A Women4GlobalFund (W4GF) webinar on July 29 2019 created space for 26 W4GF advocates and partners to explore the W4GF Community Based Monitoring & Feedback Accountability Toolkit to sustain global and national advocacy to enable women to track Global Fund investments towards gender equality across HIV, TB and malaria. To listen to the full webinar recording click here.

To download a printable version of these notes click here

Introduction

This W4GF Accountability Toolkit supports women to collect qualitative rights-based, gender-responsive data to monitor programmes funded by the Global Fund at the national level. This compliments the quantitative data already collected to measure progress towards gender equality, such as the indicators that currently only count numbers of people tested and treated but do capture to the quality and impact of services.

The W4GF Accountability Toolkit supports women to:

  • follow Global Fund supported programmes and services and conduct independent, community-led monitoring and tracking that explores effectiveness of services and qualitative client perspectives;
  • ensure that countries take the right steps to achieve gender equality and uphold human rights by highlighting what is/is not working well and advocate to re programme and scale up programmes and services that are effective; and
  • build and strengthen strategic partnerships between community and those implementing the grants – enabling women to remain meaningfully engaged and assess their own effectiveness as W4GF advocates in Global Fund processes at the national level.

To review the full slide deck on the Accountability Toolkit click here.

Global Fund Secretariat Key Points 

The presentation accessible here unpacked how CBM fits in the Global Fund. Key points to note where:

  • Global Fund is making efforts to ensure that Country Coordination Mechanisms (CCMs), understand and know more about the importance of CBM.
  • Opportunitiesto access support to conduct CBM include:
    • Getting this into Global Fund grants – Currently 44 grants include community based monitoring and the Global Fund aim for it to be included in more and have an increase in CBM supported by donors
    • TA available through the CRG Strategic Initiative
    • TA available through UNAIDS Technical Support Mechanism through UNAIDS technical offices
    • CCM Evolution.

Presentations Key Highlights   
Eastern Africa National Networks of AIDS Service Organisations (EANNASO)shared the One Impact as a digital platform to facilitate CBM in the TB response in Tanzania

  • This allows people to report the barriers they experience, strengthen the TB monitoring and evaluation systems, improve the responsiveness, equity and quality of TB services and hold TB service providers to account.
  • The App (developed by communities) collects community data. It can be used offline, is available in local languages and is free; and has a Community Health Workers inbox.
  • The App provides a platform for communities to access knowledge, access to services, connections to support; and how people can get involved. It then enables people to report barriers.
  • The App generates reports used to follow up cases from health service including people with TB. Reports inform the National TB programme and local government authorities.
  • This was approved by the Ministry of Health but the local government authority in Tanzania have not approved it and engagement is ongoing to move this forward.
Katswe Sistahood/Youth Engage Initiative shared their work to engage adolescent girls and young women in CBM
  • This collaborative process enables adolescent girls and young women to monitor Global Fund supported programmes and hold duty bearers to account.
  • Young people decided on the tools they used to engage and providing a solid understanding of the current programmes.
  • They submitted a statement to the CCM advocating for young people on the CCM.
  • Phase 1 developed the Framework and Phase 2 focused on implementation using a scorecard system with their own indicators on what they hoped to expect.
  • The next steps fill focus on lessons learnt to inform the acceptability and user friendliness of the tool developed by young people; convene bi-quarterly to go through set of indicators and rate the services and agree on scores and engage different service provides.
  • This all then feeds into the review of National AIDS Strategic Plan and then the next Global Fund supported allocation cycle and beyond.
India HIV/AIDS Alliance presented the community scorecards as part of India’s experience on CBM 
  • Communities in all their diversity and service providers collectively came up with indicators to have scorecard – 72 score cards were developed engaging 1526 key populations and 466 service provides.
  • 230 issues were raised by different communities and 169 were solved at the local level so many issues were resolved because of the very important interface meeting which included communities in all their diversity.
  • India uses a simple what’s app is used to monitor stock outs. There are 527 treatment centres across India and people on this what’s app group are able to report issues in real time and the national network of people living with HIV provide regular reports.
  • Advantages of CBM are: it encourages communities to be more accountable and to provide evidence to support their claims; enables us to harmonise a common community agenda; and enables community to unite and support each other.

Key Questions and Answers

Question: is the Accountability Toolkit available for use now or will it still be revised based on the outcomes of the planned pilot in the 3 countries you mentioned? Answer: This is available on the W4GF website and will most likely be revised based on implementation learning.

Question: Can other organizations use the same app? Can it be translated to other languages? Answer: Yes, this can be adapted to different health areas and languages but one person needs to control the dashboard.

Question: How best can we plan for CBM if it is currently not in NSPs? We are working with an NGO to submit a TA request for their midterm review process so that CBM can be included in their funding request in 2020 and how best to position CBM across the 3 diseases? Answer: Just to note CRG Strategic Initiative TA is available to engage in NSP development/revision.Tools like ALIVHE Framework, focused on HIV/GBV integration and the SRHR Checklist for women living with HIV can be helpful to support CBM and build capacity for evidence-based monitoring and accountability.

Question: How can civil society capacity be built to tap into opportunities for using CBM innovations like existing app or developing new app for monitoring health services, human rights and gender barriers? Answer: Take a look at the human rights monitoring tool and this tool on how to set up and run a community treatment observatory.

Question: Was CBM not in the previous Global Fund modular framework? Answer: It was but it was but mis classified, there were some strong treatment observatories or scorecards but in some of the grants it was monitoring of the community not by the community.

Question: How is the Global Fund ensuring that the CCM and people in power understand the importance of CBM? Answer: The Global Fund recently participated in a meeting organised by EANNASO supported by Back up on the CCM Evolution and how we can promote community based monitoring at the CCM level and we are exploring all the trainings and how we can promote CBM at a national level.

Question: Community systems strengthening (CSS) has no budget and if it is included it is often cut as it is not linked to number of people that can be tracked. How will the Global Fund cope with this issue? Answer: There is a lot of work done at country level to ensure CSS and CBM are included but at last minute these sometimes get cut. Right now, the Global Fund is revising their application material and developing trainings for the CCM and the Global Fund secretariat on the benefits of CSS including CBM as a crucial interventions to fund.

Question: Will the Global Fund develop a separate guideline on CBM or will this be based on WHO operational manual? Answer: The Global Fund is collaborating with different departments and planning a meeting in the fall with partners e.g. UNAIDS, Roll back malaria, and Stop TB on how best to work together and coordinate our work and will be including different guidance from technical partners.

The webinar was organised and hosted by the W4GF Secretariat represented by Sophie Dilmitis (Global Coordinator) and Nyasha Sithole (Support Officer). Identifiable participants included: Ben Ocra; Chengetayi Chininga; Daxa Patel; Emily Miki; Gemma Obeth; Jennifer D; Joyce Ouma; Kana; Kibuchi; Livingston Masango; Maria Jose Alcala Donegani; Melissa Ditmore; Olayide; Olimbi Hoxhaj; Rodrick Mugishagwe; Sonal Mehta; Snow; Samuel Babikene Rasi; Talent Madziva; Tambudzai Magwenzi; Tariro Kutadza; Yvonne Catherine Kahimbura. The Global Fund Community, Rights and Gender Department was represented by Rene Bangert.