[Images by Co-Voices participant Amani Deni]

Co-Voices is a bespoke web-based application developed as part of NIHR-RUHF. The application allows for survey and photo-voice data collection: research participants can offer answers to specific questions, be followed-up over time, and additionally upload photographs and audio content.

Co-Voices is currently being used to explore the lived experiences of communities and health and social care systems during COVID 19.

Focused on the impacts of COVID-19 on individual health and wellbeing, as well as health systems, NIHR-RUHF and its partners are using Co-Voices in:

  • Sierra Leone and Lebanon: to explore the experiences of communities and health professionals across areas of Sierra Leone (Freetown and Makeni) and Lebanon (Greater Beirut and the Bekaa) in relation to coping with COVID-19;
  • Gaza and Lebanon (UNRWA): to document the stressors and coping mechanisms of Palestine community members, and health and social care professionals, active in crowded refugee settlements;
  • Scotland, the UK: to understand what kind of stressors and coping mechanisms vulnerable persons (persons with a chronic health condition, homeless persons, migrants), communities, health and social workers have experienced during the course of the COVID-19 pandemic in Edinburgh;
  • Liberia (REDRESS): As part of the REDRESS research project, Co-Voices is being used to explore the views of health care workers at county levels on delivery of routine services, including neglected tropical diseases, during the pandemic.

The app has been designed to support a mixed-method approach. Co-Voices includes a survey for quantitative data collection and a photovoice component; the latter is a validated method to gather qualitative data through pictures and audio recordings directly uploaded by participants.

The project is co-led by researchers at the Institute of Global Health and Development (IGHD) of QMU, Edinburgh, American University of Beirut (AUB), and College of Medicine and Allied Health Sciences (COMAHS).

Other partners include United Nations relief and work agency for Palestine refugees in the near east (UNRWA).

This research was funded by the National Institute for Health Research (NIHR) (16/136/100 NIHR Research Unit on Health in Situations of Fragility) using UK aid from the UK Government to support global health research.


The application has been developed to support the study of the measures introduced to manage COVID-19 and explore the associated lived experiences of health care workers and communities.

For health and social care workers active at primary care levels and for community members, the app will help to:

  • explore how COVID-19 and associated public health responses affect routine health service delivery;
  • understand how challenges in care delivery and locally introduced mitigation strategies impact health and social care worker wellbeing in the context of COVID-19;
  • explore health worker perceptions on the effectiveness of care delivery in the context of the pandemic and health care workers’ trust in the health system.
  • identify how COVID-19 and associated public health responses affect daily life, including coping strategies enacted by individuals and communities, e.g. to maintain personal wellbeing, and enable the management of chronic diseases for those persons with pre-existing health conditions;
  • explore community understanding of COVID-19 messages, and associated practice, of COVID-19 related public health measures and associated trust in health systems.

NIHR Research Unit on Health in Fragility (RUHF)

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NIHR Research Unit on Health in Fragility (RUHF)

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