Engaging Youth in Global Health Research Through Photovoice and Reflexivity: The Example of the Together Project in Dhaka, Bangladesh

Meaningful youth engagement is increasingly recognized as essential to achieving substantive and sustainable improvement in youth health globally. Although 90% of the world’s young people live in low- and middle-income countries, youth involved in shaping global health agendas continue to be predominantly from high-income countries. Calls for decolonial methodologies in global health have highlighted the need to redistribute power, yet most structurally vulnerable youth remain excluded from research. Youth-led participatory action research (YPAR), like photovoice, has enormous transformative potential for decolonizing global health and promoting health equity and, to achieve this, reflexivity can be mobilized as a methodological and analytical tool. Few examples of detailed methodologies using photovoice, participatory analysis and reflexivity have been described, which could provide guidance to conduct youth-led research in global health contexts. In this paper, we share our experience of The Together Project, a YPAR engaging youth through photovoice and reflexivity to study adolescent sexual and reproductive health and rights, a culturally sensitive topic, in Dhaka, Bangladesh. We present how we have applied reflexivity through the research as a methodological and analytical tool, how we have engaged youth and their community, and how we have used Visualizing DEPICT as our participatory analysis method. Our experience shows that it is possible to foster meaningful youth engagement in global health, even in vulnerable, resource-limited contexts, and on sensitive health challenges like sexual and reproductive health issues. Reflexivity was essential to negotiate power dynamics between researchers and youth and foster positive community engagement. Through our Youth Advisory Board, which included 10 youth co-researchers from the community, and participatory analysis, knowledge production was rooted in youth’s realities, experiences, and local context. Based on lessons learned and challenges, we propose recommendations to implement YPAR using photovoice and participatory analysis in global health.