Co-creation, Co-design, and Co-production for Public Health

Understanding Co-creation, Co-design, and Co-production in Public Health

The terms ‘co-creation,’ ‘co-design,’ and ‘co-production’ are frequently used interchangeably to describe collaborative initiatives involving multiple stakeholders, particularly within public health. However, as highlighted by Vargas et al. (2022), these concepts possess essential distinctions crucial for understanding the role, extent, and timing of stakeholder engagement.

Co-creation is presented as an overarching guiding principle and the broadest construct. It refers to a collaborative approach to creative problem-solving between diverse stakeholders at all stages of an initiative, from initial problem identification and solution generation through to implementation and evaluation. Its focus is consumer and experience-centric, aiming to promote value creation by engaging stakeholders in understanding complex problems and designing contextually relevant solutions. Stakeholders in co-creation are very active, providing continuous input and co-leading development across all steps, even before the problem is fully defined.

Co-design, on the other hand, describes active collaboration between stakeholders in the design of solutions to a pre-specified problem. It promotes citizen participation to formulate or improve specific concerns, such as service or product enhancements. Co-design is centered on consumers’ insights to establish new priorities, plans, and strategies for improvement. Stakeholders, typically service users, implementers, and procurers, have an active, equal, and reciprocal relationship in the improvement process, particularly during the initial “identify, analyse, define, and design” steps of the co-creation process.

Co-production refers to implementing previously determined solutions to a previously agreed problem, with an emphasis on the most efficient use of existing resources and assets. It is production- and company-centric, engaging stakeholders mainly in the implementation stage, after an initiative has been designed. Stakeholder involvement in co-production is generally more passive, focusing on describing the acceptability and feasibility of a pre-determined strategy.

While distinct, a common emphasis across all three concepts is the input from consumers or citizens in the design and/or delivery of a product, service, initiative, or innovation. Co-creation acts as the encompassing framework, under which co-design is primarily employed for the formative “identify, analyse, define, and design” phases, and co-production comes into play during the “realise” (implementation) and “evaluate” stages of an initiative. Understanding these distinctions clarifies aspects of participatory action research and can strengthen the innovation, implementation, and overall success of public health initiatives.

APA Reference for this article:

Vargas, C., Whelan, J., Brimblecombe, J., & Allender, S. (2022). Co-creation, co-design and co-production for public health: a perspective on definitions and distinctions. Public Health Research & Practice, 32(2), e3222211. https://doi.org/10.17061/phrp3222211