Tororo District, Uganda

Project overview:

TDYAN YOVANU is implementing a Community-Led Monitoring (CLM) project in Tororo District to strengthen the quality, accessibility, and accountability of HIV, TB, and malaria services, particularly for adolescents, young people, and other vulnerable populations.

At its core, the project places community voices at the center of health system improvement. Trained community monitors work directly with service users and health workers to document lived experiences of care, identify gaps, and generate credible, community-owned evidence that can inform practical change at facility and district levels

Rather than fault-finding, CLM creates structured spaces for listening, dialogue, and shared responsibility between communities, health facilities, and duty bearers.

What the project is about:

The project responds to persistent challenges that are often invisible in routine health reports. These include long waiting times, stock-outs of essential medicines, stigma and discrimination, gaps in youth-friendly services, and weak feedback mechanisms. Through CLM, these issues are surfaced respectfully and systematically, ensuring that services are not only available on paper, but accessible, acceptable, and responsive in real life.

The intervention aligns with the Global Fund’s people-centred and rights-based approach and contributes to national and district-level efforts to strengthen HIV, TB, and malaria responses through social accountability mechanisms

Project objectives

General objective

To improve the accessibility, availability, and quality of HIV, TB, and malaria services in Tororo District, with a specific focus on adolescents, young people, and affected communities.

Specific objectives

• To document community and client experiences with HIV, TB, and malaria services across selected health facilities
• To identify systemic barriers affecting service access, equity, and quality
• To generate credible community-led evidence to inform facility-level improvement, district planning, and advocacy
• To strengthen trust and constructive engagement between communities, health workers, and local authorities

Key activities and approach:

The project is implemented using a mixed-methods CLM approach, including:

• Structured interviews with service users and health workers
• Focus group discussions with HIV, TB, and malaria clients
• Facility observations assessing service organization, staffing, and availability of essential commodities
• Continuous engagement with district leadership and facility in-charges

Community monitors are drawn from local communities, trained in ethical data collection, confidentiality, and participatory monitoring, which helps build trust and openness throughout the process

Key highlights and early results

• CLM data collection conducted across 8 health facilities in Tororo District
• 119 service user interviews and 40 health worker interviews completed
• 21 focus group discussions involving 257 community members
• Strong participation by adolescents and young people, with women and girls highly represented
• Improved dialogue and collaboration between communities and health facilities, even before data analysis is finalized

Why this project matters:

This project helps move health programming from coverage to impact. By grounding service improvement in real community experiences, CLM strengthens accountability, promotes dignity in care, and supports more responsive and equitable health systems. It also reinforces the role of youth-led and community-rooted organizations in shaping solutions that last.

Partners and funders

• The Global Fund to Fight AIDS, Tuberculosis and Malaria
• The AIDS Support Organization (TASO)
• Uganda Development and Health Associates (UDHA)
• Implemented by TDYAN YOVANU in collaboration with Tororo District local government and participating health facilities