Cocreation and codesign in maternal health: processes, outcomes and implementation challenges

Area of Science:

• Maternal Health
• Co-design & Co-creation
• Health Services Research

Background:

• Co-creation and co-design are increasingly utilized in healthcare to improve service delivery.
• Their application in maternal health aims to enhance care through stakeholder involvement.
• Understanding the processes, barriers, and facilitators is crucial for effective implementation.

Purpose of the Study:

• To systematically review the application of co-creation and co-design in maternal health.
• To characterize the processes, including barriers and facilitators.
• To summarize reported clinical and experiential outcomes.

Main Methods:

• Systematic review following PRISMA guidelines.
• Searched multiple databases (PubMed, MEDLINE, Embase, Cochrane, ScienceDirect) from 2014-2025.
• Included 60 qualitative and quantitative studies, with narrative synthesis due to heterogeneity.

Main Results:

• Co-creation/co-design were applied to develop psychosocial support, communication tools, and digital health interventions.
• Key outcomes reported were acceptability, satisfaction, engagement, and perceived relevance.
• Challenges included power imbalances and resource constraints; enablers were stakeholder involvement and iterative design.

Conclusions:

• Co-creation and co-design can support culturally relevant and equitable maternal care when well-described and context-appropriate.
• Current evidence is insufficient to draw firm conclusions on effectiveness.
• Future research needs transparent reporting, specified mechanisms/contexts, and stronger comparative designs.