Communities as Evidence Producers: Participatory & Citizen-Led Inquiry

Antimicrobial resistance (AMR) is a growing public health threat in Nepal, where overuse and misuse of antimicrobial medicines are compounded by limited regulation, low awareness, and weak health infrastructure. To foster community ownership and collective action on AMR, we implemented the Community Dialogue Approach (CDA) and integrated outputs from a Participatory Video (PV) project. The PV process enabled community members in the Kathmandu region to co-produce films reflecting their lived experiences and local understandings of antibiotic use. These community-created narratives portrayed relatable protagonists farmers, families, and local health providers negotiating real dilemmas around antimicrobial use in humans and animals.
Building on this foundation, story lines from the PV process such as a farmer's decision to treat his cow without veterinary supervision, were later embedded into flipbooks used by trained facilitators across Kapilvastu Municipality during a series of dialogues designed to stimulate discussion, reflection, and collective action on AMR. By integrating narratives developed by communities into structured dialogue sessions for communities, the CDA bridged the gap between policy-driven messages and local realities. These peer-generated stories, grounded in everyday experiences and expressed in familiar idioms, sparked curiosity and were immediately relatable for dialogue participants.
This initiative demonstrates how participatory storytelling can reposition communication as relational knowledge creation where knowledge emerges through relationships rather than being delivered didactically and how community narratives can reshape how AMR is understood, represented, and acted upon. This positions local voices at the centre of AMR communication and strengthens community-led problem-solving.

Au Mali, les programmes descendants conçus sans les jeunes ont longtemps ignoré leur énergie, leur expertise et leur créativité. 
La Brigade Citoyenne a renversé ce paradigme traditionnel en libérant le potentiel transformateur de la connexion entre les jeunes eux-mêmes. Alors que ces programmes descendants les cantonnaient à un rôle passif, nous avons créé un réseau décentralisé de 5 000 jeunes dans les 19 régions, faisant de leurs réalités quotidiennes la preuve la plus valable pour l'action. En redéfinissant "qui décide" et "ce qui compte comme savoir", nous avons radicalement transféré le pouvoir de conception et de mise en œuvre aux premiers concernés.


Les résultats sont transformateurs : 15 000 pairs mobilisés, plus d'un million de personnes touchées et une génération de jeunes qui sont passés de spectateurs à architectes de leur communauté. Et surtout le changement est entendu dans leurs voix : 


« Maintenant, on a le pouvoir de changer les choses ».
Cette initiative démontre que le savoir des jeunes, lorsqu'il est reconnu et connecté, devient la force de transformation la plus puissante qui soit pour une citoyenneté durable et inclusive. 





Cette présentation racontera comment 5 000 jeunes ont réinventé à la fois le savoir, la preuve et le pouvoir d'agir, questionnant : Qui décide ?


Le changement le plus durable ne vient pas de ce que nous faisons pour les jeunes, mais de ce que nous débloquons en eux en leur donnant les moyens d'agir ensemble.


C'est cela, le vrai pouvoir de la connexion.

At Co-creation HUB, in partnership with other stakeholders, we are catalyzing a citizen-led campaign designed to strengthen primary healthcare (PHC) delivery in Nigeria by leveraging storytelling, digital media, and community engagement. The campaign mobilizes local storytellers across Nigeria to document the realities of PHC facilities through short, 60–90 second videos that highlight both successes and service delivery gaps. These stories generate citizen-driven evidence that feeds into advocacy, accountability, and policy dialogue aimed at improving PHC systems.
By positioning citizens as storytellers and data contributors, we reframe how communities engage with the health system, moving from passive users to active participants in shaping healthcare reform. It uses creative storytelling to inspire community ownership, amplify citizen voices, and build visibility for PHC challenges that often go unnoticed.
Through digital platforms, user-generated content, and offline linkages with Community Health Watch reporters, we connect grassroots evidence with national and sub-national conversations on health system performance. Weekly recognition and incentives encourage broader participation and sustain public interest.
This innovative approach integrates social and behavior change communication (SBCC) with governance and digital inclusion, showcasing how creative media can drive transparency and accountability in public health. 

The persistent 9-month immunisation dropout has long been attributed to caregiver non-compliance or a lack of awareness, leading to behaviour change interventions that often fall short. This study challenges that assumption. Through photovoice interviews in Enugu and Kaduna, twelve mothers who had "dropped out" of the immunization schedule documented their experiences. Their visual stories reveal a deeper systemic problem: immunisation services are rigid, built around the idea of an ideal caregiver unencumbered by economic or family constraints. In reality, these women face significant barriers: clinic hours that clash with daily responsibilities, little or no support, high transportation costs, and administrative lapses such as vaccine stock‑outs with no follow‑up. These insights flip the script. Caregivers are not failing; the system is failing them. Importantly, the mothers themselves proposed solutions that form a practical reform agenda. Their insights shift the focus of health policy away from trying to "fix" caregiver behavior and toward creating a more flexible, responsive system that ensures equitable access for all. Photovoice proved a powerful tool for surfacing these realities, showing how caregiver voices can guide reforms toward a more flexible, responsive, and equitable immunization system.