BACKGROUND:
Despite the growing use of co-creation approaches in public health research, a gap remains between participatory research outputs and translation into concrete programme design, communication strategies, and demand-generation activities. Co-creation insights are often underutilised or insufficiently operationalised in real-world settings. We present findings of the brand positioning co-creation process for a new contraception method, subcutaneous depot medroxyprogesterone acetate (DMPA-SC), demonstrating how insights can inform contraception programme design, communication strategies, and demand generation efforts.

METHODS:
We undertook six co-creation workshops in three South African provinces, using the adapted 4Cs of marketing framework. Women aged 18–49 were purposively recruited through local community-based organisations, ensuring age, socio-economic, and contraceptive experience diversity. Workshops used participatory co-design activities, including guided discussions, visual prompts, and message testing. An iterative analysis was conducted across workshop outputs, facilitation materials, observer notes, and internal decision-tracking records. Analytic matrices mapped inputs, decision points, and outputs across stages of brand development. Synthesised insights are presented in a structured, programme-ready format, providing actionable guidance.

RESULTS:
Seventy-eight women participated, 58% aged 26–49. Distinct age-linked patterns emerged: younger women prioritised autonomy, privacy, reassurance, and non-judgemental support; older women drew on prior contraceptive experiences, focusing on side-effect management and long-term health considerations. Uptake barriers included fears of side effects, misinformation, and facility mistrust, while facilitators included control over choice, convenience, discreet administration, and access to credible, practical information. Insights guided demand-generation materials. Messaging was reassuring, non-judgemental, and supportive of autonomy; content highlighted benefits, addressed misconceptions, and provided practical guidance; visuals featured relatable women and clear product imagery; and service support emphasised privacy, trust, and accessibility. Collectively, these strategies position DMPA-SC as a safe, convenient option within the broader contraceptive mix.

CONCLUSIONS:
Workshops generated actionable co-creation insights informing demand-generation materials and supporting ethical integration of DMPA-SC within South Africa’s contraceptive mix.