Community-based Co-design across Geographic Locations and Cultures: Methodological Lessons from Co-design Workshops in South Africa

Till, Sarina; Farao, Jaydon; Coleman, Toshka Lauren; Shandu, Londiwe Deborah; Khuzwayo, Nonkululeko; Muthelo, Livhuwani; Mbombi, Masenyani Oupa; Bopane, Mamare; Motlhatlhedi, Molebogeng; Mabena, Gugulethu; Heerden, Alastair van; Mothiba, Tebogo Maria; Norris, Shane A; Dias, Nervo Verdezoto; Densmore, Melissa

doi:10.1145/3536169.3537786

Cited by 22 publications

(5 citation statements)

References 42 publications

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“…, 2008 ), with this review highlighting the importance of their continuous and meaningful input in influencing the acceptability, trustworthiness and perceived value of the programme. Similarly, principles of co-design emphasize the involvement of stakeholders or end users in the design of sustainable and appropriate interventions ( Till et al , 2022 ). Co-design has been used for MNH programming to develop messaging content and avenues identified by the target audience and to improve service delivery ( Kynoch et al.…”

Section: Discussionmentioning

confidence: 99%

Understanding communication in community engagement for maternal and newborn health programmes in low- and middle-income countries: a realist review

Dada,

Aivalli,

De Brún

et al. 2023

Health Policy and Planning

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As community engagement (CE) is implemented for sustainable maternal and newborn health (MNH) programming, it is important to determine how these approaches work. Low- and middle-income countries (LMICs) have become a particular focus for MNH CE activities due to their high burden of maternal and neonatal deaths. MNH messaging and communication to engage communities are likely to differ by context, but how these approaches are actually developed and implemented within CE are not well understood. Understanding how communication in CE actually works is vital in the translation of learnings across programmes and to inform future projects. The purpose of this realist review is to describe how, why, to what extent, and for whom communications in CE contributes to MNH programming in LMICs. After searching academic databases, grey literature, and suggested literature from the expert advisory committee, documents were included if they described the CE communications processes/activities used for MNH programming in an LMIC. Relevant documents were assessed for richness (depth of insight) and rigour (trustworthiness and coherence of data/theories). Data were extracted as context-mechanism-outcome configurations (CMOCs) and synthesized into demi-regularities to contribute to theory refinement. After screening 416 records, 45 CMOCs were extracted from 11 documents. This informed five programme theories explaining that communications in CE for an MNH programme work when: communities are actively involved throughout the programme, the messaging and programme are acceptable, communication sources are trusted, the community has a reciprocal relationship with the programme, and the community sees value in the programme. While these findings reflect what is often anecdotally known in CE or acknowledged in communications theory, they have implications for policy, practice and research by highlighting the importance of centering the community’s needs and priorities throughout the stages of developing and implementing communications for CE in MNH.

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Section: Discussionmentioning

confidence: 99%

Understanding communication in community engagement for maternal and newborn health programmes in low- and middle-income countries: a realist review

Dada,

Aivalli,

De Brún

et al. 2023

Health Policy and Planning

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“…We believe that community-based co-design that truly considers the stigma, needs for trust and privacy, and the understanding of cultural nuances executed in an interdisciplinary manner [ 199 ] could assist with the growth of digital interventions in this neglected yet incredibly important area of MCH.…”

Section: Discussionmentioning

confidence: 99%

Digital Health Technologies for Maternal and Child Health in Africa and Other Low- and Middle-Income Countries: Cross-disciplinary Scoping Review With Stakeholder Consultation

Till¹,

Mkhize²,

Farao³

et al. 2023

J Med Internet Res

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Background Maternal and child health (MCH) is a global health concern, especially impacting low- and middle-income countries (LMIC). Digital health technologies are creating opportunities to address the social determinants of MCH by facilitating access to information and providing other forms of support throughout the maternity journey. Previous reviews in different disciplines have synthesized digital health intervention outcomes in LMIC. However, contributions in this space are scattered across publications in different disciplines and lack coherence in what digital MCH means across fields. Objective This cross-disciplinary scoping review synthesized the existing published literature in 3 major disciplines on the use of digital health interventions for MCH in LMIC, with a particular focus on sub-Saharan Africa. Methods We conducted a scoping review using the 6-stage framework by Arksey and O’Malley across 3 disciplines, including public health, social sciences applied to health, and human-computer interaction research in health care. We searched the following databases: Scopus, PubMed, Google Scholar, ACM Digital Library, IEEE Xplore, Web of Science, and PLOS. A stakeholder consultation was undertaken to inform and validate the review. Results During the search, 284 peer-reviewed articles were identified. After removing 41 duplicates, 141 articles met our inclusion criteria: 34 from social sciences applied to health, 58 from public health, and 49 from human-computer interaction research in health care. These articles were then tagged (labeled) by 3 researchers using a custom data extraction framework to obtain the findings. First, the scope of digital MCH was found to target health education (eg, breastfeeding and child nutrition), care and follow-up of health service use (to support community health workers), maternal mental health, and nutritional and health outcomes. These interventions included mobile apps, SMS text messaging, voice messaging, web-based applications, social media, movies and videos, and wearable or sensor-based devices. Second, we highlight key challenges: little attention has been given to understanding the lived experiences of the communities; key role players (eg, fathers, grandparents, and other family members) are often excluded; and many studies are designed considering nuclear families that do not represent the family structures of the local cultures. Conclusions Digital MCH has shown steady growth in Africa and other LMIC settings. Unfortunately, the role of the community was negligible, as these interventions often do not include communities early and inclusively enough in the design process. We highlight key opportunities and sociotechnical challenges for digital MCH in LMIC, such as more affordable mobile data; better access to smartphones and wearable technologies; and the rise of custom-developed, culturally appropriate apps that are more suited to low-literacy users. We also focus on barriers such as an overreliance on text-based communications and the difficulty of MCH research and design to inform and translate into policy.

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“…We will engage with community participants to explore, experiment, co-design, co-create and iteratively validate new design ideas to address the four major challenges around IYC nutrition identified in phase I. The community-based co-design workshops will take place in parallel recognising that the socioeconomic and cultural context as well as digital literacy in each study location might differ and influence differently the outcomes of the co-design process 44 45…”

Section: Methods and Analysismentioning

confidence: 99%

Designing intervention prototypes to improve infant and young child nutrition in Peru: a participatory design study protocol

Rousham,

Pareja,

Creed-Kanashiro

et al. 2023

BMJ Open

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IntroductionNutrition during the complementary feeding period (6–23 months) is critical to ensure optimal growth and reduce the risk of diet-related disease across the life course. Strategies to reduce multiple forms of malnutrition (stunting, overweight/obesity and anaemia) in infants and young children (IYC) are a key priority in low-income and middle-income countries, including Peru. This study aims to co-design and develop prototypes for interventions to address the multiple forms of malnutrition in IYC in urban Peru, using a participatory design approach.Methods and analysisThe study will be based within peri-urban communities in two areas of Peru (Lima and Huánuco city). Following the identification of key nutritional challenges for IYC aged 6–23 months through formative research (phase I), we will conduct a series of workshops bringing together healthcare professionals from government health centres and caregivers of IYC aged 6–23 months. Workshops (on idea generation; creating future scenarios; storyboarding and early implementation and feedback) will take place in parallel in the two study areas. Through these workshops, we will engage with community participants to explore, experiment, co-design and iteratively validate new design ideas to address the challenges around IYC complementary feeding from phase I. Workshop outputs and transcripts will be analysed qualitatively using affinity diagramming and thematic analyses. The intervention prototypes will be evaluated qualitatively and piloted with the participating communities.Ethics and disseminationEthical approval for this study was obtained from the Ethical Review Committee of the Instituto de Investigación Nutricional (IIN) Peru (388-2019/CIEI-IIN), Loughborough University (C19-87) and confirmed by Cardiff University. Findings of the participatory design process will be disseminated through a deliberative workshop in Lima, Peru with national and regional government stakeholders, as well as participants and researchers involved in the design process. Further dissemination will take place through policy briefs, conferences and academic publications.

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Community-based Co-design across Geographic Locations and Cultures: Methodological Lessons from Co-design Workshops in South Africa

Cited by 22 publications

References 42 publications

Understanding communication in community engagement for maternal and newborn health programmes in low- and middle-income countries: a realist review

Understanding communication in community engagement for maternal and newborn health programmes in low- and middle-income countries: a realist review

Digital Health Technologies for Maternal and Child Health in Africa and Other Low- and Middle-Income Countries: Cross-disciplinary Scoping Review With Stakeholder Consultation

Designing intervention prototypes to improve infant and young child nutrition in Peru: a participatory design study protocol

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