Co-production has many meanings and many faces, as fellow PtPer Gemma Carey found recently at the Population Health Congress in Hobart. There was a lot of talk about introducing co-production into preventive health efforts, but nobody actually defined what they meant by that. Reading between the lines, it seemed that what the presenters were actually talking about was co-design, which is one facet of the co-production endeavour. Today I’m going to discuss the co-delivery facet, and I’ll start by defining my terms.

In co-production, ‘production’ means that the activity involves some kind of transformation of tangible or intangible inputs into more valuable outputs. ‘Co-’ means that the activity is done jointly by two or more parties. This conjures up images of people working alongside each other - perhaps a government agency getting together with citizens to design a public program. And to a lot of people - even scholars - that’s what co-production means. But my colleague Professor John Alford has spent much of his career researching and theorising a different type of co-production. For him (and in the research we recently completed together), co-production is a reciprocal process: the government organisation and the citizen each give something - such as time, effort, or resources - to each other. But it doesn’t have to be at the same time.

So we define co-production pretty broadly as any activity by a citizen that adds value (‘produces’) and is at least partly prompted by some action or behaviour of the government organisation – particularly where the citizen co-producer’s behaviours contribute in some way to achieving publicly valuable purposes (such as reduced health spending, or better environmental outcomes).

For example, a local government provides special bins and a pick-up service, and the citizen in turn sorts their rubbish and puts the recyclables into the special bin. This helps to achieve the publicly valuable purpose of reduced landfill (an example I’ll return to later). Or a government department provides an app for users to track electricity use, and the citizen then uses that app to reduce their electricity use, helping to lower greenhouse gas emissions. Or a government information campaign urges elderly people to go for regular health check-ups, and those that do go have health problems caught early, thus reducing the financial burden on the public health system.

These are all things that public managers hope to encourage in citizens, as our European colleagues Elke Loeffler and Tony Bovaird (et al) discovered when they first planned their co-production research. They did focus groups with public managers in several different European countries and found that rather than co-design (which has been the focus of much research), the managers they talked to were interested in co-delivery as discussed above - that is, encouraging citizens to actually help with the delivery of public services. The European team selected 15 of these co-delivery behaviours to explore with a large sample of citizens, and we replicated that research here in Australia.

The project fills two research gaps – firstly, there hasn’t been much quantitative empirical investigation of what citizens actually do when it comes to co-production, and secondly (as I mentioned earlier) most co-production research focuses on co-design and consultation rather than co-delivery of services. We asked 1,000 Australian adults about behaviours in the areas of health, neighbourhood safety and environment, and drew out some implications for policymakers.

You can see from Figure 1 that the top activities performed by our participants all involve individual efforts or reciprocity (as in keeping an eye on neighbours’ homes and vice versa), and a high component of private value. In the electricity reduction and health check-up examples I used earlier, the value created is both public (reduced CO2 emissions; lower burden on the health system) and private (lower electricity bills; better health). So government agencies (or NGOs) wanting to encourage co-production might want to look at how they can make activities valuable both for the greater good and for the individual.

Figure 1 Most to least popular co-production behaviours
“How often do you...?” (% reporting ‘often’ on a scale of often, sometimes, never)

Household rubbish recycling is an exception to the private value trend in co-production behaviours; it seems that government agencies have been very successful in encouraging recycling even though it represents almost entirely public value. We speculate that this is because it is a) an individual behaviour, b) easy to understand both in task complexity and environmental outcomes, and c) easy to physically/practically undertake. Governments have done much to help with b) and c) in the case of recycling, which provides a clue for how other publicly valuable co-production behaviours might be encouraged.

Another finding from our study was that self-efficacy appears to be related in some way to co-production activity. We asked participants if they thought that ordinary citizens could make a difference to outcomes in each of the three policy domains. The results were encouraging - 89% think they can make a big difference or at least some difference to neighbourhood safety, 92% think the same for the environment, and 93% for the health of themselves and others. And those who thought they could make a big difference also engaged in the highest levels of co-production in each area, as you can see from Figure 2.

Figure 2 Citizen efficacy and the co-production index*

* The co-production index (min. 5 max. 15) indicates how much co-production an individual performs in each domain of interest.

Of course we can’t tell from this finding whether self-efficacy leads to higher co-production, or higher co-production makes people feel more individually empowered, but as our European colleagues suggested, “identifying policies and initiatives which reinforce self-efficacy is...potentially attractive.”

Apart from that, we think that to encourage co-production, organisations should:

recognise that citizens mostly prefer to focus on activities that they can perform on their own, or at least without engaging in a coordinated manner with other citizens or government professionals.
try to engage citizens in activities that include a component of private value – self-interest is not paramount, as our recycling case study shows, but it does appear to be a factor in why citizens co-produce.
make things as easy as possible for co-producers – both as regards the task itself, and the information they are provided.

Also, when you’re thinking about introducing co-production into your service design or delivery efforts (or recognising and encouraging the co-production that is already there), define exactly what you mean when you say co-production. And think about what you might want from your clients, as well as what they might want from you. You might find some unexplored avenues for achieving your desired outcomes.

Written by Sophie Yates (@MsSophieRae).

Co-production: more than just co-design