Community engagement is widely recognised as an ethical and practical requirement in health research, yet there is limited clarity about how it is implemented in low- and middle-income countries. Much of the existing literature highlights the value of participation, but pays less attention to the specific processes, strategies, and mechanisms used, and to how these link to outcomes. This paper explores how community engagement is implemented in health research settings in LMICs and identifies the stages, approaches, and theoretical foundations that shape these efforts.
The study used a systematic review approach guided by PRISMA to examine how community engagement is carried out in health research in LMICs. There were three major databases that were searched for peer-reviewed articles and were published between 2011 and 2021. Although 1,389 records were initially identified, only 10 studies met the final inclusion criteria after screening. Most of these studies were led by researchers based in LMICs and covered health promotion, infectious diseases (such as malaria, HIV and tuberculosis), environmental health and primary care. In many cases, engagement was limited to informing or consulting communities, with fewer examples of genuine collaboration or empowerment. When assessed against a five-stage engagement framework, most studies did not move beyond consultation, and reporting on research quality was uneven.
In addition, the review identified several engagement methods, including workshops, focus groups, community forums, surveys, photography, digital storytelling, and creative arts activities. While these approaches created spaces for dialogue and awareness, they were often under-theorised and lacked a clear discussion of power dynamics or long-term impact. The authors argue that community engagement in LMIC research remains uneven and sometimes superficial, partly due to limited funding, inadequate training, and weak theoretical grounding. They conclude that future research should build a clearer understanding of community engagement and also improve how studies are carried out. Furthermore, community members' participation should go beyond consultation to real collaboration and shared decision-making.
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