To improve HIV services in Dominican Republic, Pact deeply engages vulnerable communities

May 13, 2024
A community-led monitoring session in Santo Domingo. Credit: Brian Clark/Pact
A community-led monitoring session in Santo Domingo. Credit: Brian Clark/Pact

It’s a sunny afternoon in Santo Domingo, Dominican Republic, and dozens of women and men are gathered at an office building on an expansive second-floor terrace. A few who are already finished are quietly chatting about their experiences as community case workers with the Pact-led Building Resilience Among HIV-Affected Families project. The rest are hunched over paper questionnaires.

Are there specific trainings that would benefit you as a case worker? What do you need in order to serve families better? What is most challenging about your job?

When everyone is finished, a staff member with a local partner in Building Resilience who is leading the session asks similar questions in an open dialogue, with notetakers recording what’s shared. 

The gathering is one of many that have been organized under Building Resilience as part of the project’s community-led monitoring component, or CLM. A tool that is being used more and more in global development, CLM is designed to help practitioners deeply listen to those we serve in order to meet their needs more effectively. CLM is defined as a mechanism, process or practice whereby service users and local communities regularly gather, analyze and use information to improve services. The focus is on gathering community input in a routine and systematic manner that translates into action and change to overcome persistent barriers to impact.

Credit: Brian Clark/Pact

CLM is one of many ways that Pact practices our engaged communities approach, under which we strive for development programming that is led by those it serves. 

In the USAID-funded Building Resilience project, which is working to address HIV among Haitians in Dominican Republic, CLM has been a key tool. In addition to conducting CLM sessions with project community case workers, Building Resilience also uses CLM to directly engage families that the project serves, including both adults and adolescents. 

“We use community-led monitoring to ensure that the families we serve have a significant voice in the project, from design through implementation,” says Pact’s Desirée Luis, head of the Building Resilience project. “It is vital in ensuring that we are focused on the right priorities – on communities’ priorities – for improving lives.”

Bethania Ruiz, a 19-year-old participant in Building Resilience, volunteered to take part in CLM because she wanted to help families living with HIV receive the most effective support possible, she says. Playing a key role in the project has made her feel empowered, she says, and she has learned about development and HIV programming. 

“It has been important to me to be involved in this,” Ruiz says. 

Credit: Brian Clark/Pact

Under Building Resilience, CLM is led by the local partner MUDE, as a strategy to make the practice more sustainable. With Pact’s support, MUDE regularly gathers case workers and families to collect critical feedback and perspective. The information goes to a CLM committee and then to Building Resilience’s technical working group. 

The goal is to identify challenges and implement solutions to improve the project’s effectiveness, and through CLM, Building Resilience has done just that, says Pact’s Franklin Marmol, a senior technical officer with the project. 

With information gained through CLM, Building Resilience has improved access to health services for vulnerable families. It has bolstered trainings for case workers on psychosocial support and more after they consistently noted the need. 

When adolescents shared that backpacks provided through Building Resilience were not sturdy enough, the project responded. When families expressed fear about stigma if their neighbors knew they were receiving support from an HIV program, Building Resilience implemented new measures to ensure discretion and privacy. When participants offered feedback on what kinds of vocational training would be most useful to them, the project tailored its offerings to match. 

“Communities have taught us so much through CLM,” Marmol says. 

“We say, ‘If you don’t ask, you’ll never know.’”