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.
This paper clarifies the principles behind community-led monitoring of health services, a methodology that uses systematic data collection by communities for evidence-based advocacy to improve accountability, governance and quality of health services.
This paper was developed by CD4C Consortium, CLAW Consortium and EANNASO-APCASO-ATAC Consortium and aims to support CLM implementers and donors into developing effective CLM programs
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).
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.
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.
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.
CLM is not a new idea. For decades, communities across the HIV, TB and Malaria movements have worked together to identify issues impacting their health and to bring action to bear on decision-makers. What is new, however, is greater recognition by donors and program implementers of the value that community-generated data and advocacy bring to program impact. As a result, CLM is now a funded priority.
How to design, plan and budget for CLM ?
Describe and prioritize CLM in Global Fund funding request or other donor programs is key, to ensure that CLM remains a programmatic and budgetary priority. Key population organizations and civil society groups should collectively organize themselves to strategize steps to concretize CLM development and implementation as part of donor’s support.
