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The Health Quality & Safety Commission New Zealand commissioned Ko Awatea, an innovation and improvement centre, to deliver a co-design programme to nine teams of healthcare providers. The co-design programme was part of Partners in Care, a broader programme developed in 2012 to support and enable patient engagement and participation across the health and disability sector. Teams received training, guidance and mentorship in Experience Based Design (EBD) methodology.1 We evaluated the co-design programme to explore barriers and facilitators to the sustainability of the co-design projects and the EBD approach. The evaluation involved seventeen semi-structured interviews with programme participants, including seven team members, five sponsors, four patients and the programme facilitator. A further two team members provided written feedback. Eight teams provided completed workbooks. Data from the interviews and workbooks was thematically analysed. Team members saw support from sponsors as important to increase visibility and successful completion of co-design projects, mitigate barriers, and to secure resources and buy-in from peers. Five of nine participating teams reported dissatisfaction with the support received. Communication and competing priorities were challenges to sponsor engagement. Sharing co-design skills with peers and alignment with organisational strategy were seen as important for sustainability. Teams identified lack of secured resources or staff time, and consumer or staff attrition as key barriers to sustainability. The conclusion: buy-in from sponsors and senior leaders, support from colleagues, user-friendliness of co-design tools, consumer and staff availability, alignment, and system or culture change were key factors that influenced project sustainability.

The Health & Quality Safety Commission New Zealand commissioned Ko Awatea, an innovation and improvement centre, to deliver a co-design programme to nine teams of healthcare providers. The co-design programme was part of Partners in Care, a broader programme developed in 2012 to support and enable patient engagement and participation across the health and disability sector. In the current programme teams received training, guidance and mentorship in Experience Based Design (EBD) methodology through a one day masterclass, seven WebEx sessions, coaching calls, email and through the completion of workbooks. We evaluated the co-design programme to explore the experiences, challenges and solutions that participating teams encountered while engaging with patients in their projects. The evaluation involved seventeen semi-structured interviews with programme participants, including seven team members, five sponsors, four patients and the programme facilitator. A further two team members provided feedback in written form and eight of nine teams provided completed workbooks. Data from the interviews and workbooks was thematically analysed. Health professionals identified key challenges to patient engagement as capturing diverse experiences, clear communication of project details and the availability and health of the patient. Patients advised the importance of improved communication, planning in advance and providing feedback and assurance about the value of their contribution. There are several important considerations to secure and maintain patient engagement in co-design. These include tailored strategies for approaching patients and capturing their experiences, pre-existing relationships and continued rapport building between patients and health professionals, good communication throughout the project, planning, and visibility of outcomes.

Kok Nam began his photographic career at Studio Focus in Lourenco Marques in the 1950s, graduated to the newspaper Noticias and joined Tempo magazine in the early 1970s. Most recently he worked at the journal Savana as a photojournalist and later director. This article opens with an account of the relationship that developed between Kok Nam and the late President Samora Machel, starting with the photographer's portrait of Machel in Nachingwea in November 1974 before Independence. It traces an arc through the Popular Republic (1976-1990) from political revelation at its inception to the difficult years of civil war and Machel's death in the plane crash at Mbuzini in 1986. The article then engages in a series of photo-commentaries across a selection of Kok Nam's photographs, several published in their time but others selected retrospectively by Kok Nam for later exhibition and circulation. The approach taken is that of 'association', exploring the connections between the photographs, their histories both then and in the intervening years and other artifacts and mediums of cultural expression that deal with similar issues or signifiers picked up in the images. Among the signifiers picked up in the article are soldiers, pigs, feet, empty villages, washing, doves and bridges. The central argument is that Kok Nam participated with many others in a kind of collective hallucination during the Popular Republic, caught up in the 'political sublime'. Later Kok Nam shows many signs of a photographic 'second thinking' that sought out a more delicate sublime in his own archive.