In this paper, we present the results of an 18-month engagement with community health workers (CHWs) in Lesotho, through which we designed a feedback-integrated platform for community health education using mobile multimedia. We initiated a co-design process using participatory action research to empower CHWs to use their own knowledge and experiences to define our shared design and research agenda. We present our process and its outcomes, noting the importance of engaging with CHWs using techniques considerate of their literacy and experience, and the necessity of separating the concept from the artefact in the process of co-design. Further, we demonstrate how deep engagement and multiple participatory action research cycles give CHWs time to develop confidence and experience around the use of technology in their work. We argue that when CHWs are empowered to contribute their creativity and local experiences in this manner, the outcome is technology that is best suited for their unique context of work, in ways that would not be achieved using conventional approaches to co-design. Finally, we present early outcomes of the co-design efforts, articulating design requirements for a feedback mechanism for CHWs
