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Measuring co-design in global health research: methodological challenges and decolonial innovations

Mannell, Jenevieve; Jama Shai, Nwabisa; Chimbindi, Natsayi; Gibbs, Andrew; (2025) Measuring co-design in global health research: methodological challenges and decolonial innovations. The Lancet Global Health 10.1016/S2214-109X(25)00438-3. (In press). Green open access

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Abstract

Although co-design is increasingly recognised as a cornerstone of implementation science in global health research, methods for its evaluation are often heterogeneous or of poor quality, and can reinforce the power inequalities they seek to address. In the worst cases, the term co-design can be used to cover up research practices that reproduce power differentials between partners from high-income countries and low-income and middle-income countries. Methodological innovation is urgently needed to move beyond measuring the number of attendees and participant satisfaction within global health interventions, and towards evaluating whether the dynamics and process of codesign are achieving equity, power sharing, and knowledge democratisation. This Viewpoint critically examines the current state of tools and measures used in implementation science and highlights trends and examples of innovations that move towards decolonising global health. We identify five key methodological innovations in measuring codesign processes and practices: theory-informed evaluation, co-developed tools, data triangulation, expanded impact metrics, and feedback loops and adaptive measurement. Our aim in presenting these measurement techniques is to inspire further innovation and move the field forward in thinking critically about what equity, power sharing, and knowledge democratisation means in practice, responding to questions of whether decolonising global health is achievable through redefining what we measure and, in turn, what we value.

Type: Article
Title: Measuring co-design in global health research: methodological challenges and decolonial innovations
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/S2214-109X(25)00438-3
Publisher version: https://doi.org/10.1016/S2214-109X(25)00438-3
Language: English
Additional information: © The Author(s), 2026. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10219509
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