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A Canadian Researcher Responding to the COVID-19 Pandemic in Low- and Middle-Income Countries

In response to the COVID-19 pandemic, researchers have been called to investigate medical, social, and policy measures to counter the detrimental impacts of the pandemic. In this article, a Community-Based Research Canada board director and University of Waterloo assistant professor, Dr. Warren Dodd was interviewed over the phone by Janna Martin, CBR Canada Secretariat Support. Below, Warren discusses his involvement in a research project addressing the challenge of low- and middle-income countries (LMICs) to care for their populations with an under financed health system and limited resources for health care workers.

Thanks for making the time for this interview! Could you tell me how this project began?

WD: In February, the government of Canada announced $27M in initial funding available for coronavirus research (see news release). This prompted Dr. Xiaolin Wei, a faculty member at the University of Toronto’s Dalla Lana School of Public Health (project lead) to bring together a team that included myself, other Canadian academics, and partners in the Philippines and Sri Lanka to write a proposal. The title of our project is, Developing integrated guidelines for health care workers in hospital and primary healthcare facilities in response to COVID-19 pandemic in Low- and Middle-Income Countries (LMICs).

WD: Xiaolin and I had established partnerships several years earlier with NGOs in the Philippines, namely International Care Ministries (ICM), a faith-based organization working on poverty alleviation. Our existing partnership with ICM in the Philippines was an important reason why our proposal was successful.

Where are you at in the project?

WD: Currently, the research team and project partners in the Philippines are adapting the World Health Organization’s guidelines (to manage COVID-19 for hospitals and health-care facilities) to make them relevant for a low-resource setting. The next step is to pilot the guidelines in hospitals and health-care facilities in the Philippines. Following the pilot, an evaluation will be conducted to learn what works, what does not work, and how the guidelines can be improved. The research team is starting in the Philippines with the goal of expanding to Sri Lanka and other low and middle-income countries. The project has funding for 2 years – ending in February 2022.

What are some challenges you are facing when it comes to striving for a timely response to the pandemic, but also taking a community-based approach?  

WD: Conducting research during a global pandemic has its challenges. The work plan had to be adjusted as travel restrictions were implemented. Initially, I was hoping to go to the Philippines in May to work more closely with partners, but now it is looking unlikely that I will be able to go at all this Spring or Summer. The physical distancing of the researchers from the context where the pilot and research is taking place, means that we are limited to only involving health-care facilities that have a reliable internet connection. This unfortunately excludes facilities that are rural or remote. The research team and I are thinking critically about how to ensure that diverse voices are included in this project, given the technology limitations. We are thinking of creative ways to accomplish projects goals.

WD: In order to be successful, the project needs to be flexible about how to involve stakeholders in meaningful ways. The stakeholders in this project are physicians, nurses, and other healthcare practitioners, who are already stretched thin. We do not want to overburden our partners, but it is a tricky balance because local partner involvement is critical for the project to move forward. During this time when the researchers cannot be in person, the project is especially community-driven, as they must rely on the knowledge and expertise of partners in the Philippines. We have weekly virtual team meetings to hear updates from our colleagues in the Philippines on how the pandemic and the response to the pandemic is evolving there. We are committed to collaborating in a context of uncertainty, in order to develop relevant guidelines.

Thank-you for telling me about your research team’s response to the COVID-19 pandemic, and for allowing me to bring your story to the Community-Based Research Canada network!

WD: Thank-you! This is a very challenging time, but I am hopeful that researchers, community partners, and community organizations can continue to work collaboratively, creatively, and compassionately to achieve shared goals and to provide support.

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