Participant satisfaction with workshops to co-design family planning interventions in Ethiopia and Kenya

Co-design has increasingly grown as an approach for designing global health interventions. Co-design has the potential to not only improve health interventions and thus health outcomes but also to promote equity in the design process, as stakeholders are engaged alongside traditionally trained designers throughout. However, evaluation of co-design remains under-practiced. In this study, we evaluate participant satisfaction with their engagement in seven co-design workshops to design innovative tools to support effective fertility management and contraceptive agency among women in Ethiopia and Kenya. Using observations, surveys, and interviews, we found participants felt valued by one another and by co-design facilitators, and gained knowledge on family planning and skills to conduct human-centred design. Participants felt they contributed to the goals of the project, but felt frustration with the irregular frequency of their engagement and limited level of influence in decision-making, highlighting persistent power asymmetries between co-design facilitators and participants, and tensions between participatory ideals and project constraints that shape what constitutes meaningful influence. Future work should explore how co-design is integrated into global health projects, how facilitators promote equitable participation, how ‘satisfaction’ can be further operationalised for continued evaluation, and how co-design impacts co-designers and health outcomes.