Timing and decision power shaped how Ethiopian and Kenyan co-designers judged family planning workshops

The outcome in this study is the participants' experience of the process itself. "If we're asking people to share their time, energy and personal experiences with us in a co-design process, we have a responsibility to understand what that process is actually like on their end. Co-design should be valuable for all those involved and not just useful for the research team," said Julia Kramer, an assistant professor of mechanical engineering at the University of Michigan and the study's corresponding author ^[13]. According to the release, few studies have checked whether co-design participants feel heard ^[17].

The setting is small. The workshops aimed to improve family planning counseling and follow-up at public health facilities ^[1]. Two teams meeting seven times each makes 14 workshops over about a year ^[1]. The researchers adapted surveys from earlier work and paired them with observation and in-depth interviews ^[6]. The release does not report how many people took part, how many completed surveys, or whether any comparison group was used. With only two teams, the interviews and observation matter as much as the scores, because they let the researchers check a good rating against what a participant says in conversation. The study, led from University of Michigan Engineering with Derz Consulting in Ethiopia and Kenya, appears in the journal CoDesign ^[2][3].

That limit applies to the most interesting result. Participants generally reported positive experiences on all three measures ^[8]. They also described value, learning and progress as linked: feeling valued helped them learn, learning helped them contribute, and seeing the project advance made them feel valued again ^[9]. People reported that pattern from inside one project. Self-reports from the same people cannot establish which link came first, or rule out a common cause, such as a skilled facilitator lifting all three at once. The release says the timing of engagement and who holds decision-making power shape meaningful participation ^[18]. Showing that they decide it would take a comparison between projects run differently.

What helped inside the room was ordinary. Breaks and casual conversation built trust, and trust made people more willing to share views and work through disagreements ^[10].

The friction came from outside it. Participants were frustrated by long gaps between workshops with no contact from the design team ^[11]. During those gaps, the researchers were balancing the workshop ideas against input from the local ministries of health and the Bill and Melinda Gates Foundation ^[12]. Part of the decision-making, then, happened in the stretches when participants heard nothing. "One of the things this process has taught me is that co-design exists within the broader context of project dynamics. It's not enough to create a co-design space within a workshop. We need to think about how those principles are built into the project itself and how the outputs are taken forward by the wider team and other decision-makers," said Emnet Woubishet Teklu, founding and managing partner at Derz Consulting and a co-author ^[15].

"I've been really encouraged by how honest our findings were. Both community member co-designers and facilitators were clear about what worked and what didn't. That kind of honest reflection is exactly what we need to understand how we can improve our engagements and make them more equitable," said Lauren Wojciechowski, a doctoral student in design science at Michigan and the lead author ^[14]. The team believes the surveys could be adapted to other co-design work, including social programs and major construction projects ^[16].