International experiences with co-production and people centredness offer lessons for covid-19 responses

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Abstract

Eva Turk and colleagues believe that there is much to learn from the experiences of low and middle income countries in co-producing knowledge and working with communities to find feasible and acceptable solutions to healthcare concerns

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The dark side of coproduction: do the costs outweigh the benefits for health research?

Kathryn Oliver, Anita Kothari, Nicholas Mays (2019)

Background Coproduction, a collaborative model of research that includes stakeholders in the research process, has been widely advocated as a means of facilitating research use and impact. We summarise the arguments in favour of coproduction, the different approaches to establishing coproductive work and their costs, and offer some advice as to when and how to consider coproduction. Debate Despite the multiplicity of reasons and incentives to coproduce, there is little consensus about what coproduction is, why we do it, what effects we are trying to achieve, or the best coproduction techniques to achieve policy, practice or population health change. Furthermore, coproduction is not free risk or cost. Tensions can arise throughout coproduced research processes between the different interests involved. We identify five types of costs associated with coproduced research affecting the research itself, the research process, professional risks for researchers and stakeholders, personal risks for researchers and stakeholders, and risks to the wider cause of scholarship. Yet, these costs are rarely referred to in the literature, which generally calls for greater inclusion of stakeholders in research processes, focusing exclusively on potential positives. There are few tools to help researchers avoid or alleviate risks to themselves and their stakeholders. Conclusions First, we recommend identifying specific motivations for coproduction and clarifying exactly which outcomes are required for whom for any particular piece of research. Second, we suggest selecting strategies specifically designed to enable these outcomes to be achieved, and properly evaluated. Finally, in the absence of strong evidence about the impact and process of coproduction, we advise a cautious approach to coproduction. This would involve conscious and reflective research practice, evaluation of how coproduced research practices change outcomes, and exploration of the costs and benefits of coproduction. We propose some preliminary advice to help decide when coproduction is likely to be more or less useful.

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Coproduction of healthcare service

Maren K Batalden, Paul Batalden, Peter Margolis … (2015)

Efforts to ensure effective participation of patients in healthcare are called by many names—patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always ‘coproduced’. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services.

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Community engagement for COVID-19 prevention and control: a rapid evidence synthesis

Brynne Gilmore, Rawlance Ndejjo, Adalbert Tchetchia … (2020)

Introduction Community engagement has been considered a fundamental component of past outbreaks, such as Ebola. However, there is concern over the lack of involvement of communities and ‘bottom-up’ approaches used within COVID-19 responses thus far. Identifying how community engagement approaches have been used in past epidemics may support more robust implementation within the COVID-19 response. Methodology A rapid evidence review was conducted to identify how community engagement is used for infectious disease prevention and control during epidemics. Three databases were searched in addition to extensive snowballing for grey literature. Previous epidemics were limited to Ebola, Zika, SARS, Middle East respiratory syndromeand H1N1 since 2000. No restrictions were applied to study design or language. Results From 1112 references identified, 32 articles met our inclusion criteria, which detail 37 initiatives. Six main community engagement actors were identified: local leaders, community and faith-based organisations, community groups, health facility committees, individuals and key stakeholders. These worked on different functions: designing and planning, community entry and trust building, social and behaviour change communication, risk communication, surveillance and tracing, and logistics and administration. Conclusion COVID-19’s global presence and social transmission pathways require social and community responses. This may be particularly important to reach marginalised populations and to support equity-informed responses. Aligning previous community engagement experience with current COVID-19 community-based strategy recommendations highlights how communities can play important and active roles in prevention and control. Countries worldwide are encouraged to assess existing community engagement structures and use community engagement approaches to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures.

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Author and article information

Contributors

Eva Turk: Role: associate professor

Anna Durrance-Bagale: Role: research fellow

Emeline Han: Role: research associate

Sadie Bell: Role: research fellow

Selina Rajan: Role: research fellow

Maria Margarita M Lota: Role: assistant professor

Chinwe Ochu: Role: head

Maria Lazo Porras: Role: research associate

Pallavi Mishra: Role: senior research fellow

Gasto Frumence: Role: associate professor

Martin McKee: Role: professor

Helena Legido-Quigley: Role: associate professor

Journal

Journal ID (nlm-ta): BMJ

Journal ID (iso-abbrev): BMJ

Journal ID (publisher-id): BMJ-UK

Journal ID (hwp): bmj

Title: The BMJ

Publisher: BMJ Publishing Group Ltd.

ISSN (Print): 0959-8138

ISSN (Electronic): 1756-1833

Publication date Collection: 2021

Publication date (Electronic): 16 February 2021

Volume: 372

Electronic Location Identifier: m4752

Affiliations

[1 ]Science Centre Health and Technology, University of South-Eastern Norway, Drammen, Norway

[2 ]University of Maribor, Faculty of Medicine, Maribor, Slovenia

[3 ]London School of Hygiene and Tropical Medicine, London, UK

[4 ]Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore

[5 ]Department of Medical Microbiology, College of Public Health, University of the Philippines, SEAMEO TROPMED Regional Center for PUBLIC Health, Hospital Administration, Environmental and Occupational Health, Manila, Philippines

[6 ]Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Nigeria

[7 ]Universidad Peruana Cayetano Heredia, Lima, Peru

[8 ]Centre for Chronic Disease Control, New Delhi, India

[9 ]School of Public Health and Social Sciences, Department of Development Studies, Muhimbili University of Health and Allied Sciences, Tanzania

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Correspondence to: M McKee Martin.mckee@ 123456lshtm.ac.uk

Article

Publisher ID: ture061097

DOI: 10.1136/bmj.m4752

PMC ID: 7879267

PubMed ID: 33593813

SO-VID: 6b238fb5-09b3-41bf-95ee-bf1f2daf3ba3

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This is an Open Access article distributed under the terms of the Creative Commons Attribution IGO License ( https://creativecommons.org/licenses/by-nc/3.0/igo/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited.

International experiences with co-production and people centredness offer lessons for covid-19 responses

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Novel Coronavirus Disease COVID-19

Most cited references 30

The dark side of coproduction: do the costs outweigh the benefits for health research?

Coproduction of healthcare service

Community engagement for COVID-19 prevention and control: a rapid evidence synthesis

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