms of the violations as well. 

Heidi Surridge  11:53

That's fantastic to hear some of your experiences there, and it really shows how gender differences and experiences are very much embedded in cultures and taken sometimes as the norm.

I'd like to turn to Mangenda now and ask if you can tell us about the main challenges you've experienced engaging gender groups within your research.

Mangenda Kamara 12:22

One of the challenges is cultural barriers. So, when we introduce these projects into communities, they have their own cultural activities that they want to stick to. Like for example, we encourage them to deliver in hospitals, we encourage them to attend antenatal care. So, for some communities that we've worked with, for example, in one of the communities, Tombo, they are happy or like to have home deliveries, which was very risky and was having high impact on maternal death. They have a lot, and it was mostly adolescents, and also some women. So, it was a bit difficult for them to accept that it's good to be delivering in [in] the PHU or facility. So, we [we] that was their challenge. We overcome that challenge by bringing the community together, talking to the stakeholders and the community about the disadvantages of women or girls delivering at home and looking into those disadvantages, and they saw the realities on [on] the ground. They had their own meeting and they brought in bylaws to [to] change that attitude. So that was how we overcome that. 

But also, referral was another challenge for them. They think if they are moved from their community and sent to a bigger hospital, they will die, their children are going to die, or there will not be nobody that will take care of them. At the end of the day, because we try to build on their trust; we go with them to the referral hospital; we [we] guide the process until they deliver and have their babies safely, and they go back to the community, that help the other members of the community to also start going now to deliver in the hospital. 

Another challenge was a distrust. Other communities who've worked when we started earlier on they [they] were not having no trust in the project because they [they] had previous NGOs that promise doing things for them and did not do it, so, they lost trust in most NGOs. So, we [we] are having problems with them in that community. So, how we overcome that we try to engage the stakeholders and bring them to the headquarter town, Freetown. Show them what we are into. Have some girls that have gone through the project. And, because when you deliver at the end of the day, we either take [take] you back to school, or you learn a trade. So, at the end of the day these girls came and explained their testimony, because they are now working at a younger age providing for their families. So we [we] are able to gain their trust back, and they started working with us very well. 

Also, time constraint was another barrier. You know, some communities we work in are farmers, some do businesses, so in terms of us going to work with them during the day was a constraint. So, we had to be flexible. We are flexible to shift the meeting time to evening hours when they shall have come back from their farming and businesses, so they will be all available, so everybody in the community will benefit.

Heidi Surridge  16:12

Mangenda, that is absolutely amazing to hear some of the work that you've been doing and the challenges and how you've adapted your community engagement around them. I'm hearing so much about members of the community being advocates following delivery and having had positive experiences in [in] hospital. I'm hearing about the [the] safe spaces and having to identify times that are convenient for everybody and working around that. And also very much about the [the] misconceptions or the [the] mistrust that can be held with researchers, and as you mentioned, non-governmental organisations, and how you've had to almost take that on board and build that trust again where it's been lost. So, thank you. 

Prince, is there anything you'd like to add to the ways in which you've adapted your community engagement and involvement to be inclusive of gender groups?

Prince Tommy Williams 17:25

Some of the ways we've been able to adapt just to be able to reach out to minority groups and involve everyone, it's using the flexibility in language. You go in one community, some people will be fluent in one local language, in other community they will be fluent like in Temna or Bendi or Creole. So we first try to identify what language would be better understandable to the people. So we try to communicate to the people in the language they best understand, so that they are able to interact with us better. And that has been helpful. 

We leave people somewhere and walk to just go to a community; walk on foot to reach into community, to engage the people that we really want to engage. And the team has been very, very good in doing that and we've seen a lot of positive results.

Heidi Surridge  18:35

Thank you, Prince, and it's really interesting to hear about the ways in which you've improved the accessibility of reaching out to these groups in your community.

So, I've got a question for you all now. How have the communities you've been working with been impacted by your inclusive approach and by being part of research? So, Sanjog.

Sanjog Thakuri 19:07

As a researcher I may not have a direct influence over impact, but my role is primarily to bring their issue to the light in the reports, and [and] ensure that they are considered as a participant. And I also ensure that whenever I take the research, I don't take the research that highlights those who are already in power, I always take the research which talk about the issues of marginalised people so that their voices and choices are represented through our various participatory tools. So, that it's, you know, in general, we [we] think that the research is all about taking their thoughts, but it's also about helping them to understand the complex issues while discussing with them, so the participatory tools help them to understand that. And this approach I believe contributes in building and recognising their agency as well.

Heidi Surridge  20:02

Thank you, Sanjog. Based on your answer there, could you explain or give an example of some of the participatory approaches you've used?

Sanjog Thakuri 20:13

These are the participatory tools that we use are not academically sound or academically approved participatory tool you use. We use the participatory tools based on the dynamics of the communities and [and] help them to understand, so that they feel okay and [and] they feel safe in that particular space. For example, sometime we do dot voting to get their thoughts on prioritising this thing. Sometimes we do community mapping to understand the way they see services so that community mapping or resource mapping can help us to know that what are the areas that community thinks that they can get the support when there's a gender based violence, or [or] discrimination happens. So, these are the participatory tools you use.

Heidi Surridge  21:01

Thank you. And Mangenda, do you have any examples of the way you think your communities have been impacted by your inclusive approach?

Mangenda Kamara 21:11

One, I would say, is empowerment. These communities have been empowered in terms [in terms] of the marginalised group of people, voicing out their opinions and like participating in decision making. For example, through our engagement in one community, we had a woman that [that] is part of 2YoungLives. Uneducated, before now she was not having that kind of boldness, but during this time she aspired to become the head woman in the community. Though she did not win, but that was a stepping stone, for a woman without education to aspire for a position with other people was a bold step, so we were happy for that. And that is one of the empowerment. 

And even the girls are being empowered with information about what to do at the end of the day, not to become pregnant. Or even if you are pregnant, what will you do to [to] help yourself out? What are the signs you look for - danger signs? How do you prevent the pregnancy? How do you take care of your baby? At the end of the day, even if they are not directly pregnant - let's say a colleague or friend is pregnant - they'll be able to support. And also at the end of the day giving them education, it's another empowerment we are giving them; they'll be able to support themselves, support their babies and all of that. 

And also building that strong collaboration between the [the] NGO or the project members and the community people is another thing. Because if you work in a community for a year or 2, at the end of the day, you can't go there again because of things you did that was not right, it's not good, but because of us engaging these communities rightly and using our values, we always go back and check whatever they are doing. 

And also, engagement is another thing. We engage them in everything, so through that they learn from us all the things we take to the community, how we solve the problems, things we come up with. Also they are learning from all those initiatives, and even in our absence, they will be able to bring solutions to their problems and sustainability overall is the [is the] key to this the impact on the community for our engagement.

Heidi Surridge  24:04

Thank you, Mangenda. It's amazing to hear about the ways in which you've supported and given that impact in terms of empowerment, sustainability and ownership. Prince, do you have anything to add to this?

Prince Tommy Williams 24:22

So to add, I think one of the benefits or the impact has been we've been able to work together and strengthen relationship between the community stakeholders, researchers, even policy makers. In the villages some of these minority or marginalised people, they don't even know some of these policies. But because of our engagements, the rights of the girls, stakeholders we empower them with the right information, sometimes they realise - oh, yes, we never knew this, but now we should be doing things differently - so that has helped greatly for the community stakeholders to take ownership and also involve those people they used to consider as marginalised in the process of decision making in communities. 

And lastly, we're also using our values. The acronym is STEADI - STEADI. The S stands for serving the community. The T stands for teamwork. The E stands for excellence. A stands for accountability. D stands for don't turn a blind eye, and the I stands for integrity. So as we empower them, we expect them to also replicate taking care and create a safe space for women, children, persons with disability in their community, and that has been very, very productive and impactful at community level.

Heidi Surridge  26:04

Thank you, Prince, absolutely fantastic to hear. We've talked about the impact on communities, I would just like to ask you about involving these gender groups in community engagement and involvement, has it made a difference to the actual research itself? Sanjog?

Sanjog Thakuri 26:25

There have been many instances when we went with a mindset that marginalised community have a lesser, no agency or resilience which was later proven wrong after speaking with them. So, I think this, when [when] we many times when we stay in one particular site and design the research and think of the community, and then when we meet them, and then we actually realise that this is not the how we think, the lived experience has a different experiences, that gives us lots of insights. 

Also, while working with the adolescent boys and girls we also surprisingly came to know that these young, the new generations are less gender sensitive, you know. And [and] it's very surprising for us because we didn't thought of that. So, I realised that working with the young people is very, very important these days while doing this. 

And third is that, like Mangenda also shared, that flexibility is also very important, because what happened was during one research we designed one hour of FGD. The FGD, which means the focus group discussions that we do with a certain group to understand their idea of the understanding of the certain issues that we conduct within the communities. But the most of the women couldn't stay during the FGD because they had the household chores that they have to do it and then they couldn't. So later we redesign, and then we break it into the half an hour for one day and half an hour another day. 

So, these are the some of the way that we did to ensure that their voices, and we also learned that not the kind of methodology which we have been practising can be worked if we really want to leave no one behind, we have to be flexible in terms of tools, time, and then approaches.

Heidi Surridge  28:15

Thank you, Sanjog, you make some very salient points there. Mangenda?

Mangenda Kamara 28:19

Community engagement or involving groups of marginalised people within the community ensures that the research topic and questions are relevant to the real life experiences of the [the] people within the community, and it also brings out a good outcome and it is impactful to them. 

And also involving the community builds trust and it enhances credibility to the research, because when people hear or see their own voices reflect in the findings they are more likely to support the results.

Heidi Surridge  29:04

Thank you Mangenda, and Prince.

Prince Tommy Williams 29:07

I think using the community engagement and involvement approach really helps people to understand the context and the researchers to also understand challenges in the community and also help the researchers to learn. I mean, in [in] the past, most researchers, we just go to the community gather data, forgetting about the relationship, hearing from the people. And these people are actually the ones that are going through; they know what they're going through, they know their problem better, they know how to really find solution better, so they need to be involved. So, through the community engagement and involvement, it has been really helpful to get fact and get the actual problems at community level; it's not just data, it's not just figures, but the real problems we're able to identify collectively. 

I think the impact has been so immense to the point that now there's a better relationship between researchers and the community people, inclusive, the girls, women, persons with disability because they see using the CEI engaging all these people, making them feeling ‘oh, yes, this is something that we are making input’, so at the end of the day they'll be very much happy to propagate or disseminate the very information, the outcome of that research.

Heidi Surridge  30:51

Thank you, Prince, and thank you all. I'm hearing here about the fundamental issue that we need to build that relationship and the trust with the communities and in doing so that the research will end up being much more credible and likely to have impact. I'd like to leave everybody with some advice. So, I'd like to invite our guests to give one key piece of advice that they'd give to people engaging communities and how to be gender inclusive when they're leaving no one behind. So, over to Sanjog.

Sanjog Thakuri 31:36

I think at first I think, like NIHR is doing, I believe every research agency should be practising CEI - community engagement initiatives - because the communities are not voiceless, you know; their voices and thoughts have been suppressed by centuries long, voice should be listened to them, consider them an expert, and recognise their lived experiences, because again, they are not voiceless, they simply haven't been heard before. So, be flexible, open, and ready to learn and learn and relearn and recognise as a researcher your own power dynamics and [and] your own privileges.

Heidi Surridge 32:13

Thank you, Sanjog. Prince.

Prince Tommy Williams 32:18

For us, there is this phrase we use “to change your mindset takes a million conversations”. It's important for researchers to know that when going to community, people know what they need - they really know what the problems are so we should be always willing to engage, learn from them. We might be the research experts, but we can also be learning from them, so we should be willing to learn from those that are considered to be the marginalised, those that are considered to be the minority. We can learn so much from them in the process, and they can even inform our thought process and policies to benefit them and all of us. 

Heidi Surridge  33:07

Thank you Prince, and I do love your one million conversations and that good community involvement needs that. Mangenda, your advice.

Mangenda Kamara 33:19

As a researcher, my community engagement experts, I will advise fellow researchers to prioritise listening to community members which includes the marginalised or underrepresented groups in the community. Listen to them, understand their needs, concerns, and then be open to dialogue and feedback, because that is where the problem lies. You want to talk to the community people or advise them to take whatever you are telling them, but you don't want them to give you feedback on your work, whether you are doing well or not. You have to be open to that feedback and be ready to make corrections so you'll be able to pass on your information very well. 

Also be open to different languages. Don't always say your own language is the best; accept all the languages and be fair to everyone. Treat everybody fairly in the community; don't be biased, then you'll be able to sail through any community you enter into. 

Heidi Surridge  34:37

Thank you, Mangenda. Well, overall, thank you again, Prince. Thank you, Sanjog, and thank you Mangenda, for your time and your fantastic contributions to this podcast. And a huge thank you from all of us to you, the listener. 

Please do share, post on X and tune into other episodes in the series which can be found on our website or wherever you listen to your podcasts, and please do let us know what you think by sending an email to social.media@nihr.ac.uk. Finally, a reminder that the NIHR and Mesh community engagement network online course called An Introduction and Practical Guide to Community Engagement and Involvement in Global Health Research is now available and it's free to all. For details, please visit The Global Health Training Centre website or visit www.nihr.ac.uk and search for community engagement and involvement. There you will find the course in the resources section. And that's all from us, so thank you very much again for listening, and please do enjoy the rest of your day.