Salway et al. BMC Public Health 2011, 11:514 http://www.biomedcentral.com/1471-2458/11/514 research funding and ethical approval processes. User participation in health research is supported by large numbers of third sector organisations as well as a net- work of state-funded organisations - so-called LINks - set up to promote and support the involvement of local people in the commissioning of health and social care services, and the national-level body, INVOLVE, that has an explicit remit to promote the empowerment of the public to become involved in research [70]. The importance of such involvement is particularly empha- sised within the field of migration, ethnicity and health research, with many researchers and consumer organisa- tions arguing that user participation is a fundamental principle of good research in this area [71,72]. In Canada too, there is widespread expectation of service user involvement in healthcare and a well-established research tradition of user involvement with state fund- ing encouraging so-called ‘collaborative or engaged scholarship’ through the provision of grants for commu- nity-university partnerships [73,74]. As in the UK, such approaches have been used widely with community groups representing marginalised populations, particu- larly indigenous populations [75]. As such, our Canadian and UK researchers had the advantage of well-established networks and past experi- ence of engaging service users and community members in their research; a significant contrast to the German situation where such involvement is much less well devel- oped and few structures exist to support inclusive or parti- cipatory research designs. These divergent research contexts were evident in the differential make-up of parti- cipants to the three in-country workshops held as part of the project. In the UK and Canada representatives of ser- vice user organisations as well as migrant/minority women who had recently experienced maternity services were recruited to the workshops and Project Advisory Groups relatively easily. However in Germany, the lack of pre- existing structures and short time frame made it difficult to identify migrant/minority women willing to engage with the study in this way and other strategies were adopted, including a series of individual interviews, to gain insights from these important stakeholders. While the differential research contexts prompted debate and offered the potential for learning across the teams, it also added complexity. While the UK and Canadian work would be importantly shaped by the per- spectives and priorities of migrant/minority women themselves, such engagement would be much less in Germany. There was no easy solution to this problem, but it did suggest the need for careful and ongoing reflection and documentation of the ways in which such user involvement shaped the generation, interpretation and presentation of data. Furthermore, it raised the question of whether and how migrant/minority service Page 10 of 13 users participating in the UK and Canadian parts of the study should or could be involved in the generation of knowledge relating to Germany and the broader integra- tion of data across the countries alongside members of the research team. Clearly, the extent to which these aspects of opera- tional structure are considered problematic relates fun- damentally to one’s epistemological and political stance. For those researchers who argue in favour of user invol- vement and diversity of research teams both in terms of (i) generating more authentic and useful findings, and (ii) the democratisation of the research process, a cross- national design that cannot ensure these elements, is cause for concern. Indeed, some researchers suggest we should be wary of research accounts that have not been adequately informed by the experiential knowledge of those who are the subject of the research [76]. Summary The discussion above has illustrated a number of ways in which our cross-national comparative approach pre- sented both opportunities and significant challenges to researching migrant/minority maternal health. On the positive side, it would appear that cross- national comparative research can enhance the ethical and scientific rigour of research into migration, ethnicity and health by: forcing researchers to engage in both ideological and methodological critical reflexivity; increasing awareness that the concepts and meth- ods employed by researchers and the ‘knowledge’ so generated are intimately bound up with social and historical relations and do not simply reflect an external ‘reality’; engendering an appreciation of the need to situate analyses of health within the wider socio-political setting; helping researchers (and research users) to see familiar issues from new perspectives and thereby encouraging innovative solutions; encouraging researchers to frame research in ways that move beyond fixed ‘groups’ and ‘categories’ to look at processes of identification, inclusion and exclusion; encouraging a multi-level analysis that explores local, national and global influences on migrant/min- ority health; and encouraging conceptual and methodological devel- opment through the exchange of ideas and experi- ence between diverse research teams. However, it should also be recognised that cross- national comparative research in migration, ethnicity