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Finding the gaps

“The purpose is to identify the gaps that they have been missing, that they are not aware that they are missing. We want these facilities to be a zone whereby youth can come freely, as we’ve noticed that most youth don’t come to the facility because of health care worker attitudes.”

Inviting someone into your space to monitor how you do things is difficult for anyone, and it is especially difficult in the high-pressure environment of primary healthcare facilities. But it is critically important for the users of services to be in engaged in how these services are delivered. Young people, particularly adolescent girls and young women, are disproportionately affected by HIV and AIDS in South Africa. As Community Data Collector, Clementine Tibe explains, if young people can’t access good services, the problem will continue to grow: “When we have a youth-friendly sister in the facility, that sister can attract the young ones to come to the facility.”

“The statistics of young people being pregnant, being HIV positive is high. So we want to minimise that. Instead, we want to build a better future for them whereby they can be educated. We don’t want young mothers. We want young doctors. We want young lawyers. We want young teachers. We want better role models for ourselves. We don’t want this generation to be a generation of young mothers being infected with HIV.”

Clementine is a trained community-level data collector whose job is to monitor access to, and the quality of, health services in and around facilities such as the clinic where she is based – a small community clinic on the West Rand serving a large population. “It’s a small clinic and we lack infrastructure,” says Clementine who works for local organisation, Rotanganedza Community Care. “We don’t have enough space. This is a poor community so sometimes it is a challenge.”

The Community-Led Monitoring and Advocacy project is part of a partnership between NACOSA and the International Treatment Preparedness Coalition (ITPC) aimed at improving access to HIV prevention and treatment services for key and vulnerable populations, such as adolescent girls and young women. “We collect the data from, it’s a system that the government uses. And also we interview people to identify the gaps that people face, barriers in accessing PrEP and barriers in accessing family planning,” explains Clementine.

Clementine and her colleague at the clinic

“It is very important to have relationships with other stakeholders. At first we were struggling a lot with collecting data. We had to create relationships with the healthcare workers. We go to them and we ask them and if we don’t understand anything they feel free to tell us so they do trust us with very crucial information.

The data Clementine and her colleagues collect is used as evidence to inform advocacy and action at a local, national and even global level. Clementine would like to see this information used to build partnerships among activists, policymakers, technical partners, donors, organisations and others to co-create solutions that will improve access and quality of services, particularly for young people.

“I wanted to be a nurse so working here has given me the love of the patient, helping people, doing a lot and bringing change. You feel engaged.” Through their relationship with Clementine and a healthy review process, health workers have seen how clinics can be dynamic spaces where people are supporting each other to do their jobs well to better serve the community and help turn the tide on HIV and AIDS in South Africa.

🎞WATCH a short video on Clementine’s work as a community data collector: