3 Community-led Services
3.4 Community-led quality improvement
Community committees
• Main mechanism for communities to provide feedback and to shape the quality of programme services
• Regular meetings to review service provision, troubleshoot problems, track changes, build understanding and accountability, and address other community issues
Improving the quality, accessibility and acceptability of programme services requires collecting routine feedback on the community’ s experience of local services. There are several ways to do this.
3.4.1 Community committees
A community committee is a forum for members of the community to bring important issues, problems and solutions to the attention of the programme on a routine basis. Committees review clinical services, commodity distribution, the functioning of safe spaces and initiatives to address structural barriers. Members of the committees should ideally be elected by the community on a regular basis, e. g. annually. Relevant implementing organization staff may be members of the committee or may be invited to its meetings to discuss issues that arise.
As shown in the management structure for community services depicted in Chapter 6, Figure 6.3, community committees operate primarily at the frontline level, although they may also contribute to oversight of the programme at the municipality / sub-municipality level.
Community committees should meet monthly. A meeting report like the one shown in Figure 3.10 may be used to systematically consider issues and report to the community and programme.
When action is taken by programme staff or community outreach workers themselves, the results should be shared at subsequent meetings to ensure good communication with the community. A record of these discussions and actions should be maintained. The committee can also be a communication channel for the programme to discuss any changes that are being considered, and to share monitoring data with the community.
Because the community committee may at times raise quality issues that programme staff are reluctant to address, it is essential that programme management staff from a higher level be involved than those immediately responsible for the components of the intervention locally. Confidentiality should be respected at all times and senior management should monitor the committee to ensure that the community has the freedom to be critical. An advocate trusted by community outreach workers should act as the programme intermediary; ideally this person should be a community member, although they may be paired with a staff member from the implementing organization who can advocate for changes. There should be a mechanism to communicate problems upwards and beyond local managers if they are perceived to be obstacles to change.
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