Community-Led Monitoring (CLM) is a process where communities take the lead to routinely monitor an issue that matters to them.
Communities then work alongside policymakers to co-create solutions to the problems they have identified.
When problems uncovered through CLM aren’t resolved, communities escalate with evidence-based advocacy and campaigning until they achieve implementation of corrective actions by duty bearers.
When communities lead, they define their own priorities and indicators, collect and analyze their own data, and bring issues forward to service providers and decision-makers to collectively fix problems and to hold duty bearers to account. This is different from community-BASED research, in which communities are the subjects of the research, but the process is defined, led and analyzed by an outside party (ministries of health, academic institutions, donors etc.)
The first wave of CLM efforts in global health to date have most often focused on HIV and TB. A fundamental step in this process is community education about the diseases. When community members have a comprehensive and evidence-based understanding of the science at play, they are best able to determine which critical issues they want to monitor, as well as the standards of health they deserve.
For example, people living with HIV deserve to be on treatment regimens that work best for their bodies, which requires regular monitoring of viral load and taking measures to avoid drug resistance (for example, treatment interruptions).
CLM originated in part because community-identified problems were too often dismissed as “anecdotal evidence.” CLM enables communities to validate their claims and determine the extent of an issue, by collecting quantitative and qualitative data on a recurring basis.
When CLM data are analyzed for trends, community advocates are able to pinpoint specific problems that help them and decision-makers zero in on practices and policies that require targeted action.
To truly unlock the potential of CLM, communities need a platform to share their data and findings with decision-makers. Key stakeholders need to be aware of the issues, and the roles they have in fixing them. Ideally, problems are identified quickly and addressed without delay, bringing rapid relief to communities.
CLM is focused on fact-finding, not fault-finding – building trusting and effective relationships for meaningful change is fundamental to the ethos of CLM.
When community concerns are not taken seriously, citizen scientists must hold duty-bearers to account. For example, if communities are given a seat at the decision-making table, but not given a platform to speak; or CLM reports are shared, but their recommendations do not result in change – we must mobilize for action.
The cycle of CLM is not complete until meaningful change occurs. For example: policies are revised, bad practices are stopped, and lives are improved.
Advocacy in every setting will be different, but in every case, it will be grounded in community data.
