Enacting and re-politicising co-design: a critical perspective on eHealth interventions

The recent institutionalisation of the co-design approach in eHealth interventions has resulted in an increased focus on providing technological solutions rather than addressing social issues, which has led co-design to gradually lose its political value. The aim of this theoretical article is to propose a re-politicisation of the co-design process of eHealth technologies through the application of the concept of “enactment”. Drawing on various interpretation of this concept, this paper argues for the merits of scrutinising the co-design of eHealth technologies as a dual process of enactment. One the one hand, eHealth technologies are enacted by the practices of individuals involved in the co-design process, such as researchers, stakeholders, tech producers and users. On the other hand, these computational systems enact individuals as objects of concern through structural elements like affordances and datafication processes. Thus, the concept of “enactment” serves as a critical lens for exploring how different figures involved in co-design both shape and are shaped by the socio-technical systems they participate in producing, whilst also examining how diverse forms of social power, inequalities and knowledge imbalances are negotiated and brought into being within this dynamic and relational process.