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Some Complexities of Seeking Access for Ethnographic Research in Health-Care Institutions

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  • Lisa Kowalchuk

Abstract

A growing body of scholarship reflects on the complexities and challenges of attaining access for ethnographic research. Some of these are particular to formal organizations, including the understudied gatekeeping role of institutional review boards (IRBs) in organizations that provide state services to vulnerable populations. This article examines access challenges encountered in a project to conduct observation and photography of the work routines of nurses in El Salvador’s public health-care system. An examination of the contrasting responses and outcomes of access negotiation with several different sets of authorities in the health-care system reveals that even in large bureaucratic research sites with formally structured gatekeeping roles, rapport developed over time with influential individuals can shape access negotiation outcomes, partly through informal social relationships. The findings also show that that without technically denying access, IRBs may set conditions that effectively make the “research bargain†too costly. Also suggested by the comparative analysis are organizational (hospital) and system (Health Ministry and public health-care system) factors that may make authorities at different levels more or less open, protective, or defensive in their stance toward cooperating with academic researchers. The article concludes by signaling the need for ongoing discussion on what social researchers can expect from IRBs, especially in developing countries.

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  • Lisa Kowalchuk, 2019. "Some Complexities of Seeking Access for Ethnographic Research in Health-Care Institutions," SAGE Open, , vol. 9(2), pages 21582440198, June.
    • Handle: RePEc:sae:sagope:v:9:y:2019:i:2:p:2158244019857860
    DOI: 10.1177/2158244019857860
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    1. van der Geest, Sjaak & Finkler, Kaja, 2004. "Hospital ethnography: introduction," Social Science & Medicine, Elsevier, vol. 59(10), pages 1995-2001, November.
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