From Research Subject to Knowledge Holder: Rethinking Who Leads Migrant Health Research

Migrant communities have long been studied, surveyed, and analysed by public health researchers, yet they have rarely been the ones asking the questions, steering the funding, or signing the papers. A reflective commentary published in the International Journal for Equity in Health argues that this imbalance is no longer defensible, and that the next stage of migrant health research must move beyond participation and co-production towards something more radical: epistemic justice and migrant-centred governance. Written by Maria Gabriela Uribe Guajardo of the Leeder Centre for Health Policy, Economics and Data at the University of Sydney, the paper traces a personal and professional journey from being a migrant navigating unfamiliar health and social systems to becoming a researcher who deliberately positions migrant leaders as experts, co-authors, and decision-makers in her own research program.

The central claim of the commentary is deceptively simple but institutionally disruptive. Participatory and co-produced approaches are now well established in migrant health research, supported by a proliferation of frameworks explaining how to conduct research with rather than on migrant communities. Yet, as Uribe Guajardo documents, real-world stories of co-creation remain inconsistently reported and tend to concentrate in the operational aspects of projects, such as recruitment and data collection, rather than in agenda-setting, analysis, leadership, dissemination, or decision-making. Research continues to be conducted predominantly on migrants rather than with migrants as equal partners in knowledge production. The paper argues that without changing who holds authority over knowledge, existing patterns of epistemic marginalisation will simply be reinforced.

Epistemic justice, a concept drawn from philosophy and increasingly applied in decolonial health scholarship, sits at the heart of the argument. In this framing, epistemic justice means enabling marginalised researchers and communities to think about and analyse their own experiences in ways that value and appropriately recognise those experiences, particularly when those interpretations clash with dominant, institutionally sanctioned discourses. Applied to public health, it requires challenging the traditional hierarchies that privilege academic and institutional expertise while marginalising lived expertise. Uribe Guajardo contends that migrants should be recognised not merely as research participants or beneficiaries, but as legitimate knowers whose knowledge is systematically incorporated into decision-making, and as leaders, agenda-setters, and producers of public health evidence.

The evidence for this argument comes from an evolving program of research spanning three domains: health and social care integration, public health emergency preparedness, and international collaborations with migrant communities, frontline workers, and researchers. In the earliest phase, the work focused on understanding and strengthening the systems that support migrants in Sydney, Australia, before shifting attention to who holds power within those systems. Studies of policy mechanisms for integrating health and social care for culturally and linguistically diverse communities identified how governance arrangements, partnerships, workforce models, and service coordination could support more integrated responses, while also exposing persistent fragmentation across sectors. Related work on data sharing found that information exchange between sectors remained limited, hampered by inadequate governance, funding structures, and organisational capacity to meet migrant communities’ needs.

These early findings pointed to a structural gap that goes beyond service delivery. Even where integration models made progress, community representatives, migrants themselves, were rarely formally embedded in the health or social care systems that shape research, policy, and practice affecting their lives. The research concluded that effective migrant responsiveness depends not only on how services are delivered, but on the policy infrastructures that enable organisations to work together through shared governance, including clearly embedded community decision-making, information flows, and resources. Meaningful and equitable integration of migrant voices in research, policy, and practice, the paper notes, remains low, and researchers have yet to challenge the system in sustainable ways.

A second strand of the commentary examines the relational infrastructure that underpins any genuine shift in power. Relationships and partnerships, both formal and informal, proved decisive throughout the research program, and never more so than during the COVID-19 pandemic. During the crisis, these networks were crucial in translating health and public information, facilitating access to health and social services, identifying emerging needs, and supporting communities through successive waves, including the Delta phase in Sydney’s diverse ethnic communities. Policymakers contributed insight into system-level priorities and constraints; service providers described the practical realities of implementation; and community-led organisations and migrant volunteers illuminated how policies and services are actually experienced on the ground. Bringing these perspectives together produced a more comprehensive understanding of the barriers and opportunities for equity than any single vantage point could offer.

Yet this relational work carries a cost that academic systems rarely acknowledge. Meaningful engagement with migrant representatives requires significant investments of time, trust, and relationship-building, and formal institutions must in turn develop trust in community-led organisations and individuals. Building partnerships across health, social care, and community sectors involved ongoing communication, repeated engagement, coordination of diverse interests, and a commitment to understanding stakeholder priorities beyond the immediate objectives of crises or funded projects. Uribe Guajardo is candid that this invisible labour sits outside traditional measures of academic productivity, even though it is essential for producing evidence that is relevant, actionable, and capable of supporting system-wide change. In her account, the partnerships became both a mechanism for generating evidence and an outcome in themselves, fostering connections that support ongoing collaboration and contribute to more integrated, responsive, and inclusive systems.

The commentary also offers a technical account of what co-production actually requires in migrant health research, and where it most often falls short. Positionality must be acknowledged first, followed by deliberate trust-building with communities and the creation of spaces that value lived experience while avoiding colonising narratives and frameworks. Co-production, the paper argues, often begins before co-production formally starts: engaging and getting to know migrant leaders before a grant application or project is developed allows researchers to leverage fully formed relationships rather than assembling community panels as an afterthought. Recognising communities as legitimate knowledge holders and contributors, including as authors on publications, creates a concrete shift towards epistemic justice. In Uribe Guajardo’s own program, forming formal governance structures in which migrant representatives formally drive the research, including through reimbursement, strengthened knowledge generation and helped ensure the research was not positioned for epistemic extraction, while giving back to the community in ways the community itself chose to define.

Importantly, the paper warns against a subtle failure mode: rejecting non-traditional narratives simply because they do not fit conventional research conventions. Instead, research approaches should prioritise and accommodate diverse forms of knowledge, including those grounded in lived experience, culture, and community practice, which may require challenging, adapting, or rejecting colonising frameworks that fail to align with the realities and priorities of participating communities. The commentary extends this logic to how success itself is measured. Existing governance and research systems frequently rely on institutionally determined indicators, such as academic outputs, that overlook what communities value. Shared governance, by contrast, creates space for communities to participate not only in identifying problems but in defining desired outcomes, including cultural expression, social connectedness, and self-determination.

The destination of this journey, Uribe Guajardo argues, is a model in which reciprocity and sustained engagement are not ancillary to governance but constitute governance itself. Relational infrastructure, encompassing long-term partnership building, shared accountability, and ongoing investment in community relationships, is a critical yet frequently undervalued component of shared governance; without it, participation risks becoming symbolic rather than transformative. She also cautions against framing migrants solely through narratives of vulnerability and disadvantage: while attention to structural inequities remains essential, shared governance requires simultaneous recognition of migrant agency, creativity, resilience, resistance, and leadership. The commentary distils the conceptual ladder that the field must climb: collaboration concerns relationships and partnerships, co-production concerns meaningful contributions to research and practice, epistemic justice concerns the recognition of migrants as legitimate knowers, and governance concerns authority, power, and decision-making. Viewed this way, the next evolution of migrant health research lies not in strengthening participation or co-production alone, but in advancing institutionally embedded models of migrant-centred governance, with these processes reported as outcomes of the research itself. The result, the paper suggests, would be public health research, policy, and practice that are more equitable, accountable, and responsive to the communities they claim to serve.

Subject of Research: Epistemic justice and migrant-centred governance in public health research

Article Title: Leading by example: a migrant health researcher’s journey from participation to epistemic justice and migrant-centred governance in public health research

Article References: Leading by example: a migrant health researcher’s journey from participation to epistemic justice and migrant-centred governance in public health research. (n.d.). https://doi.org/10.1186/s12939-026-03055-y

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03055-y

Keywords: migrant health, epistemic justice, co-production, participatory research, public health, health equity, shared governance, community engagement, health and social care integration, decolonising research, COVID-19, research leadership