Interventions for community systems strengthening

Purpose

Community system strengthening is about strengthening systems. It is about investing in the system pillars that enable community organizations and key population networks and groups to maximize their contribution to all aspects of health programming. Strengthening community systems also means investing in an environment that is enabling for communities and community organizations and ensuring that there is a place at the table for civil society organizations to be consulted on health-related decisions at every step.

Intervention areas

There are five main interventions that UNDP deploys for community systems strengthening: 1) strengthening an enabling environment for health; 2) strengthening institutional capacity, planning and leadership; 3) strengthening community-led monitoring and research; 4) strengthening community-led advocacy; and 5) strengthening community linkages, collaboration and coordination.

Building an enabling environment for community systems

This intervention involves work with other stakeholders to create and reinforce a legal, policy, regulatory and strategy environment that is conducive and responsive to health for all sectors of the community and that reinforces the work of community-led organizations. It is important to involve community-led and key population organizations in the design, implementation and monitoring of activities in this intervention.

It includes:

  • Providing financial and/or technical support for capacity strengthening of key duty bearers such as parliamentarians, national human rights institutions, health service providers, policymakers, law enforcement officials, lawyers and the judiciary to create an awareness of the importance of community systems and of the barriers to health and access to services that particular communities or groups face. Duty bearers need to be able to understand and address legal, policy, regulatory and strategy barriers to access to health services and have the capacity to avert and respond to human rights violations.
  • Providing financial and/or technical support for capacity strengthening of key duty bearers to understand the important role played by policy dialogue and community-led advocacy in access to health, to ensure the provision of necessary space for community-led advocacy and to protect the safety of activists.
  • Providing technical support and advocate for the inclusion of community systems and activities in health and other relevant strategies, budgets, indicators and targets at national and sub-national levels.
  • Providing technical support and advocating for the registration of community groups by the government.
  • Advocating with donors and the government for stable and predictable financial resources and core funding for community systems, as lack of core funding is often a barrier to effective institutional development for community-led organizations.
  • Advocating for or providing technical support to strengthen the capacity of health systems to generate accurate data that can be used by community systems to track quality and coverage of health services, health policy, targets and financing. Lack of good data are a common barrier to community-led monitoring of health services.

Strengthening institutional capacity, planning and leadership

This intervention involves strengthening the capacity of individuals, community groups, organizations and networks in a range of areas necessary for them to fulfil their roles in service provision, social mobilization, monitoring and advocacy.

It includes:

  • Providing financial and/or technical support and mentoring for planning, financial management, institutional and organizational development, systems development, human resources and leadership development, transparency, equity and community sector organizing.
  • Providing financial and/or technical support (including training and tools) to the community sector as required to enable them to fulfil roles in service provision, social mobilization, monitoring and advocacy. Community members should not be asked to work without proper remuneration.  It is necessary to find or provide support for both core funding for community-based organizations and networks, including organizational overheads and staff salaries and stipends, and targeted funding for implementing programmes and interventions.
  • Providing financial and/or technical support (including training, tools and equipment) for strengthening e-governance of community systems and to build social media capital and capacity to ensure data security and confidentiality. This involves support to develop and roll out digital community platforms and other mechanisms that enable flexible communication in situations where in-person contact is unsafe, unfeasible or undesirable (for example in contexts where surveillance and criminalization make face-to-face advocacy challenging). These platforms should facilitate key population and other community groups to share information, communicate with their constituents, contribute to national and subnational planning, and participate in other consultations and decision-making processes.

Strengthening community-led monitoring and research

This intervention involves strengthening the capacity of community-based organizations and other community groups to monitor, document and analyse the performance of health services as a basis for accountability, advocacy and policy activities. Key population groups often have their own long-established ways of collecting and acting on information. Community-based monitoring simply formalises and builds on these systems, linking them to services provided by the government and non-governmental organizations. Refer to the Health Information Systems section for more information.

It includes:

  • Providing financial and/or technical support (including training and tools) to establish and implement community-led mechanisms for ongoing monitoring of health policies and strategies, of performance against targets and of the quality of health services and related activities.
  • Providing financial and/or technical support for community-led monitoring and tracking of other factors that are part of an enabling environment for health and well-being, such as financing of programmes, discrimination, gender-based inequalities and other social, economic and environmental determinants of health. Again, this is dependent on having good national and subnational information.
  • Providing financial and/or technical support (including training and tools) for operational research and the generation of research-based and experiential evidence for results-based programming. Good practice dictates that research is community-led, meaning that community members take a lead in the design of research protocols and methods, the collection and analysis of data and the dissemination and validation of findings. How to effectively maintain confidentiality is usually an important issue to consider in community-led research. Experts involved should be there to facilitate communities to decide what is important to research, how research is carried out and what happens to research findings.

Strengthening community-led advocacy

This intervention involves strengthening the capacity of community-led organizations and key population groups to hold service providers, national programmes, policy-makers, and local and national leaders accountable for the effective delivery of services and other health-related activities.

It includes:

  • Providing financial and/or technical support (including training and tools) and mentoring for community-led organizations and key population groups to design and conduct advocacy activities at local and national levels aimed at holding to account those responsible for health policy and service provision, including disease-specific programmes. Advocacy activities aimed at broader issues that affect health and access to services are also important, such as activities that highlight discrimination, gender inequality, sustainable financing and the protection and promotion of human rights.
  • Providing financial and/or technical support to develop and adapt policy engagement scans and other tools that can be used to highlight the process by which civil society organizations can engage with policy and law reform, in a particular country or region, to influence health responses.
  • Providing financial and/or technical support (including training and tools) to enable community-led organizations and key population groups to effectively use data and findings from monitoring and research activities for advocacy with key duty bearers, such as parliamentarians, national human rights institutions, service providers, policymakers, law enforcement officials, lawyers and the judiciary. This would include developing materials in support of strategic litigation, developing and disseminating policy and media briefs, and developing material for social media, webinars and other online events. It would also include support to conduct training and to develop training materials.

Strengthening community linkages, collaboration and coordination

This intervention involves strengthening the capacity of community organizations and networks to work within a community systems framework.

It includes:

  • Providing financial and/or technical support and mentoring to develop platforms and mechanisms for networking and for developing effective linkages within and between community groups and networks working on different aspects of improving health and well-being. Mechanisms for coordinating and collaborating with broader movements should also be developed, to mainstream health issues in, for example, human rights, environmental and women’s movements.
  • Providing financial and/or technical support and mentoring to develop strong informal and formal relationships between communities, community stakeholders and other stakeholders to enable them to work in complementary and mutually reinforcing ways, maximizing the use of resources and avoiding unnecessary duplication and competition. This might involve the use of memoranda of understanding to cement partnerships between community organizations, developing consortia for joint access to funding, onward referral of clients, sharing training opportunities and materials, sharing technical expertise, seconding staff between community organizations and mentoring new community organizations or key population groups. It might also involve creating space for community dialogues so that key issues can be discussed and priorities agreed on.

Key resources

Guidance Note on Community Systems Strengthening and Tuberculosis
Stop TB Partnership
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