Telephony and trade-offs in fieldwork with the ‘unreached’: on the conduct of telephonic interviews with indigenous study participants in southern India

When COVID-19 hit India, a qualitative research study had been underway the southern state of Kerala, to understand the perspectives of the front-line health workers and the Kattunayakan tribal community towards health service utilisation. This community is relatively underserved, and a great deal of our emphasis was on understanding health system barriers experienced on both demand and supply side. COVID-19 showed us that these barriers pertain not just to heath systems, but also to the conduct of health research. We completed fieldwork in one hamlet before lockdowns were announced and changed our fieldwork approach for the remaining two different hamlets. The main change was a shift to the use of mobile telephony for fieldwork. This technological shift necessitated substantial changes in the design of fieldwork, the scope of our inquiry, as well as the composition and power dynamics within our team. First, adjusting to technology-driven fieldwork posed restrictions but also enhanced the agency and comfort of participants in some ways. Study design changes attributable to COVID-19 restrictions were brought about, but also gave us critical insight into the impact of COVID-19 and related outbreaks. There was de fact greater reliance on community researchers, which meant we ceded control to the community itself, upsetting typical research power dynamics, which can be quite top-down. We present these methodological reflections for wider consideration.