Tokenistic co-design: participation without power in Indigenous health evaluations

Objectives Co-design evaluation methodology can be appropriate for Aboriginal and Torres Strait Islander health and wellbeing programs due to its principles of power-sharing and collaboration. We argue, however, that commissioners of evaluations use the term, co-design, uncritically to describe activities that are misaligned with contemporary co-design theory. Methods Through qualitative interview data with key stakeholders in the commissioning process (commissioners, evaluators and service providers), we examined perceptions and sentiments towards the use and misuse of co-design in the process of commissioning Indigenous health and wellbeing evaluations. Results A disconnect between the understanding of co-design theory and its use in practice is evident, with perceptions of what constitutes genuine co-design varying considerably across participants involved in the commissioning process. Conclusions The misuse of co-design to describe commissioning and evaluation practices that do not genuinely adhere to co-design principles has a detrimental effect on the utility of program evaluations, the implementation of Indigenous ethical and research frameworks in a genuine way, and risks co-design becoming relegated to a meaningless buzzword.