[Micky Hingorani]

I think, at one level, the overall objective of the study or trial will help inform what stakeholders and what type of relationship you are seeking with each stakeholder. Through such activities as community mapping one might get to learn in-depth about the research site community, who are the influential people, what organisations and what services do they provide, what issues or challenges the community is confronted with, who is doing what already differently or similar to what you want to do. So for us the basis is what the the donors are giving money for, what the study wants to achieve and what we learn from the research site communities that help the research team determine the importance of involving one stakeholder over the other.

[Micky Hingorani]

stakeholder selection is a vigorous activity that should involve the whole study team. The team has to carefully select the people who affect or will be affected by the trial and measure the input, influence and area of expertise they possess and how their participation will impact the trial and its study area. therefore to the nature of relationship with each stakeholder is guided by the level of investment and influence they have on the trial
The importance is also measured on the above i.e
1. expertise
2. influence
3. impact on the study objectives of the trial
4.interests and perspectives
5. position in society/ level of authority etc

[Micky Hingorani]

Stakeholder mapping is critical for us to be able to identify or determine the involvement of a particular stakeholder. It could be political buy in or it could be just an influential stakeholder. Most of the time we would determine the importance of a stakeholder around key issues such as approval to conduct the study. In community level it would be to gain access to local clinic or community.

[Micky Hingorani]

I agree with you Siyabonga political buy in is also critical in our context because if the community perceives the research team or institution as more aligned with a group of people favoring one political party over the other it might be difficult to work in that context. So sensitivity to such issues is quite critical for us.

[Micky Hingorani]

I agree with you

[Micky Hingorani]

In order to determine the type of relationship you have, you must understand the important of the 4 quadrants listed under the GPP BluePrint. You have to determine the stakeholder’s interest level of how they want to be involved and if they’re interested, give them the steps and resources to take in their inolvement.

Based on common sense, its the one that speak up during the involvement that can be identified as the stakeholder to go to.

[Micky Hingorani]

I’ve been involved with participating in initial outreach for research purposes and I know for a fact that social media and contacting different community organizations that are involved in reaching out to the certain demographic is the best way to get different stakeholders to understand your research and support the activities as well.

[Micky Hingorani]

The starting point of GPP is first identify and map local key stakeholders. Ensure that relavant stakeholders are represented through out the research process. We believe that is important for us to know who are the stakeholders and how do they influence or can be affected by the trail. All this can help us determine the kind of relationship we need to build which each stakeholder.Building a relationship with potential stakeholders make sure you have mutual understanding and ensure that the population to be recruited,trail participant and people living in that surrounding area their interest are represented.

[Micky Hingorani]

we determine the type of relationship with a particular stakeholder firstly by mapping the the local stakeholders so that we determine the relevancy of the level of implementation of a given trial .this might be at the local level and we have got to determine the importance of the stakeholders at another level for instance at the district level. All these stakeholders are important because their contribution towards research activities differs.Let me share this living example when we were still doing a PrEP study among sero- discordant couples we had a powerful influential Haji ( a Moslem man) very rich , politically stable always unopposed ,he had four the wives all were negative and he was HIV positive. But when this trial came up ,he came out to tell the public that it is very possible to be in marriage while you are sero – discordant people were shocked they started testing with their wives many couples didn’t know that they were in such relationship .So Haji helped to reduce on cases of domestic violence,so why am i saying all this he was a politician but very helpful in research campaigns.
We need all levels of stakeholders so longer as they understand the objectives of the study and show their willingness to participate and implement them. But we are also conscious because some time back on our CAB some members were using the board as their political platform so we now mindful of such stakeholders.

[Micky Hingorani]

I think a comprehensive mapping of all potential stakeholders who may be relevant to our trial would be the first step, through which we can gain a better understanding of who are the potential stakeholders in the community and in a broader range. After mapping all relevant stakeholders, it is important to also evaluate (1) their knowledge and understanding of the upcoming trial, (2) their attitudes towards to trial and their willingness to participate in the trial and collaborate with us, (3) if there is any existing relationship between us and each stakeholder, what has been done before and what could be improved, (4) how our trial would potentially affect them, (5) what perspectives and expertise each stakeholder could potentially contribute to the design and implementation of our trial. We would also like to have some discussion with those potential stakeholders to share our goals and also collect their suggestions in terms of what relationship with us that they are expecting.

While it is our goal to seek an overall healthy, beneficial and mutual trust relationship with all stakeholders, we also realize that our specific goal with different stakeholders actually varies. For instance, we know from our previous experience that stakeholders such as local policy makers and officials in the ministry of health may hold a rather passive attitude towards our trial among MSM community due to the sensitive nature of HIV/AIDS and MSM issue. As such, it is very important to build a good relationship with them because their opposition of the trial or unwillingness to collaborate will possibly lead to postpone of activities or increase difficulties in implementation. So our goal with them is to try to gain their understanding of this trial and to generate their buy-in as much as we can.

[Micky Hingorani]

Hi Yumeng. You brought a very good point. Its very important evaluating if all potential stakeholders have common understading and their expecatation willing with the trial.

[Micky Hingorani]

We determine the importance of involving one stakeholder versus another by maping local stakeholders in order to identify the local stakeholder that will be relevant to the trial. The selected stakeholder should be representative of the trial population and they should meet the requirements of the research agenda and needs. The research team and the stakeholder ‘s relationship is very much important and we seek a meaningful and mutual benefiting with our stakeholder and such is determined by considering the study needs.

[Micky Hingorani]

Firstly we base the targeted stakeholder based on the needs of the study i.e. do we need a shelter for abused women, do we need legal services,etc. We then communicate with each identified stakeholder so as to build rapport and we also invite them to visit our clinic so we can form an understanding and know their criteria for participant acceptance so we can refer according to their capacity. In summary, all stakeholders are identified and relationships are ormed based on the study needs.

[Micky Hingorani]

Firstly it is important to notify stakeholders of the limit in resources. We will then meet at areas convenient to the stakeholders so as to cut transportation costs. There is always material that is free for all within the internet that we can use for our activities. we also make the use of social media groups where we can debate and share suggestions through personalized profiles so we can identify and keep track.

[Micky Hingorani]

Based on the stakeholder priority grid described in the GPP Blueprint, it would be desirable to have all our stakeholders fall under Quadrant 1, having high interest and high influence in the research project and we working in close partnership with them. But this isn’t the case. In the PrEP demonstration project, Nigeria, we certainly do have the full spectrum of relationships – partner, involve, inform and consider – with our different stakeholders in our research project.
In order to determine the type of relationship we are seeking with our stakeholders, there are a number of approaches we take. For example, when drafting the list of stakeholders, we know those stakeholders we had engaged in the past, the type of relationships we had with them and the lessons learned in terms of how important they were in the previous trial(s), how much influence they had and so on. Taking these into consideration, we can determine whether to maintain that same level of engagement or if we need a different level. But I think this will depend on our research objectives and agenda. For example, in the previous Nigerian HIV projects such as the oral tenofovir trial and the microbicide trials, the populations of men who have sex with men (MSM) and female sex workers were actively engaged as partners but for this current PrEP project, not so much because the objectives are different as well as the target population which is serodiscordant heterosexual couples.
The role stakeholders (whether individuals, groups e.t.c.) play in society help in determining their importance and the type of relationship we seek with them. For instance some stakeholders are very involved in advocacy and inform policy. Some are activists and may have strong grassroot influence for instance on social media. Such stakeholders will be given high priority either in quadrant 1 (partner) or quadrant 2 (involve) relationships.
I also think that for all potential stakeholders, we have to determine their knowledge and perspectives about the research goals and objectives. This is because poor knowledge or misconceptions about the research may initially make some stakeholders indifferent or even antagonistic towards the research. This is where formative research activities like focus groups, key informant interviews and survey early in the planning stage and stakeholder advisory mechanisms throughout the research process come in.
We need to provide opportunities for stakeholders to ask questions, raise concerns and express their expectations about the research. Prioritizing stakeholders should be dynamic because the influence, values or even the interest of stakeholders may change as the research progresses and stakeholder engagement should evolve to address these changes when necessary.