Co-creating public health practice: lessons from a long-term university–community partnership in Bishop Lavis, South Africa
1
Global Health, Stellenbosch University, Tygerberg, South Africa
2
Bishop Lavis, Public Health and Social Innovation Hub, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1765
ABSTRACT
ABSTRACT:
Community participation is a cornerstone of public health policy, yet in practice it is often weakly implemented and limited to short-term engagement activities. Co-creation has been proposed as a way to operationalise participation by engaging communities and institutions in jointly identifying priorities, designing responses, and generating learning over time. However, there is limited empirical reflection on how co-creation unfolds in practice across long-term partnerships, particularly in low-resourced urban settings in low- and middle-income contexts. This paper reflects on a five-year university–community partnership in Bishop Lavis, Cape Town, examining how co-creation principles were enacted to address local public health priorities. 1,3 We conducted a reflective analysis of a sustained partnership between a faculty of medicine and health sciences, community leadership structures, civil society organisations, and local health actors. Drawing on partnership documentation, meeting records, and collective reflection, we examined key phases of the collaboration, including entry and trust-building, adaptation during covid-19, co-designed community wellness initiatives, and consolidation into a structured co-creation platform. The analysis was informed by co-creation and participatory public health literature to identify key processes, enabling conditions, and challenges. 2,4 The partnership evolved from informal engagement toward structured co-design and co-production. Co-created initiatives, including community-led wellness activities, strengthened trust, contextual relevance, and shared ownership. Learning across cycles of action enabled adaptation rather than repetition of one-off events. Persistent challenges included sustaining engagement, negotiating roles and power, and aligning institutional processes with relational ways of working. These findings highlight co-creation as an iterative, relational practice embedded in context rather than a linear method. 1,3 This case demonstrates that co-creation can support more equitable and sustainable public health practice when embedded within long-term partnerships rather than treated as a discrete, project-based intervention. Reflecting on the Bishop Lavis experience offers transferable insights for practitioners and institutions seeking deeper, context-responsive collaboration. 2,4
Community participation is a cornerstone of public health policy, yet in practice it is often weakly implemented and limited to short-term engagement activities. Co-creation has been proposed as a way to operationalise participation by engaging communities and institutions in jointly identifying priorities, designing responses, and generating learning over time. However, there is limited empirical reflection on how co-creation unfolds in practice across long-term partnerships, particularly in low-resourced urban settings in low- and middle-income contexts. This paper reflects on a five-year university–community partnership in Bishop Lavis, Cape Town, examining how co-creation principles were enacted to address local public health priorities. 1,3 We conducted a reflective analysis of a sustained partnership between a faculty of medicine and health sciences, community leadership structures, civil society organisations, and local health actors. Drawing on partnership documentation, meeting records, and collective reflection, we examined key phases of the collaboration, including entry and trust-building, adaptation during covid-19, co-designed community wellness initiatives, and consolidation into a structured co-creation platform. The analysis was informed by co-creation and participatory public health literature to identify key processes, enabling conditions, and challenges. 2,4 The partnership evolved from informal engagement toward structured co-design and co-production. Co-created initiatives, including community-led wellness activities, strengthened trust, contextual relevance, and shared ownership. Learning across cycles of action enabled adaptation rather than repetition of one-off events. Persistent challenges included sustaining engagement, negotiating roles and power, and aligning institutional processes with relational ways of working. These findings highlight co-creation as an iterative, relational practice embedded in context rather than a linear method. 1,3 This case demonstrates that co-creation can support more equitable and sustainable public health practice when embedded within long-term partnerships rather than treated as a discrete, project-based intervention. Reflecting on the Bishop Lavis experience offers transferable insights for practitioners and institutions seeking deeper, context-responsive collaboration. 2,4
| eISSN: | 2654-1459 |
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