Community Voices Driving Changes: Dissemination of Rwanda’s Integrated Community-Led Monitoring (iCLM) Pilot Findings for HIV, TB, and Malaria

Date: December 24, 2025

As part of Rwanda’s Integrated Community-Led Monitoring (iCLM) Model for HIV, TB, and Malaria, the Rwanda NGOs Forum on HIV/AIDS and Health Promotion (RNGOF on HIV/AIDS & HP), in collaboration with Rwanda Biomedical Centre (RBC), Civil Society Organizations (CSOs), and Community-Led Organizations (CLOs), with support from The Global Fund, successfully disseminated district-level iCLM pilot findings across Bugesera, Rwamagana, and Gasabo Districts. This event was more than just a presentation of findings — it was a powerful demonstration of how community voices can shape health systems, improve service delivery, and better serve high-risk groups, key and vulnerable populations, people with disabilities, and faith-based leaders.

Why iCLM for HIV, TB, and Malaria Matters

The Integrated Community-Led Monitoring (iCLM) Model is Rwanda’s first multi-disease community-led monitoring approach. It includes:

An innovative iCLM System for community data management
A mobile application enabling routine, rigorous evidence collection
Strong mechanisms to hold service providers accountable

This is not merely a technical innovation — it is a social transformation that empowers people living with, most at risk of, and affected by these diseases to influence decisions that directly impact their lives. Community engagement and empowerment were central to the success of this model. Key and vulnerable populations, persons with disabilities, faith leaders, and civil society organizations actively contributed to shaping it — ensuring iCLM remains a truly people-centered solution.

What the Findings Reveal

Despite notable progress, the pilot identified persistent gaps in service delivery across HIV, TB, and malaria programs, particularly in the four key dimensions: Availability, Accessibility, Acceptability, and Quality (AAAQ).

Cross-cutting Issues

Shortages of healthcare professionals
Lack of targeted Information, Education, and Communication (IEC) materials

HIV Services – Key Challenges

Low availability of condoms and lubricants
Persistent stigma and discrimination against key populations
Limited support for treatment adherence
Poor awareness of viral load monitoring
Concerns around consent, confidentiality, and welcoming environments

These barriers disproportionately affect adolescent girls and young women, female sex workers, men who have sex with men, and persons with disabilities.

Tuberculosis – Key Challenges

Delays in community diagnosis
Weak TB–HIV integration
Low treatment literacy
Poor contact tracing
Inadequate preventive therapy for family members

Malaria – Key Challenges

Frequent medicine stock-outs at community level
Lack of mosquito repellents
Inconsistent application of treatment guidelines by community health workers
Post-diagnosis treatment gaps

Commitment to Action

District stakeholders acknowledged these findings as reflecting daily realities. They committed to joint action involving:

Communities
Ministry of Health
Rwanda Biomedical Centre
Civil society
Development partners

The goal: to deliver more equitable, people-centered, and responsive health services.

The Bigger Picture

The iCLM pilot represents more than a health program — it is a powerful governance mechanism. By transforming community voices into actionable evidence, Rwanda is establishing a model for truly participatory health systems worldwide.

As Rwanda prepares to scale up the iCLM Model, the question is not whether this approach works — it does. The real challenge is how quickly we can expand it and collectively address the highlighted issues to ensure no one is left behind in the fight against HIV, TB, and malaria.

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