Workshops that are in-person, interactive and often in distant places are suddenly off limits due to COVID-19. This poses a big problem for the global development community and the constant work of improving health, education and other vital systems, which requires navigating (and nudging) stakeholders’ knowledge, interests and ability to work together.
“Co-creation workshops” use participatory methods to produce mutually beneficial outcomes — such as a new strategy for a complex problem like access to quality primary health care — among stakeholders whose cooperation is essential, but whose perspectives usually vary. Typically concentrated into two to five days and involving 20–50 people, co-creation workshops are a great way to do the navigating and nudging among stakeholders that system improvement requires. But what now?
While countries try to flatten the curve of COVID-19 cases and resource needs, it is possible to flatten a different curve of workshop-based, stakeholder-driven co-creation. A new virtual curve can keep vital health system improvements moving while health leaders have to keep their distance.
Spreading 10 essential functions of a co-creation workshop
Spread essential functions and resources
Workshops have essential and non-essential features. Awareness raising among key actors? Essential. Buffet food arriving a little too early or a little too late? Non-essential. Applying diverse voices to analyze root causes of a problem? Essential and powerful.
The essential functions of productive co-creation workshops — several shown in the table below — must now be spread out and delivered through virtual means. In-person workshops concentrate most essential functions and their required resources into a few days gathered at a physical venue. Workshops organizers may start talking well in advance, but efforts ramp up dramatically just before the event — when participants may also need to travel.
The workshop itself is a very intense use of resources: several days from all participants; venue, food, equipment and often lodging costs; and political capital costs of keeping busy people from their full-time jobs and families. Notoriously, follow-up actions can drop off dramatically post-workshop or be entirely absent.
Embrace virtual co-creation, diversify delivery…and improve sustainability?
Combining technology and remote facilitation, the essential functions of workshops can still be achieved through a virtual co-creation process with a longer time horizon and more diverse means of delivery.
A remote facilitation team can advance the early phases of problem definition and stakeholder identification through one-on-one phone calls, emails and co-edited documents. They can also structure problem analysis and co-creation methods — already usually done by a small team pre-workshop — through remote work.
Many communities of practice in health and education are known to use large webinars to effectively raise attendees’ awareness of key issues and approaches; and smaller online gatherings, with facilitated chats and tools like virtual whiteboards, can be effectively used to have a group work together to define challenges or problems, conduct root cause analysis and formulate solutions. Such small and large webinars can punctuate multiple points along the co-creation curve, in between a wide array of smaller group and individualized communications. Webpages or virtual spaces like Microsoft Teams can make the whole process visible to all involved. It is even possible that this new rhythm (integrating smaller bits of co-creation into participants’ daily routines over a longer time) could prove more effective for lasting health system change.
Status Quo Delivery
New, Virtual Delivery
|Defining a problem and identifying key stakeholders
|Conducting in-person scoping and planning meetings in order to develop a concept note and an invitation list
|Conducting virtual outreach (email, phone calls) in order to develop a concept note and a stakeholder list—now unconstrained by venue space/budget
|Designing a process for problem analysis and co-creation
|Developing an agenda for an in-person meeting
|Developing a workplan for virtual co-creation process
|Raising awareness of key issues and approaches
|Packet of readings and live presentations
|Webinars, shared readings and responses
|Conducting root cause analysis and formulating solutions with diverse voices
|Designing large group or break-out activities to “unpack” challenges and begin to co-create solutions while ensuring all stakeholders are engaged
|Designing smaller, interactive webinars or group video/tele-conferences
|Building trust and solidarity
|Icebreakers, coffee break chats, group photo Tweeted to the world
|Virtual icebreakers, more frequent and varied virtual exchanges over longer time period
|Pointing out the elephant in the room
|Using in-person facilitation methods that diplomatically raise and navigate sensitive issues
|Short written briefs/presentations coupled with online, facilitated panel
|Demonstrating a problem or innovation
|Short videos shared, with comments or Q&A through shared website or group calls; expert “drop-ins” to virtual group meetings
|Building consensus and setting priorities
|Having group report-outs, plenary discussion, sticky-note voting or other means
|Showing and tracking participants’ inputs in a visible, virtual space (MS Teams or similar) and using online voting technologies like menti.com and SurveyMonkey
|Joint work planning
|Completing workplan templates with facilitator support
|Completing workplan templates with facilitator support online
|Following up and ensuring actions are taken and connections continue
|Too often missing?
|Sustain more easily through longer, less daily-intensive co-creation, plus communication habits and tools that remain accessible after a high point.
Upcoming virtual co-creation opportunities
As part of our emerging response to COVID-19, Results for Development has begun increasing use of these virtual co-creation principles in our system strengthening work with partners around the globe. Examples from our health system strengthening work include:
- In Guinea, we have begun helping government, NGOs, and development partners to work together virtually to improve the design, roll-out, and sustainability of Guinea’s National Community Health Strategy, with support from the USAID and Bill & Melinda Gates Foundation-funded Health Systems Strengthening Accelerator.
- In Ghana, we plan to facilitate a virtual co-creation process to assess strengths, needs, and innovative strategies for Ghana’s Health Facilities Regulatory Agency (HeFRA) to ensure quality primary health care, also with support from the Health Systems Strengthening Accelerator.
- In Indonesia, we and partners are seeking virtual ways to continue a multi-stakeholder process to design pilot activities to improve purchasing arrangements and provider payment systems for priority services, including tuberculosis (TB) and maternity care, with support from the USAID Health Financing Activity and TB Private Sector Project.
There are certainly advantages of in-person workshops that are more difficult or impossible to replicate virtually. Trust building and negotiation over sensitive issues is more challenging remotely, for example, and we hope to learn about the best ways to do so. Ensuring equal opportunity to participate is also tougher virtually given differential access to IT and bandwidth. Health and education system stakeholders — often with competing interests and always navigating tough political and ethical choices — will ultimately need to come together, physically and conceptually, to continue strengthening systems in the long-term. But, amid COVID-19 restrictions in the coming months and years, they can also take full advantage of virtual co-creation with adequate planning, adjusted budgets (decreased travel budget and increased IT costs) and skilled facilitation.
We will continue to learn and share from these efforts, and are eager to continue learning from others. Comment below and let us know how you’re managing co-creation and facilitation with partners across varying time zones and distances.