Understanding co-production with vulnerable populations: challenges, enablers and outcomes

Co-production emerged to engage users in public services as an intrinsic source of value and a democratic right, generating empowerment and social capital. This normative promise is undermined by an equity problem: vulnerable populations face barriers to full participation and are systematically excluded from co-productive processes despite having the greatest need for public services. Although attention to this issue has grown, the literature lacks a comprehensive cross-sector, cross-population analysis. A systematic literature review combining bibliometric mapping with qualitative narrative synthesis is conducted, placing vulnerability and its consequences for the co-production process at the centre of inquiry. This article contributes to co-production theory by highlighting the limits of standard assumptions for vulnerable populations, and offers practical implications for designing inclusive co-production processes.

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Publication Details

Journal
Public Management Review
Published
2026-06-25
DOI
https://doi.org/10.1080/14719037.2026.2693783
Primary Topic
Healthcare innovation and challenges
Type
article
Field-Weighted Citation Impact
0.00
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article

Understanding co-production with vulnerable populations: challenges, enablers and outcomes

Denita Cepiku, Angelica Zazzera
Public Management Review
Healthcare innovation and challenges
article

Understanding co-production with vulnerable populations: challenges, enablers and outcomes

Denita Cepiku, Angelica Zazzera
article en

Abstract

Co-production emerged to engage users in public services as an intrinsic source of value and a democratic right, generating empowerment and social capital. This normative promise is undermined by an equity problem: vulnerable populations face barriers to full participation and are systematically excluded from co-productive processes despite having the greatest need for public services. Although attention to this issue has grown, the literature lacks a comprehensive cross-sector, cross-population analysis. A systematic literature review combining bibliometric mapping with qualitative narrative synthesis is conducted, placing vulnerability and its consequences for the co-production process at the centre of inquiry. This article contributes to co-production theory by highlighting the limits of standard assumptions for vulnerable populations, and offers practical implications for designing inclusive co-production processes.

Public Management Review
University of Rome Tor Vergata (IT), Bocconi University (IT)
No poverty
Openalex Percentile: Top 2%
Healthcare innovation and challenges
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Understanding co-production with vulnerable populations: challenges, enablers and outcomes — Denita Cepiku, Angelica Zazzera · Public Management Review (2026) | TGRS Research Map | TGRS