ITPC (2023) Citizen Science Survey Data on Community-Led Monitoring Feedback Mechanisms
Background: There is growing consensus that community-led monitoring (CLM) data is an essential component of wider HIV program quality improvement and accountability. Yet, little is known about how CLM data are discussed and used. To optimize the use of CLM data for decision-making, a better understanding CLM feedback mechanisms is needed.
Methods: The Citizen Science project (November 2020-present) conducts CLM of HIV services at 33 health facilities in Malawi and South Africa. From March-August 2023, an operational research initiative sought to understand how the CLM data is fed back to key actors. An online survey was administered among 188 stakeholders, the majority of whom were recipients of care (33%), healthcare workers (29%), and CLM data collectors (27%). Face-to-face interviews with 118 similar stakeholders provided further nuance and depth.
Results: CLM data is shared though at least 25 different feedback mechanisms. More than half (54%) of respondents said CLM feedback happens in real time, during data collection. At the health facility, CLM data is regularly discussed during formal meetings, but nearly a quarter (24%) said it also comes up in casual conversation. More than half (52%) of healthcare workers discuss CLM data at least once a week, compared to 39% of other stakeholders. CLM data sharing usually occurs when project team members call a meeting, however, 36% of respondents said health facilities also request CLM data. Community leadership is critical, since 36% of stakeholders said they remember CLM data better if people living with HIV present it to them, and 19% if key populations do. Stakeholders are more likely to act on CLM data if there is consensus on the findings, there are agreed action points, and the District Health Management Team is involved.
Conclusions: CLM data use may improved if protocols for informal feedback mechanisms are developed, affected communities lead, and solutions are co-created.
