Starter kit: Co-creation in Global Health

Introduction

Co-creation is not a single method, but a structured approach to working together, embracing differences in knowledge, experience, and power. In global health, it is used to design, adapt, and implement interventions in ways that are contextually grounded, collectively owned, and more likely to be sustained over time. 

This starter kit presents co-creation as a process that focuses on how to bring together diverse stakeholders to engage in meaningful collaboration, mutual learning, and shared decision-making throughout the lifecycle of a project. 

Rather than offering a fixed recipe, this resource supports users in making informed methodological choices. It provides practical guidance on when co-creation is appropriate, how to plan, design, and facilitate it, and how to evaluate its contribution to both process and outcomes.

PART 1: Why is co-creation important in global health

Co-creation aims to democratise research and bridge the gap between research and practice. It responds to growing public demand for meaningful engagement in research, helping ensure that health interventions are better tailored to people’s needs and circumstances.

By engaging diverse stakeholders in collaborative problem-solving, co-creation enhances participation and supports the development of contextually appropriate and sustainable solutions. It is increasingly recognised as an approach for improving the relevance, impact, and uptake of interventions, services, and policies.

Let’s start by looking at real-world examples and evidence of how co-creation can improve health interventions. As a central use case, we highlight the journey of the PartoMa Project (from pilot to scale-up) drawing on both experience and evaluation results.

What you will find in this video

	The problem of waterfall implementation
	Experience and evidence from the PartoMa project

Recommended readings

PART 2: What is co-creation in global health

Co-creation is understood as an iterative and collaborative process in which stakeholders work together across multiple stages of a project, including problem framing, design, implementation, and evaluation. 

A key feature of co-creation is that it enables meaningful interaction between co-creators, where different forms of knowledge can be exchanged, challenged, and integrated. This goes beyond consultation or engagement activities that rely primarily on individual input without collective engagement. 

Co-creation is therefore distinct from approaches that involve stakeholders only at a single point in time or in a limited advisory role. Instead, it requires deliberate design of processes that support shared sense-making, negotiation of priorities, and joint decision-making.  Across contexts, effective co-creation processes tend to share a set of core principles: good governance, collective intelligence process, and scientific and methodological rigour.

Importantly, co-creation is not always the appropriate approach. It requires time, resources, and facilitation capacity, and may not be suitable in contexts where decisions must be made rapidly or where stakeholder involvement cannot be meaningfully supported.

What you will find in this video

	Practical definition of co-creation in global health
	To co-create or not: Decision tree

Recommended readings

PART 3: How do we do co-creation in global health?

Planning for co-creation involves a series of interconnected decisions: these include defining the purpose of co-creation, assessing need, identifying who should be involved, selecting appropriate methods, and determining how outcomes will be used.  

A common challenge is treating co-creation as a one-off activity rather than a process that unfolds over time. Effective planning, therefore, requires considering how different co-creation activities (i.e. methods) connect across phases of a project, from early-stage exploration to implementation and evaluation. 

The choice of methods should be guided by the intended function of each activity, such as generating ideas, building consensus, or testing solutions, and appropriateness for those with whom you will co-create, rather than by familiarity or convenience. This starter kit provides tools to support these decisions while allowing flexibility to adapt to context.

This video shows one example from the MBD-Free project of how co-creation could be designed to address the specific challenge of addressing mosquito-borne diseases in Zanzibar. However, this is one example for inspiration. Co-creation can take on many different forms depending on the decisions mentioned above.

What you will find in this video

	Setting the stage		Co-creation methods
	Stakeholder mapping		Implementation
	Needs Assessment		Evaluation and reporting
	Recruitment

Evaluating Co-creation

Evaluating co-creation requires attention to both process and outcomes. This includes assessing not only what was produced, but how the process unfolded. 

Process evaluation may examine factors such as inclusivity, quality of interaction, and the extent to which co-creators influenced decisions. Outcome evaluation may focus on the relevance, acceptability, and feasibility of the resulting interventions. 

Because co-creation processes are context-dependent and adaptive, evaluation approaches should be flexible and proportionate. For instance, embedding simple reflective practices throughout the co-creation process can provide valuable insights without creating unnecessary burden.

Recommended tools and templates

PART 4: Tips on facilitating co-creation

Facilitating co-creation involves more than guiding activities. It requires actively shaping the conditions for collaboration, including building trust, managing group dynamics, and creating space for different perspectives to be expressed. 

Facilitators play a key role in balancing structure and flexibility. They must ensure that activities are purposeful and inclusive, while remaining responsive to emerging needs and dynamics within the group.

Attention to power is also central to facilitation. This includes recognising whose voices are heard, whose are marginalised, and how decisions are made. Effective facilitation does not eliminate power differences, but makes them visible and works to mitigate their effects on the process.

What you will find in this video

	What makes a good facilitator		Managing power dynamics and ownership
	Setting the stage for collaboration		Adaptive and inclusive facilitation
	Relational and communication skills		Facilitating evaluation and reporting

For this part, take out your pen and paper and capture as much tips as you can:

Recommended additional resources

The following resources may be helpful for those interested in becoming a facilitator. However, it is important to note that facilitation skills cannot be developed through reading alone. We strongly recommend participating in an in-person or online training course, as the facilitator plays a critical role in determining the success of a co-creation process.