583 Nexus of ethics and participant reimbursements in migration and health research in South Africa: the quandary of the 50 Rand note & suspicion of 1.5 litres of drinking water

Abstract OP 36: Challenges and Opportunities for Health 2, B207 (FCSH), September 5, 2025, 10:15 - 11:15 Aims This study explores the intricate nexus between ethical migration and health research practices and the use of participant reimbursements in research involving migrant populations. Conducted in Musina, the research presented here interrogates the symbolic and practical implications of offering the 50 Rand note (US$3) as monetary reimbursement to migrant participants, along with 1.5 litres of drinking water. The ethical discourse around participant reimbursement continues to provoke critical debate among researchers, ethics committees, and community advisory boards. Methods Using a multi-method approach, field insights were gained during the completion of 628 administered surveys and 64 in-depth interviews with migrant participants. Field observations, daily research team debriefs, and community workshops. The research team presented important opportunities for collective reflections on experiences in the field and the ethical dilemmas encountered. This data is drawn from research exploring cycles of gender-based violence and poor mental health among migrant populations (GEMMS), which aims to inform and develop interventions to improve the health and well-being of migrant populations in precarious contexts. Results Our approach facilitated a multidimensional understanding of the ethical dilemmas faced when undertaking research with migrants, incorporating views of participants and researchers. Findings reveal a complex landscape whereby participant reimbursements are interpreted through cultural, spiritual, and economic lenses. The 50 Rand note was both symbolically and materially significant, understood simultaneously as a gesture of goodwill and a potential source of coercion. The provision of 1.5 litres of water was treated with suspicion by some participants. Conclusions The study recommends a context-sensitive approach to participant reimbursement that foregrounds cultural context and ethical accountability. It advocates for strengthened co-design of reimbursement strategies with community input, the inclusion of ethical reflexivity in field training, daily debriefs and field reports, and urges institutions to foster dialogue on recalibrating ethical review processes for research.