Co-Production as a Site for Negotiation: Reflections on Participatory Qualitative Methods for Health Equity in Young Women’s Healthcare

Participatory approaches, including co-production, are often adopted as a way of centring lived experience in the design of healthcare interventions and training and are now mainstream within UK health research. Such approaches are borne out of the idea that people should be valued as experts in their own lives, emphasising active involvement as collaborative partners. Co-production projects reflect feminist ethical principles through a focus on shared power, reflexive practice, and the fostering of inclusive and supportive environments for open discussion. Yet, in practice it is challenging to engage with co-production methods and maintain these principles. This paper critically examines participatory co-production as a qualitative method for health justice, drawing on a co-design project with young women and healthcare professionals in Scotland. Rather than evaluating the effectiveness of a co-produced training resource, we use the co-production process itself as analytic material. We use vignettes to explore how participatory qualitative methods surface tensions between young women’s lived experiences of healthcare and healthcare professionals’ situated understandings of delivering good care within structurally constrained systems. We advance the methodological literature in this field by offering novel insights about how the very injustice we are aiming to resist (gendered ageism in healthcare) may be reproduced at the site of co-production. In doing so, we contribute a reflexive methodological account of co-production with young women affected by marginalisation and professional groups as a site of negotiation, exposure, and opportunity, and consider what this means for qualitative inquiry aimed at advancing health equity.