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Beyond Participation to Coproduction Nerida Hyett MHSc BOT PhD Candidate, Lecturer La Trobe Rural Health School July 2013. Improving the Health of Communities through Participation. COMMUNITY HEALTH LITERACY. INCLUSION AND EXCLUSION IN COMMUNITIES.

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Beyond Participation to Coproduction
  • Nerida Hyett MHSc BOT
  • PhD Candidate, Lecturer
  • La Trobe Rural Health School
  • July 2013
improving the health of communities through participation
Improving the Health of Communities through Participation




community participation and health
Community Participation and Health
  • Schmidt & Rifkin (1996) defined community participation in health as:
  • A social process whereby specific groups with shared needs living in a defined geographic area actively pursue identification of their needs, take decisions and establish mechanisms to meet their needs
iap2 spectrum of public participation
Iap2 Spectrum of Public Participation
  • Adapted from the IAP2 Spectrum
arnstein s ladder
Arnstein’s Ladder

Arnstein, S. (1969)

inclusion and representation
Inclusion and representation
  • Seeking a diversity of views rather than a representative view
  • Public is not homogenous
  • Dynamic and self-defining entity
  • Active public whose positions are formed through a process of engagement, and dialogue, with others
mobilisation and sustainability
Mobilisation and Sustainability
  • Readiness
  • Community assets, skills and resources
  • Funding
  • Community organising
  • Local solutions
  • Longevity
  • Intensity
  • Involving consumers in the production of the services they consume
  • Lived experience has equal weight with clinician experience
  • Overcome challenges posed by health service silos
  • Social process
  • New health care delivery models resulting in long term changes
  • More effective use of natural and existing resources
  • Volunteers
  • New pathways into education and training
examples of coproduction
Examples of coproduction
  • National Health Service UK: Consumers co-design care pathways, primarily for chronic disease
  • Peterborough Citizen Power: Recovery Champions working with AOD services to co-design more effective interventions for service users, and institutional mapping to integrate care between services
  • Service Users Network South London: Co-design and co- facilitation of a group program for people with personality disorders
  • More examples available here:
lessons learned
Lessons learned
  • Dialogue is critical
  • Social and financial imperative
  • There is no panacea and this is not easy
  • Requires a cultural change
  • Assumes that people want to be involved, some may not want to be, and this might change for different issues
  • Does not necessarily need expensive or time-consuming methods
  • Building coproduction into existing processes is more cost effective and meaningful
  • Arnstein, S. A. (1969). A ladder of citizen participation. Journal of the American Institute of Planners, 35, 216-224.
  • Bovaird, T. (2007). Beyond engagement and participation: User and community coproduction of public services. Public Administration Review, 67(5), 846-860.
  • Coproduction Network. Resources. Retrieved from
  • Draper, A. K., Hewitt, G., & Rifkin, S. (2010). Chasing the dragon: developing indicators for the assessment of community participation in health programmes. Social Science & Medicine, 71(6), 1102-1109. doi:10.1016/j.socscimed.2010.05.016
  • Nesta. (2011). The Business Case for People Powered Health . Retrieved from
  • Needham, C. (2007). Realising the potential of co-production: negotiating improvements in public services. Social Policy and Society, 7(2), 221-231.
  • Rifkin, S. B., Muller, F., & Bichmann, W. (1988,). Primary health care: On measuring participation. Social Science & Medicine, 26(9), 931-940. doi: