03299nas a2200421   4500000000100000008004100001653001500042653001000057653000900067653001300076653001800089653001100107653001700118653004200135653001100177653002100188653000900209653001600218653001200234653002500246653003000271653001600301100002000317700001000337700001400347700001100361700001700372700001300389700001400402700001200416700001200428245014400440856008900584300000900673490000700682520217400689022001402863       2014                            d10aAdolescent10aAdult10aAged10aCameroon10aComprehension10aFemale10aFocus Groups10aHealth Knowledge, Attitudes, Practice10aHumans10aInformed Consent10aMale10aMiddle Aged10aPoverty10aQualitative Research10aResidence Characteristics10aYoung Adult1 aKengne-Ouafo JA1 aNji T1 aTantoh WF1 aNyoh D1 aTendongfor N1 aEnyong P1 aNewport M1 aDavey G1 aWanji S00aPerceptions of consent, permission structures and approaches to the community: a rapid ethical assessment performed in North West Cameroon.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195877/pdf/12889_2013_Article_7141.pdf  a10260 v143 a<p><strong>BACKGROUND: </strong>Understanding local contextual factors is important when conducting international collaborative studies in low-income country settings. Rapid ethical assessment (a brief qualitative intervention designed to map the ethical terrain of a research setting prior to recruitment of participants), has been used in a range of research-naïve settings. We used rapid ethical assessment to explore ethical issues and challenges associated with approaching communities and gaining informed consent in North West Cameroon.</p>

<p><strong>METHODS: </strong>This qualitative study was carried out in two health districts in the North West Region of Cameroon between February and April 2012. Eleven focus group discussions (with a total of 107 participants) were carried out among adult community members, while 72 in-depth interviews included health workers, non-government organisation staff and local community leaders. Data were collected in English and pidgin, translated where necessary into English, transcribed and coded following themes.</p>

<p><strong>RESULTS: </strong>Many community members had some understanding of informed consent, probably through exposure to agricultural research in the past. Participants described a centralised permission-giving structure in their communities, though there was evidence of some subversion of these structures by the educated young and by women. Several acceptable routes for approaching the communities were outlined, all including the health centre and the Fon (traditional leader). The importance of time spent in sensitizing the community and explaining information was stressed.</p>

<p><strong>CONCLUSIONS: </strong>Respondents held relatively sophisticated understanding of consent and were able to outline the structures of permission-giving in the community. Although the structures are unique to these communities, the role of certain trusted groups is common to several other communities in Kenya and Ethiopia explored using similar techniques. The information gained through Rapid Ethical Assessment will form an important guide for future studies in North West Cameroon.</p>
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