Community Responses & Systems

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The Global Fund has long supported community responses to the three diseases. While some elements of the response to AIDS, tuberculosis and malaria, by their very nature, are best implemented by the formal sector, we encourage countries to also look at tackling the issues from the ground up, by working in, through and with communities. We encourage and support communities to participate in advocacy efforts; monitoring the effectiveness of programs, holding them to account; the design of programs; the delivery of services; governance of grants at the country level; and governance of the Global Fund.

The role of community systems

Communities are not just beneficiaries of services. Communities are also actors, making vital contributions to improving health. When communities get involved, programs have greater impact. They expand the reach of services, engage people with health care, and overcome stigma and discrimination.

Community organizations and networks have an important role to play in helping countries provide comprehensive health care services. They:

  • Have a unique ability to interact with affected communities
  • Can react quickly to community needs and issues
  • Are highly effective at providing services
  • Help address the broader issues and barriers that prevent access to services

Bringing TB awareness to the community

Health volunteer Lach Sam takes part in a TB refresher course at a local health center in Samrong, Cambodia. Being a TB patient herself does not stop Lach Sam from continuing to provide treatment to others in her community. She also seeks out new suspected cases and organizes gatherings to teach villagers about the disease and how to prevent it. Volunteers in each village help not only to improve access to TB health services, they also raise awareness and fight stigma, leading to excellent treatment outcomes. The volunteer training program is supported by the Global Fund and its partners.

Investing in community systems

Countries submitting funding requests to the Global Fund are encouraged to describe how communities, including community-based organizations, will be involved in programs. Involvement should include both delivering services and monitoring the quality and performance of the services being provided.

Applicants must also provide an assessment of the strengths and weaknesses of community systems and include measures for addressing those weaknesses.

In addition, applicants have the option of allocating funding to such initiatives as:

  • Community-based monitoring, such as the monitoring of the quality and accessibility of services
  • Community-led advocacy
  • Social mobilization as well as building linkages, collaboration and coordination between communities and other health actors
  • Institutional capacity building, planning and leadership development

All of these are particularly important for improving programs that serve key, vulnerable and excluded populations. Enabling these populations to be involved in monitoring and advocacy will make it possible for members of those populations to express their needs, which will help to ensure that services and activities are appropriately designed and delivered.

“Fighting diseases such as HIV is not about a biomedical approach, but a meaningful participation of communities and it's about people.”
Carolyn Gomes, Caribbean Vulnerable Communities Coalition

Theater as powerful tool to prevent HIV

Actors Vanessa (left) and Alex perform in a play about a girl who loses a dear friend to HIV. Among Garifuna populations living in Honduras, plays like these are a popular and effective way of communicating messages about sensitive topics such as HIV, and often generate heated discussions afterwards. “Audiences have been very accepting,” says Vanessa. “I can really feel the change among youth.” The Global Fund supports the organizing of these events, the distribution of condoms, as well as the training that enables actors to deliver HIV prevention messages as effectively as possible.

Support for community responses and systems

We support community responses and systems because we believe that they are vital and that they should be systematically incorporated into national disease programs and health systems, but in many countries, they are still not seen as integral to overall systems for health, and there are limited efforts to plan and support them.

For this reason, we are investing US$15 million in the Community, Rights and Gender Strategic Initiative for the period 2017-2019. This money is used to:

  • Develop the capacity of key and vulnerable populations networks to meaningfully engage in Global Fund-related policy decisions that affect their lives
  • Fund technical cooperation to support the involvement of civil society and communities in Global Fund-related processes throughout the grant life cycle
  • Strengthen communication and regional dialogue across civil society organizations, key and vulnerable population networks and relevant stakeholders on Global Fund-related matters

Since we introduced our allocation-based funding model in 2014, this initiative has deployed around 80 technical assistance assignments to support the engagement of civil society in more than 30 country dialogue and 16 regional grant processes.

The Global Fund also provides additional guidance on community, rights and gender issues; produces internal policies to reflect these priorities; and works with partners to provide targeted analysis and support.

Neighbors helping neighbors in the fight against malaria

In northern Rwanda, Janviere, a community health worker, visits the home of her neighbor Mr Gashimba to demonstrate use of a bed net to protect him from malaria. Janviere is part of the government’s campaign to provide malaria prevention and treatment in even the most remote rural areas of the country. Elected by her fellow villagers, Janviere has received training through a program supported by the Global Fund, and through prevention education and other interventions is helping to bring better health to her fellow community members.

Published 15 April 2017