ITPC (2023) Citizen Science Survey Data on Community-Led Monitoring Feedback Mechanisms

<b>Background:</b> There is growing consensus that community-led monitoring (CLM) data is an essential component of wider HIV program quality improvement and accountability. Yet, little is known about how CLM data are discussed and used. To optimize the use of CLM data for decision-making, a better understanding CLM feedback mechanisms is needed.<b>Methods: </b>The Citizen Science project (November 2020-present) conducts CLM of HIV services at 33 health facilities in Malawi and South Africa. From March-August 2023, an operational research initiative sought to understand how the CLM data is fed back to key actors. An online survey was administered among 188 stakeholders, the majority of whom were recipients of care (33%),<b> </b>healthcare workers (29%), and CLM data collectors (27%). Face-to-face interviews with 118 similar stakeholders provided further nuance and depth.<b>Results: </b>CLM data is shared though at least 25 different feedback mechanisms. More than half (54%) of respondents said CLM feedback happens in real time, during data collection. At the health facility, CLM data is regularly discussed during formal meetings, but nearly a quarter (24%) said it also comes up in casual conversation. More than half (52%) of healthcare workers discuss CLM data at least once a week, compared to 39% of other stakeholders. CLM data sharing usually occurs when project team members call a meeting, however, 36% of respondents said health facilities also request CLM data. Community leadership is critical, since 36% of stakeholders said they remember CLM data better if people living with HIV present it to them, and 19% if key populations do. Stakeholders are more likely to act on CLM data if there is consensus on the findings, there are agreed action points, and the District Health Management Team is involved.<b>Conclusions:</b> CLM data use may improved if protocols for informal feedback mechanisms are developed, affected communities lead, and solutions are co-created.

<b>背景：</b>目前日益达成共识，即社区主导监测（CLM）数据是更广泛的HIV项目质量改进与问责制的重要组成部分。然而，关于CLM数据的讨论及使用方式知之甚少。为优化CLM数据在决策中的应用，需进一步理解CLM反馈机制。<b>方法：</b>公民科学项目（2020年11月至今）在马拉维和南非的33家卫生机构开展了HIV服务的CLM。2023年3月至8月，一项行动研究（operational research）计划旨在了解CLM数据如何反馈给关键行动者（key actors）。研究对188名利益相关者（stakeholders）进行了在线调查，其中大多数为受关怀者（33%）、医护人员（29%）及CLM数据收集者（27%）。通过与118名同类利益相关者的面对面访谈，获得了更细致深入的信息。<b>结果：</b>CLM数据通过至少25种不同的反馈机制进行共享。超过半数（54%）的受访者表示，CLM反馈在数据收集期间实时发生。在卫生机构中，CLM数据常于正式会议中讨论，但近四分之一（24%）的受访者表示其也会在非正式交流中出现。超过半数（52%）的医护人员每周至少讨论一次CLM数据，而其他利益相关者的这一比例为39%。CLM数据共享通常在项目团队成员召集会议时进行，但36%的受访者表示卫生机构也会主动请求CLM数据。社区领导力至关重要：36%的利益相关者表示，若由HIV感染者（people living with HIV）呈现CLM数据，他们会记得更清楚；若由重点人群（key populations）呈现，则为19%。当各方对研究结果达成共识、存在商定的行动要点且地区卫生管理团队（District Health Management Team）参与其中时，利益相关者更可能根据CLM数据采取行动。<b>结论：</b>若能制定非正式反馈机制的规程、由受影响社区主导并共同制定解决方案，则CLM数据的使用或可得到改善。