Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 90

3 Community-led Services

3.4.2 Other community-led approaches to reinforce quality of clinical services
• Obtain agreement with referral clinics to display patients’ rights charters, which are a statement
of government policy for all who enter a medical facility.
• Obtain agreement with senior medical personal to post information in clinics on the right to
confidentiality.
• Design ways to share information about reliable services in the community, e.g. good doctors to
go to for speculum exams, or trustworthy testing and counselling centres and personnel. This
information may be posted on a notice board or on a protected Facebook page.
• Schedule regular contact (via visits or letters) with the chief medical officer of a facility to formally
report issues and give positive feedback.
• Educate the community on patients’ rights and community-based monitoring of services.
• Formally introduce committee members to health-service providers.

3.4.3 Community quality assurance in monitoring and evaluation
Monitoring quality of community service implementation
Programmes are more effective when routine monitoring is designed with local input and there are
systems for using data at the community level. Ideally, the programme at the central level should
engage those managing multiple sites to determine what information is useful to them to monitor
their programmes. (A simple approach is to brainstorm the aspects of the programme that they
typically examine during site visits.)
Where interventions are not already community-led, community leaders should be consulted on the
kinds of measures that are important to improve the quality of services and outreach.
All programmes need to collect and report data to monitor progress and hold the programme
accountable for its objectives. It is important to develop a clear understanding in the community on
what data will be collected, how this will happen, and how the data are to be used locally. Data should
not simply be “reported up” to a higher level; an approach should be designed that also integrates
monitoring for use at the local level. This is important because targets that are set at high levels are
easily misinterpreted as being the primary goal of the programme, leading, for example, to focus
on the number of people accessing services rather than the quality of those services or sex worker
engagement in the programme.
Figure 3.11 shows how programme data may be collected and used at the local level as well as at
higher levels of the programme.
It is useful for the local implementing organization and the outreach system (including community
outreach workers and supervisors/managers) to regularly review and discuss the monitoring data
shown in Table 3.2.

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