ArticleFrontiers in health services2026
Revolutionizing African healthcare: harnessing co-creation, patient empowerment, and future thinking for patient outcomes.
Article in Frontiers in health services, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: African healthcare systems continue to face poor patient outcomes, yet the role of co-creation in improving outcomes within low-resource settings remains poorly understood. Existing literature treats co-creation, patient empowerment, and future thinking as separate constructs and rarely examines the motivational and cognitive pathways linking them. Drawing on Self-Determination Theory (SDT) and Future-Oriented Theory (FOT), this study tests a dual-pathway model of co-creation in Ghanaian healthcare. Methods: A cross-sectional survey was conducted among 385 patients in Ghanaian hospitals in 2025. Structural equation modeling was used to assess relationships among co-creation, patient empowerment, future thinking, and patient outcomes, with empowerment and future thinking tested as parallel mediators. Results: Co-creation was positively associated with patient empowerment, future thinking, and patient outcomes. Both patient empowerment and future thinking partially mediated the relationship between co-creation and patient outcomes. The findings show co-creation improves outcomes primarily by building autonomy and competence, which then activate forward planning that guides health behavior. Discussion: This study extends SDT and FOT to African healthcare and reveals a previously untested dual-pathway mechanism in Ghana. Co-creation functions as an implementation-focused process rather than a decision-focused process in low-resource contexts, emphasizing patient adherence within resource constraints rather than treatment choice. For policy and management, co-creation initiatives should combine autonomy support with tools that help patients mentally simulate future health actions to improve outcomes.
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