UCOP+, the Congolese Union of Organizations of People Living with HIV, through funding and technical support from UNAIDS, set up the Observatory project, designed to collect and analyse data to guide action to improve the quality of HIV services.
“The Observatory, which looks at access to and the quality of HIV and HIV/tuberculosis services, is a community-based initiative. Its main objective is to help the government and civil society define and implement national policies in accordance with international norms and standards,” said Natalie Marini, Human Rights and Gender Adviser at the UNAIDS Country Office for the Democratic Republic of the Congo.
The Observatory was set up following repeated stock-outs of HIV and tuberculosis medicine, requests for payment for services that are supposed to be free, the persistence of stigma and discrimination and human rights violations and the long distances that people have to travel to access health care. Three areas are monitored monthly—the availability of services, the quality of care, including the availability of medicine, and accessibility of care.
The initiative shows the importance of collaboration between civil society, health services and donors in the HIV response and has led to an improvement in HIV/tuberculosis services in health facilities. “The Observatory is an indispensable tool that gives us the first clues about supply,” said Aimé Mboyo, director for the National AIDS Control Programme. “It helps us enormously.” The data from the Observatory complements the data of the National Health Information System (SNIS).
Since its launch in 2013, the Observatory has contributed to reducing the cost of access to health care in some health facilities and has anticipated stock-outs and helped to reduce their frequency. The Observatory has also reduced self-stigma by valuing the people who use the services and putting them at the heart of the system. “Before, I didn’t have anything to say about the care offered to me,” said Joséphine Ntumba (not her real name), who is living with HIV. “Now I can give my opinion and make a difference.”
The concept of a “community observatory” has been shown to be a success and is now integrated in the concept note for the Democratic Republic of the Congo of the Global Fund to Fight AIDS, Tuberculosis and Malaria. However, there is still a long way to go—only three out of 23 provincial health departments are covered.