Advocacy for the integration of Community-Led Monitoring into health systems in Togo

---

Extract from the article: The National Council for the Fight against AIDS and Sexually Transmitted Infections (CNLS-IST), in collaboration with UNAIDS, organised an advocacy meeting in favour of the introduction of Community-Led Monitoring (CLM) as a focus for health...

---

The National Council for the Fight against AIDS and Sexually Transmitted Infections (CNLS-IST), in collaboration with UNAIDS, organised an advocacy meeting in favour of the introduction of Community-Led Monitoring (CLM) as a focus for health district management teams on 10 July 2025 in Lomé. The aim of this meeting is to strengthen collaboration between community monitoring mechanisms and health decision-makers at all levels of the health pyramid, in order to better integrate CLM into health systems and accountability mechanisms.

Since 2020, Togo has been experimenting with CLM through the Network of Associations of People Living with HIV in Togo (RAS+), with the support of partners such as UNAIDS and USAID. In 2021, the Global Fund took over to extend the activities to four of the country's six health regions. Despite this promising experience, the CLM still faces a number of challenges, such as the fact that community monitoring data is not sufficiently taken into account in public policy, limited integration into the national monitoring system, and a lack of institutional recognition. This advocacy meeting was organised in response to these challenges.

"Usually, we provide figures such as the screening rate, prevalence and the number of patients on ARV treatment. But these are quantitative indicators. We now want to go beyond the figures, to assess the quality of services, in particular: are users well received in the health centres? Are they satisfied with the care, prevention and access to medicines and inputs ? When we say that care is free, is this really the case in the field ? This meeting is therefore essential to ensure that decision-makers, regional and prefectoral players, focal points and representatives of civil society regard users as genuine partners. The aim is to ensure that, behind the data, the actual human quality of the services is there", emphasised Dr Pitché Vincent, national coordinator of the SP/CNLS-IST.

                                                                                                                                                                                                                                   

For Dr Diallo Yayé Kanny, UNAIDS Country Director in Togo, Community-Led Monitoring is a valuable tool for ensuring that beneficiaries are well received, and that services are provided in compliance with standards.  "It also enables us to report on the realities on the ground. When the people concerned are placed at the centre of the response, the results follow. The CLM also helps us to identify the obstacles to access to care, and therefore to propose concrete solutions. Five years ahead of 2030, there's no better strategy than to strengthen leadership With 2030 just five years away, there is no better strategy than to strengthen community leadership, through the CLM and other initiatives already underway", she added.

For his part, Augustin Dokla, Chairman of RAS+, emphasised the transformative power of the CLM. "Community-led monitoring is a real tool for empowerment and accountability. We, RAS+ Togo, along with the Cupidon network and other actors involved in CLM, have already obtained the support of the Ministry of Health at national level. It is now important to have the support of local and regional authorities. As members of the communities affected, we are the first to experience the reality of the services offered for HIV, malaria and tuberculosis. This dialogue will enable decentralised decision-makers to be more receptive to our warnings about problems of access, shortages of medicines and quality of care. Together, we will be able to identify sustainable solutions and improve the services that the State makes available to the population", he emphasised. 

The effective implementation of Community-Led Monitoring is much more than just a technical tool. It embodies a profound transformation of health governance, placing users at the heart of the health system.

Raymond DZAKPATA