Internet research and the implications for ethical research practice

The Internet has extended the opportunity for researchers to investigate human actions and interactions. This study aims to critically examine the various ways that ethical considerations associated with Internet-Mediated Research (IMR) are constructed as a social reality by Australian Human Research Ethics Committee (HREC) and the implications for research practice. This project builds on research undertaken in the United States by Buchannan and Ess (2009) which discussed US Institutional Review Boards (IRBs) and the state of Internet research ethics. An explanatory sequential mixed design, consisting of two distinct phases was conducted (Creswell & Plano Clark, 2003). Quantitative data was collected and analysed in the first phase (Study 1) via an online survey of Australian Human Research Ethics Committee members from March to April 2016. Semi-structured interviews (n=3) were then conducted with Chairpersons of Australian Human Research Ethics Committees (Study 2) and analysed to further explain and clarify results found in the first data collection phase. Results of current processes and practices of Australian HRECs obtained in Study 1 were found to be similar to those reported by US IRBs and suggested that ethical review boards may be ill-equipped and ill-trained to navigate the review of IMR protocols. However, the addition of a qualitative overlay via the Australian HREC Chairperson’s interviews in Study 2 provided additional detail that suggested that reviewing IMR protocols is more complex than previously understood. Thematic analysis of the interview data identified that the ethical review of IMR protocols is thoroughly undertaken via a principle-based process as it is not viewed as being different to any other research method or tool. Additionally, ethical responsibility in this space is shared amongst the HREC, researchers, and participants themselves

\u27Everybody has settled in so well\u27: How migrants make connections and build social capital in Geelong

Australian and Victorian Government policies encourage settlement&nbsp;in regional areas for international migrants, refugees and internal&nbsp;migrants. Migrants to regional areas are diverse in terms of their&nbsp;area or country of origin, skills and occupation, family status&nbsp;and other demographic characteristics. The regional cities to&nbsp;which they migrate are also varied in terms of their community&nbsp;resources, social and cultural capital. The objective shared by all&nbsp;of these cities is for migrants to engage successfully with their&nbsp;new communities. Just how this occurs is the subject of debate&nbsp;and a lack of clarity. This therefore calls for a sound, theoretically&nbsp;informed understanding of how employers and community groups&nbsp;(formal and informal) can effectively assist migrants to make&nbsp;social connections in regional cities, and practical strategies which&nbsp;respond to these insights. The well-established social determinants&nbsp;of health tell us that the more socially included, connected and&nbsp;stable workforce and their families are, the better will be their&nbsp;physical and mental health and wellbeing.People in Australia generally move to live near family and friends;&nbsp;for better access to work or work opportunities; or to live in an&nbsp;attractive neighbourhood. Policies and programs intended to assist&nbsp;with settlement tend to be short term and project based. Good&nbsp;practice in assisting migrants make social connections however&nbsp;is long term and embedded into the community. Workplaces and&nbsp;community groups that are already established, and groups that&nbsp;migrants or others tend to form naturally, are good examples of&nbsp;such best practice. Workplaces, local government, institutions&nbsp;such as schools, community spaces and other organisations can&nbsp;also assist in the settling in process and can complement formal&nbsp;and informal community groups, once a sound evidence base is&nbsp;established.This is the second paper to emerge from a research project&nbsp;running over 2011-2012 at the Alfred Deakin Research Institute&nbsp;(ADRI), Deakin University in Geelong. The first Working Paper&nbsp;(No. 32) (Jackson et al., 2012) located the research theoretically.&nbsp;This second Working Paper will report on the research itself,&nbsp;its methods and outcomes as well as policy implications. The&nbsp;first section of this paper will briefly outline the project before&nbsp;considering those who have migrated to Geelong in the past two&nbsp;to five years: to investigate why they moved to Geelong; how&nbsp;they made connections and with whom; and, what was the value&nbsp;of those connections (Section 2). The third section of the paper&nbsp;examines how employers, non-government organisations (NGOs)&nbsp;and other facilitators effectively assist migrants to make social&nbsp;connections. The fourth and fifth sections look at the barriers to&nbsp;making connections but also those things &ndash; organisation and&nbsp;policies - that facilitated settling in. Section six summarises the&nbsp;findings and makes a series of policy recommendations for&nbsp;individuals, organisations and government on how to better the&nbsp;prospects for migrant in regional centres.</div

Supervision of community peer counsellors for infant feeding in South Africa: an exploratory qualitative study

<p>Abstract</p> <p>Background</p> <p>Recent years have seen a re-emergence of community health worker (CHW) interventions, especially in relation to HIV care, and in increasing coverage of child health interventions. Such programmes can be particularly appealing in the face of human resource shortages and fragmented health systems. However, do we know enough about how these interventions function in order to support the investment? While research based on strong quantitative study designs such as randomised controlled trials increasingly document their impact, there has been less empirical analysis of the internal mechanisms through which CHW interventions succeed or fail. Qualitative process evaluations can help fill this gap.</p> <p>Methods</p> <p>This qualitative paper reports on the experience of three CHW supervisors who were responsible for supporting infant feeding peer counsellors. The intervention took place in three diverse settings in South Africa. Each setting employed one CHW supervisor, each of whom was individually interviewed for this study. The study forms part of the process evaluation of a large-scale randomized controlled trial of infant feeding peer counselling support.</p> <p>Results</p> <p>Our findings highlight the complexities of supervising and supporting CHWs. In order to facilitate effective infant feeding peer counselling, supervisors in this study had to move beyond mere technical management of the intervention to broader people management. While their capacity to achieve this was based on their own prior experience, it was enhanced through being supported themselves. In turn, resource limitations and concerns over safety and being in a rural setting were raised as some of the challenges to supervision. Adding to the complexity was the issue of HIV. Supervisors not only had to support CHWs in their attempts to offer peer counselling to mothers who were potentially HIV positive, but they also had to deal with supporting HIV-positive peer counsellors.</p> <p>Conclusions</p> <p>This study highlights the need to pay attention to the experiences of supervisors so as to better understand the components of supervision in the field. Such understanding can enhance future policy making, planning and implementation of peer community health worker programmes.</p

Supervision of community peer counsellors for infant feeding in South Africa: an exploratory qualitative study

<p>Abstract</p> <p>Background</p> <p>Recent years have seen a re-emergence of community health worker (CHW) interventions, especially in relation to HIV care, and in increasing coverage of child health interventions. Such programmes can be particularly appealing in the face of human resource shortages and fragmented health systems. However, do we know enough about how these interventions function in order to support the investment? While research based on strong quantitative study designs such as randomised controlled trials increasingly document their impact, there has been less empirical analysis of the internal mechanisms through which CHW interventions succeed or fail. Qualitative process evaluations can help fill this gap.</p> <p>Methods</p> <p>This qualitative paper reports on the experience of three CHW supervisors who were responsible for supporting infant feeding peer counsellors. The intervention took place in three diverse settings in South Africa. Each setting employed one CHW supervisor, each of whom was individually interviewed for this study. The study forms part of the process evaluation of a large-scale randomized controlled trial of infant feeding peer counselling support.</p> <p>Results</p> <p>Our findings highlight the complexities of supervising and supporting CHWs. In order to facilitate effective infant feeding peer counselling, supervisors in this study had to move beyond mere technical management of the intervention to broader people management. While their capacity to achieve this was based on their own prior experience, it was enhanced through being supported themselves. In turn, resource limitations and concerns over safety and being in a rural setting were raised as some of the challenges to supervision. Adding to the complexity was the issue of HIV. Supervisors not only had to support CHWs in their attempts to offer peer counselling to mothers who were potentially HIV positive, but they also had to deal with supporting HIV-positive peer counsellors.</p> <p>Conclusions</p> <p>This study highlights the need to pay attention to the experiences of supervisors so as to better understand the components of supervision in the field. Such understanding can enhance future policy making, planning and implementation of peer community health worker programmes.</p

Explaining household socio-economic related child health inequalities using multiple methods in three diverse settings in South Africa

Background: Despite free healthcare to pregnant women and children under the age of six, access to healthcare has failed to secure better child health outcomes amongst all children of the country. There is growing evidence of socioeconomic gradient on child health outcomes Methods: The objectives of this study were to measure inequalities in child mortality, HIV transmission and vaccination coverage within a cohort of infants in South Africa. We also used the decomposition technique to identify the factors that contribute to the inequalities in these three child health outcomes. We used data from a prospective cohort study of mother-child pairs in three sites in South African. A relative index of household socioeconomic status was developed using principal component analysis. This paper uses the concentration index to summarise inequalities in child mortality, HIV transmission and vaccination coverage. Results: We observed disparities in the availability of infrastructure between least poor and most poor families, and inequalities in all measured child health outcomes. Overall, 75 (8.5%) infants died between birth and 36 weeks. Infant mortality and HIV transmission was higher among the poorest families within the sample. Immunisation coverage was higher among the least poor. The inequalities were mainly due to the area of residence and socioeconomic position. Conclusion: This study provides evidence that socio-economic inequalities are highly prevalent within the relatively poor black population. Poor socio-economic position exposes infants to ill health. In addition, the use of immunisation services was lower in the poor households. These inequalities need to be explicitly addressed in future programme planning to improve child health for all South Africans

Free formula milk in the prevention of mother-to-child transmission programme: voices of a peri-urban community in South Africa on policy change.

BACKGROUND: In 2001, South Africa began implementing the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme. This programme included distribution of free formula milk for infants up to 6 months of age at all public health facilities. Effective from 1 January 2011, KwaZulu-Natal became the first province to phase out free formula milk from its PMTCT programme. On 23 August 2011, the South African National Department of Health adopted promotion of exclusive breastfeeding as the national infant feeding strategy and made a decision to withdraw free formula milk from the PMTCT programme. OBJECTIVE: To explore the perceptions and understanding of households at community level on the policy decision to phase out free formula milk from the PMTCT programme in South Africa. METHODS: An exploratory qualitative study was conducted amongst women enrolled in a community randomized trial known as Good Start III. Focus group discussions were held with grandmothers, fathers and teenage mothers; and in-depth interviews were performed with HIV-positive and HIV-negative mothers. Data were analysed using thematic analysis. RESULTS: Identified themes included: (1) variations in awareness and lack of understanding of the basis for the policy change, (2) abuse of and dysfunctional policy as perceived reasons for policy change and (3) proposed strategies for communicating the policy change. CONCLUSION: There is an urgent need to develop a multifaceted communication strategy clearly articulating the reasons for the infant feeding policy change and promoting the new breastfeeding strategy. The communication strategy should take into account inputs from the community. With a supportive environment and one national infant feeding strategy, South Africa has an opportunity to reverse years of poor infant feeding practices and to improve the health of all children in the country

Testing together challenges the relationship': Consequences of HIV Testing as a couple in a High HIV prevalence setting in Rural South Africa

OBJECTIVE: We conducted qualitative individual and combined interviews with couples to explore their experiences since the time of taking an HIV test and receiving the test result together, as part of a home-based HIV counselling and testing intervention. METHODS: This study was conducted in October 2011 in rural KwaZulu-Natal, South Africa, about 2 years after couples tested and received results together. Fourteen couples were purposively sampled: discordant, concordant negative and concordant positive couples. FINDINGS: Learning about each other’s status together challenged relationships of the couples in different ways depending on HIV status and gender. The mutual information confirmed suspected infidelity that had not been discussed before. Negative women in discordant partnerships remained with their positive partner due to social pressure and struggled to maintain their HIV negative status. Most of the couple relationships were characterized by silence and mistrust. Knowledge of sero-status also led to loss of sexual intimacy in some couples especially the discordant. For most men in concordant negative couples, knowledge of status was an awakening of the importance of fidelity and an opportunity for behaviour change, while for concordant positive and discordant couples, it was seen as proof of infidelity. Although positive HIV status was perceived as confirmation of infidelity, couples continued their relationship and offered some support for each other, living and managing life together. Sexual life in these couples was characterized by conflict and sometimes violence. In the concordant negative couples, trust was enhanced and behaviour change was promised. CONCLUSIONS: Findings suggest that testing together as couples challenged relationships in both negative and positive ways. Further, knowledge of HIV status indicated potential to influence behaviour change especially among concordant negatives. In the discordant and concordant positive couples, traditional gender roles exposed women’s vulnerability and their lack of decision-making power.Department of HE and Training approved lis

Beyond greed: why armed groups tax

Based on a review of the diverse practices of how armed groups tax, we highlight that a full account of why armed groups tax needs to go beyond revenue motivations, to also engage with explanations related to ideology, legitimacy, institution building, legibility and control of populations, and the performance of public authority. This article builds on two distinct literatures, on armed groups and on taxation, to provide the first systematic exploration of the motivations of armed group taxation. We problematize common approaches toward armed group taxation and state-building, and outline key questions of a new research agenda