In March, members of the COHESION Project met for two weeks in Lima, Peru, to design interventions. The team was joined by a group of consultants specialized in intervention design where we worked together to define potential interventions and to start developing the protocol for implementation and evaluation.

Using the findings of our formative research and co-creation activities, the team worked hard over two weeks to identify interventions that meet the project aims to strengthen health systems, reach the most vulnerable, be gender responsive and sustainable. The team identified the WHO health systems responsiveness framework (de Silva, 2000; Letkovicova et al., 2005) that comprises eight responsiveness domains as a guiding framework for intervention design and evaluation; 1) Dignity, 2) Autonomy, 3) Confidentiality, 4) Clear Communication 5) Prompt attention, 6) Quality of amenities, 7) Access to social support networks, and 8) Choice of care provider. According to this framework, interaction between citizens and the health system is key to the responsiveness of a “service experience”.

In April 2018, team members in Mozambique, Nepal and Peru will conduct a final round of co-creation sessions with stakeholders at the community, health system and policy levels, to present the responsiveness framework and receive their feedback. The aim is that each country prioritizes the domains.

Over the next months, the team will finalize the interventions and corresponding protocol and submit them for review by the advisory board and funders for approval.


de Silva, A. (2000). A framework for measuring responsiveness. GPE Discussion Paper Series: No. 32. World Health Organization. Retrieved from

Letkovicova, H., Prasad, A., La Vallée, R., Valentine, N., Adhikari, P., & van der Heide. (2005). The Health systems responsiveness analytical guidelines for surveys in the multi-country survey study. World Health Organization. Retrieved from