Power, data and social accountability: defining a community-led monitoring model for strengthened health service delivery

By Ndivhuwo Rambau, Soeurette Policar, Alana Sharp, Elise Lankiewicz, Allan Nsubuga, Luke Chimhanda, Anele Yawa, Kenneth Mwehonge, Donald Denis Tobaiwa, Gérald Marie Alfred, Matthew M. Kavanagh, Asia Russell, Solange Baptiste, Onesmus Mlewa Kalama, Rodelyn M. Marte, Naïké Ledan, Brian Honermann, Krista Lauer, Nadia Rafif, Susan Perez, Gang Sun, Anna Grimsrud, Laurel Sprague, and Keith Mienies

Born out of models of political accountability and historical healthcare advocacy led by people living with HIV, community-led monitoring (CLM) of health service delivery holds potential as a social accountability model to increase the accessibility and quality of health systems. However, the effectiveness of the CLM model in strengthening accountability and improving service delivery relies on its alignment with evidence-based principles for social accountability mechanisms. We propose a set of unifying principles for CLM to support the impact on the quality and availability of health services.

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Facilitators and barriers to community-led monitoring of health programs: Qualitative evidence from the global implementation landscape

Alana R. Sharp, Ngqabutho Mpofu, Elise Lankiewicz, Beatrice Ajonye, Ndivhuwo P. Rambau, Stefanie Dringus, Brian Honermann, Ngozi Erondu, Asia Russell, Kenneth Mwehonge, Cláudia Aguiar, Naïké Ledan, Matthew M. Kavanagh

This study aimed to identify early challenges and lessons learned from CLM implementation, with the aim of informing and improving the implementation of CLM programs and ultimately achieving greater impact on the delivery of services. Twenty-five CLM implementors representing 21 countries participated in an interview. With the rapid expansion of CLM, this study serves as an important first step in characterizing challenges and successes in the CLM landscape. Successful implementation of CLM requires prioritizing community ownership and leadership, donor commitment to sustainable and reliable funding, and strengthened support of programs across the data collection and advocacy lifecycle.

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Drivers of HIV treatment interruption: Early findings from community-led monitoring program in Haiti

By Soeurette Policar, Alana Sharp, Joanne Isidor Hyppolite, Gérald Marie Alfred, Eva Steide, Leïnadine Lucien, Naïké Ledan, and Matthew Kavanagh

Failure to retain people living with HIV (PLHIV) in care remains a significant barrier to achieving epidemic control in Haiti, with as many as 30% lost from care within one year of starting treatment. Community-led monitoring (CLM) is an emerging approach of improving healthcare and accountability to service users, through a cycle of monitoring and advocacy. In 2020, a CLM program was launched in Haiti to identify barriers to retention and advocating for better health services.

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