Background: Audio-visual diary to collect data on daily routines of study participants is relatively new in health systems research. The concept uses participatory research techniques to elicit participants' views, priorities and empower them to take action.

Methods: We discuss a collaborative qualitative study conducted by university researchers, rural communities and health managers (Southwest Ethiopia). We used Videovoice to understand the role of community health volunteers as mediators of accessible and responsive Primary Health Care in Ethiopia. Footage is obtained from 30 Health Development Army leaders in 3 diverse districts, over 3–4 months. Following community engagement and training, participants received an encrypted phone with recording capability. They are supported by researchers through regular contacts, to establish trust, support, and reduce social desirability. A co-production workshop with participants and researchers to interpret the findings will be held.

Results: Employing Videovoice diaries demonstrates that collaborations involving academic researchers, community members and volunteers (as lay researchers) and managers have considerable benefits as well as challenges. Videovoice shifts power to the participants: they determine what to capture, what is important and how to convey their views and activities. Data is enriched by participant-generated insights into the reasons behind their decisions. Intensive engagement, effective communication and trust are essential in understanding constraints and preferences of their role, and interpreting findings. A multi-disciplinary research team will enhance the analytical process.

Discussion: Videovoice can be a useful tool in enabling lay researchers to describe their daily life, better understand their needs, and identify mechanisms for change. The approach can strengthen the immediacy of the research, capturing perceptions within context. Co-production will involve a significant shift in power and emergence of new directions.