Ethical considerations of phone-based interviews from three studies of COVID-19 impact in Bihar, India

Karima Khalil; Priya Das; Rochana Kammowanee; Deepika Saluja; Priyanjali Mitra; Shamayita Das; Dipwanita Gharai; Dinesh Bhatt; Navneet Kumar; Samuel Franzen

doi:10.1136/bmjgh-2021-005981

Ethical considerations of phone-based interviews from three studies of COVID-19 impact in Bihar, India

BMJ Glob Health. 2021 Aug;6(Suppl 5):e005981. doi: 10.1136/bmjgh-2021-005981.

Authors

Affiliations

¹ Software and Gender, Oxford Policy Management, New Delhi, India karimahkhalil@gmail.com.
² Health System Software and Gender, Oxford Policy Management, New Delhi, India.
³ Sociology, University of Chicago Division of the Social Sciences, Chicago, Illinois, USA.
⁴ Software and Gender, Oxford Policy Management, New Delhi, India.
⁵ Training and Survey Operations, Oxford Policy Management, New Delhi, India.
⁶ Training and Survey Operations, Oxford Policy Management, Oxford, UK.
⁷ Monitoring and Evaluation, Health Portfolio, Oxford Policy Management, Oxford, UK.

Abstract

Phone-based interviews present a range of ethical challenges, including how to ensure informed consent and privacy and maintain confidentiality. Our paper presents conceptual and practical ethical considerations taken into account across three telephone studies on the impact of COVID-19 conducted following India's nationwide lockdown imposed in March 2020. Two studies captured COVID-19 response impact on primary-level Reproductive Maternal Neonatal and Child Health (RMNCH) services and on provider wellness, respectively. The third study focused on how the gendered experience of COVID-19 and the state's response to control transmission impacted women's lives, focusing on health services, livelihood, entitlements and social change, by interviewing individual women. The ethical challenges as well as the advantages of digital data collection are presented with recommendations for low-resource settings. Ethical considerations included the above challenges as well as avoiding posing unreasonable time burden on the respondents, framing questions with a gendered lens, considering emotional states given contagion concerns and economic uncertainties, and redressing pandemic-induced distress. Using scripted Hindi was challenging in consent-taking, as was protecting household respondents' privacy and confidentiality during lockdown. Unanticipated positive ethical implications of using a telephone approach included providing respondents privacy and catharsis, respondents choosing convenient interview times and affording health providers more privacy than institutional inperson interviews. Internalising empathy, respect and appreciative enquiry are key to establishing rapport in the absence of prior relationships. Institutional Review Board (IRB) time limits on call duration need to be flexible to allow for 'active listening' and empathetic enquiry in surveys on the impact of COVID-19.

Keywords: COVID-19; health policy; health services research; health systems evaluation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Child
Communicable Disease Control
Female
Humans
India
Infant, Newborn
Privacy
SARS-CoV-2