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With global malaria cases on the rise, the WHO has placed increased emphasis on National Malaria Programmes to tailor interventions to country and programmatic needs. This paper presents the Plus Project’s experience of applying a codesign approach to design country-specific models of perennial malaria chemoprevention (PMC), a chemoprevention intervention aimed at reducing morbidity and mortality due to malaria and anaemia in children. Codesign workshops were held in each of the project’s focus countries (Benin, Cameroon, Côte d'Ivoire and Mozambique) with the primary objective of designing the country-specific PMC model. The three-and-a-half-day workshops were adapted to each country’s context and included stakeholders from national and subnational malaria, immunisation and child health programmes, as well as national and international development partners and research institutions. The meetings were iterative and collaborative, harnessing a variety of participatory methods including journey mapping and surveys to reach group consensus on the PMC models best suited to each country’s specific context. The Plus Project’s codesign approach resulted in four different PMC strategies, with a range from four to eight contact points and different codelivery interventions, each taking advantage of country-specific health system delivery platforms, operational logistics and political contexts. This collaborative, codesign process also helped gather additional programmatic insights to aid PMC implementation while providing an opportunity to increase stakeholder buy-in. With an emphasis on collaborative decision-making, the learnings collected through these workshops can be applied to a variety of programmatic applications, extending beyond malaria.