Community-led Advocacy & Action Network

The specific problem being solved is the lack of access to good quality HIV and health services. This lack of access is especially pronounced among key and vulnerable populations.  Over 1.2 million people are esrimated to be living with HIV in Zimbabwe, with many more being members of the LGBTIQ+ communities. Contributing factors to the lack of access to HIV and health services include poverty, stigma and discrimination, inadequate health infrastructure, low levels of HIV-related knowledge, limited availability of HIV services, and lack of capacity to advocate independently.

Representation remains a huge barrier.  Only one youth-led organisations out of the 19 CBOs is implementing CLM in Zimbabwe despite being the most affected by HIV. Young people lack resources and capacity to self organize and independently implement CLM or Sexual Reproductive Health Rights projects. Dispite CLM data showing young people discontinuing treatment due to lack of friendly private HIV infrastructure, young people have no capacity to push for policy change on HIV treatment. On the other hand, CLM data is biased because monitors are known to the monitored who are reported to provide rehearsed answers.  Furthermore, only 255 health care services out of the 1200 facilities monitored. CLM in Zimbabwe is not community-led but PEPFAR and National AIDS Council led which makes it Top-Down and communities are not comfortable with the current working structure. Community-led Advocacy and Actions seeks to  solve ths challenge by creating a network of  Community-led Advocacy platform to champion advocacy campaigns for increased access in all the 1200 health facilities.

The Community-led Monitoring project in Zimbabwe is a participatory approach to monitoring and improving the quality of health services in the country. The project involves identifying and recruiting community members to monitor and collect data on the quality and quantity of health services at the facikity and  in their communities.

The community members are trained and equipped with the necessary skills and tools to collect and analyze data on various health indicators such as maternal and child health, HIV/AIDS, malaria, and tuberculosis. The data collected is then used to advocate for changes in the health system and to hold health service providers accountable for their performance.

The project uses various technologies to facilitate data collection and analysis, including mobile phones, tablets, and computer software. Community members are provided with mobile phones and trained on how to use them to collect data through a mobile application called ComCare. The data collected is then uploaded to a central database where it is analyzed and used to generate reports and visualizations that can be used for advocacy purposes.

The project also uses community meetings and workshops to share the findings of the data collected and to engage with community members and health service providers on ways to improve the quality of health services. Through this participatory approach, the project empowers communities to take ownership of their health and to work towards improving the quality of health services in their communities.

The Community-led Monitoring project in Zimbabwe serves communities that are underserved by the health system in the country. These are typically Key and Vulnerable Populations  and  rural communities, where access to good quality health services is limited, and where the burden of disease is often high. The project aims to directly and meaningfully improve the lives of Key and Vulnerable Populations by empowering them to monitor and improve the quality of health services in their areas.

The target population for this project are community members, including PLHIV, LGBTIQ,people who use drugs, people with disabikity, who are trained to collect data on various health indicators and to advocate for improvements in the health system. These community members are typically volunteers who are passionate about improving the health of their communities but lack the resources and skills to do so effectively.

Currently, these communities are underserved by the health system in Zimbabwe due to a lack of resources, infrastructure, and trained health professionals. This leads to poor health outcomes, including high rates of maternal and child mortality, discontinued treatment of HIV/AIDS, malaria, and tuberculosis. These communities often lack access to basic health services such as clean water, sanitation, and basic medicines. Young people for example have the lowest Viral Load coverage and suppression at 56% and 73% respectively.

The solution addresses the needs of these communities by empowering them to take control of their health and to advocate for improvements in the health system. By providing them with the necessary skills and tools to collect and analyze data on health indicators, the project enables them to identify gaps in the health system and to advocate for improvements. This can lead to better access to health services, improved health outcomes, and greater accountability of health service providers to the communities they serve. Overall, the project has the potential to make a significant and lasting impact on the lives of these communities.

In community-led Advocacy and Action project,  our team is representative of the communities being served. That is all Provincial Coordinators and Community Health Advocates monitoring faclities are recruited from PLHIV, PWD, PWUID, Young People. The community members have a deep understanding of the local context, culture, and needs of their respective communities. The team lead should has more than 20 years of HIV programming and advocacy experience working with the community and a strong commitment to community empowerment and participation.

To understand the needs of the community, the team engages in a participatory needs assessment process, which involves working closely with community members to identify their priorities and challenges. This process  includes engaging with community leaders, holding community meetings and workshops, and conducting surveys and interviews with community members.

As the project is developed, community input and ideas were meaningfully incorporated into the design and implementation process.  Community members were included in the selection of health indicators to be monitored, developing data collection tools that are culturally appropriate and relevant to the community, and ensuring that the data collected is used to inform advocacy efforts that reflect the community's priorities and agendas.

Overall, the CLA project was designed and will be implemented in a way that prioritizes community participation and empowerment. This includes ongoing quarterly meetings ans other engagement with community members, a commitment to building trust and relationships, and a willingness to adapt and adjust the project based on community feedback and input.
 

Solve is a platform that fosters innovation and collaboration to address global challenges, and it offers various resources, such as funding, mentorship, partnerships, and networking opportunities, to support Solver teams in advancing their solutions. Therefore, a community-led advocacy project to monitor health facilities might apply to Solve to access these resources and overcome some of the barriers that hinder their success.

Specific barriers that I face in implementing my solution are financial, technical and cultural related. For instance, I  lack the funding to scale up the project from 255 health care facilities to 1200 and to acquire the necessary technology and equipment such as smart phones to monitor health facilities effectively. So far we have not faced any legal or regulatory challenges  limiting our ability to collect and share data on health facilities, or cultural barriers that preventing us from effectively engaging with certain communities. We however need technical assistance to manage, analyze and packave collected data for adcocacy. Addirionally as poor communities were struggle to find partners or investors who share our vision and are willing to support our project. The current funder PEPFAR, is conflicted because it is self-funding to be monitored. Furthermore, PEPFAR's approach is not effective due to biased data, their monitors work at the health facilities they monitor.

By applying to Solve, Solver teams can connect with partners who can provide the financial, technical, legal, cultural, or market-related support we need to overcome these barriers and advance our solution. For example, Solve might connect us with investors, donors, or grantmakers who can provide funding to scale up this project. It might also provide technical expertise and mentorship to help our team improve our monitoring tools and data analysis methods. Additionally, Solve may connect us with legal experts who can help us navigate regulatory challenges and with cultural advisors who can help the team build trust and engagement with communities. Overall, Solve aims to help Solver teams overcome the barriers they face and maximize their impact in addressing global challenges.

Monitoring health facilities to identify barriers using technology is innovative in several ways. First, it  provides more accurate and timely data on the quality of health services and the barriers that communities face in accessing them. Traditional methods of monitoring health facilities, such as surveys and inspections, can be time-consuming, costly, and subjective, and may not capture the full picture of the challenges that communities face. By using technology, such as mobile apps, sensors, or remote monitoring systems, it can be possible to collect real-time data on the availability, accessibility, and quality of health services, as well as the experiences and feedback of patients and communities.

Second, monitoring health facilities using technology  enables more efficient and targeted interventions to address the identified barriers. By analyzing the data collected from health facilities, it can be possible to identify the root causes of the barriers and design tailored solutions to address them. For example, if the data shows that a health facility lacks essential medicines, it can be possible to mobilize resources to procure and distribute the medicines quickly, rather than waiting for a routine inspection or survey.

Third, monitoring health facilities using technology promotes greater transparency and accountability in the health sector. By making the data on health facilities publicly available, it can be possible to engage communities, civil society organizations, and policy makers in monitoring and improving the quality of health services. It can also help to identify and address cases of corruption, mismanagement, or neglect in the health sector.

Overall, a solution that monitors health facilities to identify barriers using technology catalyzes broader positive impacts in the health sector by promoting data-driven decision making, improving the quality and accessibility of health services, and enhancing transparency and accountability. It will also change the market by creating new opportunities for technology companies, data analytics firms, and other stakeholders to develop innovative solutions that address the complex challenges of the health sector.
 

 - Increase the availability,affordability and accessibility of essential health services in underserved communities by identifying and addressing the barriers that prevent communities from accessing them.

- Enhance transparency and accountability in the health sector by promoting data-driven decision making and engaging communities, CSOs, and policy makers in monitoring and improving the quality of health services.
- Empower communities to advocate for their health rights and needs by providing them with the tools, information, and support they need to monitor and improve the quality of health services.

To achieve these impact goals, the community-led advocacy project will use various strategies and tactics, such as:

- Mobilizing and training community health workers, volunteers, and advocates to collect data on health facilities, engage with communities, and advocate for their health needs and rights.
- Developing and deploying technology tools, such as mobile apps, sensors, or remote monitoring systems, to collect real-time data on the availability, accessibility, and quality of health services.
- Analyzing and visualizing the data collected from health facilities to identify the root causes of the barriers and design tailored solutions to address them.
- Engaging with policy makers, health providers, and other stakeholders to advocate for policy and practice for improved  quality and accessibility of health services.
- Providing communities with information, and support to enable them to advocate for their health needs and rights, and to hold health providers and policy makers accountable for delivering quality health services.

In the next year, the CLA project will set the following impact goals:

- Establish partnerships with local health providers, civil society organizations, and policy makers to pilot the monitoring and advocacy model in a few selected communities.
- Train and mobilize community volunteers, and advocates to collect data on health facilities and engage with communities.
- Develop and deploy technology tools to collect and analyze data on health facilities and barriers to access.
- Compile and analyze the data collected from health facilities to identify the root causes of the barriers and design tailored solutions to address them.
- Engage with policy makers, health providers, and other stakeholders to advocate for policy and practice changes that improve the quality and accessibility of health services in the communities.

In five years, the community-led advocacy project could set the following impact goals:

- Scale up the monitoring and advocacy model to cover more communities and health facilities in the region or country.
- Build a sustainable network of community health workers, volunteers, and advocates who can collect data on health facilities, engage with communities, and advocate for their health needs and rights.
- Develop and deploy more advanced technology tools, such as artificial intelligence and machine learning algorithms, to collect and analyze data on health facilities and barriers to access.
- Establish partnerships with national and international health organizations, donors, and investors to secure funding and technical support for the scaling up of the project.
- Influence policy and practice changes at the national and international levels to improve the quality and accessibility of health services and promote transparency and accountability in the health sector.

In the community-led advocacy project, measuring progress towards impact goals will be challenging as the impact is often intangible and difficult to measure. However, there are several indicators that will be used to measure progress towards impact goals. Here is how impact will be measured:

1. Number of people engaged: This indicator measures the number of people who have been engaged in the advocacy project. This will include the number of people who have attended community meetings, signed petitions, or participated in other activities related to the project.

2. Policy changes: This indicator measures the extent to which the advocacy project has led to changes in policies or regulations. This will include changes at the local or national level that are relevant to the project's goals.

3. Awareness-raising: This indicator measures the extent to which the project has raised awareness about the issues being addressed. This will include the number of people who have been reached through media coverage, social media posts, or other awareness-raising activities.

4. Community mobilization: This indicator measures the extent to which the project has mobilized the community to take action. This will include the number of people who have taken action as a result of the project, such as attending a rally or contacting their elected officials.

5. Collaboration and partnerships: This indicator measures the extent to which the project has built partnerships and collaborations with other organizations or individuals. This will include the number of partnerships formed, as well as the strength and effectiveness of those partnerships.

6. Long-term impact: This indicator measures the long-term impact of the project. This will include the sustainability of the project and its impact on the community over time.

These indicators can be used to track progress towards impact goals and inform programmatic decisions and adaptations as needed. The indicators will be aligned with the specific goals and objectives of the advocacy project, as well as with the UN Sustainable Development Goals if applicable.
 

 For a community-led advocacy project to monitor health facilities to identify barriers, the theory of change will look like this:

1. Activities: Mobilize and train community health  advocates and volunteers to collect data on health facilities, engage with communities, and advocate for their health needs and rights.

2. Outputs: Increased capacity of community health advicates and  volunteers,  to collect data on health facilities, engage with communities, and advocate for their health needs and rights.

3. Outcomes:

- Improved availability and accessibility of essential health services in underserved communities by identifying and addressing the barriers that prevent communities from accessing them.
- Greater transparency and accountability in the health sector by promoting data-driven decision making and engaging communities, civil society organizations, and policy makers in monitoring and improving the quality of health services.
- Empowered communities to advocate for their health rights and needs by providing them with the tools, information, and support they need to monitor and improve the quality of health services.

4. Impact: Improved health outcomes and well-being for communities in underserved areas.

The theory of change suggests that by mobilizing and training community health workers, volunteers, and advocates to collect data on health facilities, engage with communities, and advocate for their health needs and rights, a community-led advocacy project can achieve the immediate output of increased capacity. This increased capacity can then lead to the longer-term outcomes of improving the availability and accessibility of essential health services in underserved communities, enhancing transparency and accountability in the health sector, and empowering communities to advocate for their health rights and needs. Ultimately, these outcomes can contribute to the impact of improved health outcomes and well-being for communities in underserved areas.

To support the theory of change, thebcommunity-led advocacy project could conduct third-party research to validate the linkages between its activities, outputs, outcomes, and impact. For example, it will track and analyze the data collected from health facilities and communities to measure the effectiveness of its advocacy efforts in addressing the identified barriers and improving the quality and accessibility of health services. It could also engage with external evaluators, researchers, or peer organizations to assess the impact of its project on health outcomes and well-being in the target communities.
 

Community-led advocacy projects leverage various types of technology to advance their goals. Here are sme of core technologies that will power community-led advocacy projects:

1. Social media: Social media platforms such as Facebook, Twitter, and Instagram will be used to raise awareness about advocacy issues and mobilize communities to take action. Social media will also be used to connect with like-minded individuals and organizations and build partnerships.

2. Mobile technology: SMS technology and mobile apps can will be used to reach individuals who may not have access to traditional forms of communication, such as email or social media. Mobile technology will be also be used to conduct surveys, collect data, and mobilize communities. ComCare is currently being used.

3. Data analysis tools: Data analysis tools will be used to analyze and interpret data collected through surveys, petitions, or other sources. This data can be used to identify trends, make informed decisions, and track progress towards goals.

4. Collaboration tools: Collaboration tools such as Google Docs, Slack, and Trello will be used to facilitate communication and collaboration among team members and partners.

5. AI and machine learning: AI and machine learning will be used to analyze large amounts of data and identify patterns and trends. This will be useful in identifying opportunities for advocacy and developing targeted campaigns.

6. Open data platforms: Open data platforms, ComCare will be used to share information and data related to advocacy issues. This can facilitate collaboration, inform decision-making, and promote transparency.

Overall, the core technology that powers community-led advocacy projects is the use of digital tools and platforms to connect, engage, and mobilize communities. These technologies will help to amplify voices, raise awareness, and drive change.

Traditional, ancestral, and natural technologies and knowledge systems such as traditional birth attendents will be used to provide culturally appropriate and effective care for communities.

In addition, natural technologies such as biochar, agroforestry, and water harvesting can be used to improve soil fertility, conserve water resources, and enhance biodiversity. These techniques are often low-cost and require minimal inputs, making them accessible and sustainable for communities.

  Local communities will be engaged and their knowledge and expertise respected when developing and implementing these approaches.The project places the health facility user and the traditional chief at the centre of health advocacy.
 

Ensuring diversity in the community-led advocacy project monitoring health facilities for access to good quality health services in Zimbabwe is important to ensure that the project is representative of the local population and that all community members have a voice in the advocacy process. Here are some strategies that we have used to promote diversity in the project:

1. Consortium: Engaged with a wide range of community members drawn from all 10 provinces of Zimbabwe: When identifying stakeholders to participate in the project, we made an effort to engage with a diverse range of community members. This includes people living with HIV, people who use and inject drugs, people with disabilities, Sex Workers, pregnant mothers, individuals from different ethnic, linguistic, and cultural backgrounds, as well as individuals from different socioeconomic backgrounds and people of faith.

2. Use inclusive language: All communication related to the project uses inclusive language that does not exclude or marginalize any particular group of people.

3. Provided training and support: Provided training and support to community members who may not have experience with advocacy work, to ensure that everyone has an equal opportunity to participate and contribute.

4. Created a safe and inclusive space: Ensure that the project creates a safe and inclusive space where all community members feel comfortable sharing their perspectives and experiences.

5. Use participatory methods: We use participatory methods to involve community members in the project, such as participatory mapping, community surveys, and focus group discussions.

6. We make sure that all voices are heard, including those of marginalized groups.

By implementing these strategies, the project ensures that it is inclusive and representative of the local population, and that all community members have an equal opportunity to participate and contribute.
 

 Based on the goals and objectives of the project, we employ the:

1. Grant-funded model:  seeking grants from foundations, government agencies, and other organizations to fund the project. Funding will be used to cover the costs of data collection, Comkunity Health Advocates remuneration, advocacy activities, such as awareness-raising campaigns, community mobilization, and capacity building.

2. Social enterprise model: This model involves creating a social enterprise that generates revenue through the sale of goods or services, and using the profits to support the advocacy project.  The project will sell farm fresh vegetables and locally-produced goods.

3. Crowdfunding model:  raising funds through online platforms, such as Kickstarter or GoFundMe. Crowdfunding will also be used as an effective way to raise awareness about the project and engage a wide range of supporters.

4. Corporate sponsorship model:  seek corporate sponsorship from companies that share the project's values and goals. Corporate sponsorship will provide funding and other resources, such as expertise and networks, to support the project.

5. Membership model: This a membership-based organization that charges membership fees to individuals or organizations that want to support the project. Members will receive benefits such as access to resources, networking opportunities, and advocacy training.

Ultimately, the most effective business model that will sustain this project is volunteerism by empowered community members trained to monitor and advocacate independently.
 

Achieving financial sustainability for a community-led advocacy project requires careful planning and implementation of strategies that can generate reliable and diverse sources of funding. Here are some of the strategies for achieving financial sustainability for the community-led advocacy project:

1. Develop a diversified funding portfolio: Relying on a single funding source can be risky, as changes in funding priorities or availability can have a significant impact on the project's sustainability. Developing a diversified funding portfolio that includes grants, donations, corporate sponsorships, and earned income will help to mitigate this risk and ensure that the project has access to a range of funding sources.

2. Develop partnerships: We are collaborating with other organizations, such as local businesses, NGOs, or government agencies, to provide access to additional resources, funding, and expertise. Developing strong partnerships has also helped us to build the project's credibility and legitimacy.

3. Develop income-generating activities: Developing income-generating activities that align with the project's mission and values  provides a reliable source of funding. 

4. Implement efficient financial management: Effective financial management is critical to achieving financial sustainability. We developed a clear budget, tracking expenses and revenue, and ensuring that financial reporting is accurate and transparent.

5. Engage in fundraising and donor cultivation: Engaging in fundraising and donor cultivation activities  helps us to build relationships with potential funders and increase the project's visibility. We will host fundraising events, developing a donor database, and developing compelling fundraising materials.

6. Develop a long-term strategic plan: Developing a long-term strategic plan that includes clear goals, objectives, and timelines will help to ensure that the project is sustainable over the long term. This plan will include strategies for achieving financial sustainability, as well as strategies for achieving the project's broader mission and goals.

Overall, achieving financial sustainability for a community-led advocacy project will require us to be strategic regarding frequency of data collection and conducting advocacy activities. 
 

PEPFAR supports 19 CBOs currently minitoring CLM with USD400,000. We have managed to secure the services of community members who are volunteering to monitor using their smart phones. We have also secured M&E services at 50% from a qualified community member