Submission ID 116802
| Issue/Objective | Community-Led Monitoring (CLM) and advocacy are increasingly recognized as social accountability strategies essential for improving health equity and improving universal health coverage. This paper explores Amref Health Africa's experience in implementing CLM within the Global Fund project in Kenya, aimed at empowering communities to hold health systems accountable and addressing disparities in healthcare delivery. The project ensures marginalized and underserved populations receive accessible, affordable, and effective healthcare. Between the year 2021 and 2024 CLM was implemented in 15 counties, focusing on HIV, TB and Malaria and incorporating human rights and gender dimensions. The objectives were: Upgrade CLM electronic tools for giving feedback; Empower communities and CSOs to give feedback on health services as they experience them; Advocate for quality health services. |
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| Methodology/Approach | A national CLM framework and training materials were developed which guided the implementation. A participatory approach was used to engage 450 community members, who were peers to key and vulnerable populations for HIV, TB and Malaria, in monitoring service delivery and advocating for better healthcare access and quality. The Imonitor ATM+ application is the CLM tool used which enabled users to report issues and provide real-time feedback on health services. The Peer monitors were given a stipend of approximately USD 16 per month. |
| Results | From July 2022 to June 2024, 32,984 issues were reported across 47 counties and 2,607 facilities reached, with 26,457 (81%) from 15 project supported counties. Of these, 68% were related to commodities and service delivery. Drugs and medicines availability and adequacy accounted for 70% of commodity issues, while 67% of service delivery issues concerned quality of care, and 27% related to staffing. These shows the health systems issues affecting primary health care. Advocacy efforts started in October 2023 led to improved allocation of medicines, infrastructure development, increased allocation to HIV, TB and malaria, recruitment of health care workers among others. |
| Discussion/Conclusion | Despite challenges such as sustainability and resistance from authorities, the project demonstrated that CLM, alongside advocacy, can be a powerful mechanism for achieving health equity. Collaboration between communities and health providers was crucial in fostering trust and accountability, making communities central to health service improvements and decision-making. |
| Presenters and affiliations | Christine Mwamsidu Amref Health Africa in Kenya Benson Ulo Amref Health Africa in Kenya |
