Community gatekeepers and the conundrum of confidentiality and coercion

Sunu Thomas has described a research study in which she gained access through a community health worker to members of the community seeking treatment for infertility. One of the research participants who had undergone such a sensitive treatment and her family were concerned that the community health worker's presence during the interview would breach the confidentiality of their health information. In this commentary, I will discuss the issues of balancing accessibility versus confidentiality, and of coercion in the process of approaching community members through gatekeepers of the community.