Fostering Accountability and Ownership through Citizen Monitoring

Issues: Evidence is growing to support the benefits of actively engaging affected communities in monitoring HIV services and stigma and discrimination. Description: The national network of PLHIV in Mali (RMAP+), with limited external technical assistance, undertook a pilot project to monitor the quality of health services from the perspective of service users. They developed a system for/by the PLHIV which, in the process, enabled RMAP+ to better survey its membership, translate this information into member association action plans and an evidence-based advocacy platform for participation in policy dialogue. The project resulted in a greater appreciation of health services from the point of view of PLHIV as well as an increased capacity of a national PLHIV network to undertake a research project including design, data collection and analysis. Dissemination led to a commitment by national stakeholders to use the results in the design of a national strategic plan and identification of key follow-up activities to take the project to a national level. Lessons Learned: A PLHIV-led process can produce high-quality results for use in developing an effective advocacy agenda. A participatory process that transitions leadership into the hands of a PLHIV network can appreciably increase ownership and a feedback loop for better governance. Recommendations: Although the information gathered in such a process is extremely valuable, a more complete picture can be made by triangulating the information with the opinions of health service providers and a more qualitative exploration of key themes with PLHIV.