A Weeklong National Training for Master Trainers, CSOs and Community Members iCLM Model, Tools, and Pilot Findings

Kigali | 12th -16th January 2026

A landmark two-day national training on Integrated Community-Led Monitoring (iCLM) for HIV, Tuberculosis (TB), and Malaria was recently hosted by the Rwanda NGOs Forum on HIV/AIDS and Health Promotion (RNGOF on HIV/AIDS & HP) from 12 to 16 January 2026. The event brought together representatives from Civil Society Organizations (CSOs), high-risk groups for Malaria and TB and key and vulnerable populations for HIV, person with disabilities (PWUD), faith leaders, and implementing partners from across the country, providing a platform for knowledge sharing, capacity building, and collaborative planning. The training aimed to strengthen integrated community-led monitoring (iCLM), promoting accountability, responsiveness, and equity in the delivery of HIV, TB, and Malaria services. Through interactive sessions, participants gained a thorough understanding of the CLM concept and principles, its practical applications, and Rwanda’s 2025 disease priorities, highlighting the essential role of communities in shaping health service delivery.

By adopting this integrated community-led monitoring approach, Rwanda reinforces its commitment to people-centered, data-driven, and rights-based health systems. The initiative aligns closely with the country’s broader health sector transformation agenda, showcasing Rwanda’s leadership in pioneering innovative approaches to public health governance. The training further emphasized the importance of strong partnerships and collaboration between civil society, communities, and implementing agencies to ensure that health interventions are effective, inefficiency, inclusive, and responsive to the needs of the communities.

Opening and Training Objectives

The training was officially opened by the Rwanda NGOs Forum on HIV/AIDS and Health Promotion, which underscored the strategic importance of integrated Community-Led Monitoring (iCLM) as a tool for closing services gaps between communities and health service providers. Participants were welcomed and introduced, followed by a detailed briefing on the training objectives, the pre-test evalution of CLM and iCLM to gauge their knowledge, and national epidemiological updates and program priorities for HIV, TB and Malaria).

The primary objective of the training was to equip RNGOF staff, CSOs and community representatives with the knowledge, skills, and shared understanding required to implement integrated CLM for HIV, TB and Malaria effectively. Moving beyond disease-specific monitoring, the integrated community-led monitoring model for HIV, TB and Malaria reflects the reality that communities often face multiple and interconnected health challenges while navigating health system, requiring coordinated responses rather than siloed interventions.

Understanding Community-Led Monitoring (CLM)

Community-Led Monitoring is a systematic, community-driven approach that empowers communities particularly those at risk, living with and most affected by the disease/condition to routinely collect, analyze, and use data on the availability, accessibility, acceptability, and quality of health services. Unlike traditional monitoring systems, CLM positions communities not as passive beneficiaries, but as active accountability actors within the health system. The Integrated community-led Monitoring (iCLM) model adopted in Rwanda for HIV, TB and Malaria was informed by established CLM frameworks developed by PEPFAR, UNAIDS, and EANNASO, and has been carefully adapted to the national context. The model is grounded in four core principles:

By integrating HIV, TB, and Malaria within a single monitoring framework, the iCLM model addresses overlapping vulnerabilities, service delivery bottlenecks, and systemic inefficiencies experienced by communities, while promoting efficiency and coherence across HIV, TB and Malaria programs.

HIV Programmatic Insights

Training participants reviewed national HIV program data to anchor CLM discussions in evidence. In 2025, Rwanda conducted 1,987,601 HIV tests nationwide, with a positivity yield of 0.62 percent, reflecting sustained progress toward epidemic control. However, geographical disparities persist, with higher positivity yields observed in parts of the City of Kigali and Eastern Province, signaling the need for evidence-based, targeted, community-led interventions.

Antiretroviral Therapy (ART) coverage remained high at 96.9 percent, corresponding to 229,275 people currently receiving treatment. Despite this progress, a slight decline in ART coverage among females aged 0–14 years from 80 percent to 78 percent was noted. This trend highlights the critical role of community-led monitoring in identifying service gaps affecting children and adolescents and ensuring timely corrective action.

Moving forward, strategic priorities include reducing stigma and discrimination among people living with HIV and Key Populations (Female sex workers [FSWs] and Men who have sex with men [MSM]), community engagement in leading actions to prevent HIV, Tailored Interventions, Enhance integration of HIV services with non-communicable diseases, sexual and reproductive health, and mental health services, and enhanced surveillance and research to advance the HIV response.

Malaria Situation and Emerging Trends

Malaria continues to pose a significant public health challenge in Rwanda, with data indicating pronounced geographic concentration. Gisagara, Gasabo, Kicukiro, Bugesera, Nyagatare District remains the most affected. On top of that, the top 15 districts have 86% of the malaria burden treated in Rwanda from January to October 2025. This underscores the need for localized, community-driven monitoring and response strategies. Of particular concern was the increase in 16 malaria-related deaths reported in November 2025, highlighting persistent gaps in early detection, referral, and timely treatment.

Through the iCLM approach, malaria high-risk communities are expected to systematically document service interruptions, commodity stock-outs, delayed care-seeking, and barriers to preventive interventions such as insecticide-treated net distribution and use, and mosquito repellents. This community-generated evidence is essential for prompt response and improved service delivery.

Tuberculosis and the Role of Communities

However, key challenges persist, including:

Community-based interventions such as household visits, targeted health education, and tailored communication strategies were identified as essential components of iCLM to strengthen early detection, improve treatment adherence, and reduce transmission

Deepening the Rwandan-specific Integrated CLM Model

The training focused on operationalizing integrated CLM for HIV, TB, and Malaria. Participants engaged in practical sessions on data collection tools, ethical considerations, analysis, and structured engagement with health facilities, district authorities, and national stakeholders.

Key areas of focus included:

Expected Outcomes and Health System Impact

The Integrated Community-Led Monitoring model for HIV, TB and Malaria is expected to generate significant system-level impact, including:

Training participants consistently highlighted CLM as a powerful solution for addressing persistent service delivery gaps and delays, while strengthening trust and responsiveness within the health system.

A weeklong national training marked a major milestone in Rwanda’s journey toward people-centered and accountable health systems. By institutionalizing Integrated Community-Led Monitoring for HIV, TB, and Malaria, Rwanda has positioned itself as a global pioneer, offering a replicable model for other countries seeking to strengthen community accountability and improve health outcomes.

As implementation advances, the Rwanda NGO Forum on HIV/AIDS and Health Promotion, in collaboration with community-led organizations (CLOs)/Civil Society Organizations (CSOs), communities, and government partners, will continue to play a pivotal role in ensuring that community voices remain central to health decision-making, transforming evidence into action and accountability into measurable impact.