Community health is a cornerstone of public health, emphasizing active participation by community members in improving their individual and collective well-being. From 2018 to 2020, eight community health projects were launched under L’Initiative, and a recent evaluation spanning June 2020 to June 2023 highlights significant insights and challenges. This evaluation was conducted by HMST, showcasing our commitment to driving impactful change in community health. 

Key findings from the evaluation 

1. Community involvement: a mixed picture 
   Despite the focus on community participation, most projects viewed communities as passive beneficiaries rather than active partners. Peer education (PE) emerged as the central strategy across all initiatives, but broader community-led approaches were less prevalent. Notably, the Equipop project stood out for its more active integration of beneficiaries. 

2. Capacity building and empowerment 
   While many projects offered training for peer educators and community actors, it was often insufficient to meet the required tasks. The lack of ongoing training and capacity reinforcement hindered the long-term impact and empowerment of these actors. Strengthening skills and institutional capacities remains a crucial area for improvement. 

3. Challenges in sustainability and collaboration 
   Collaboration with national health systems and authorities was limited. Half of the projects worked formally with national HIV/AIDS programs, but broader integration with community health systems was lacking. Sustainability is a pressing issue, as most projects lack clear exit strategies and instead rely on securing new funding. 

4. Documenting impact 
   Projects demonstrated notable achievements in reducing HIV-related discrimination, challenging harmful social norms, and improving access to tailored health services. However, only three projects had robust data systems to document needs and track outcomes comprehensively. This gap highlights the importance of evidence-based approaches to scale successful interventions. 

Recommendations for future projects 

1. Enhancing community inclusion 
   Future initiatives should prioritize community involvement in defining priorities, planning, and evaluation. Innovative approaches, such as citizen oversight and community monitoring, can empower communities to take greater ownership of health outcomes. 

2. Strengthening capacity building 
   A systematic capacity-building strategy is essential. This includes institutional diagnostics, developing tailored reinforcement plans, and ensuring ongoing support for community organizations and peer educators. 

3. Fostering collaboration with national systems 
   Building formal partnerships with national health authorities and systems can enhance the sustainability of community health strategies. Regular exchange frameworks between community actors and health ministry representatives can formalize roles, improve recognition, and address remuneration challenges. 

4. Investing in evidence and advocacy 
   Developing targeted tools to document and share project lessons can support advocacy for scaling successful interventions nationally. Stronger evidence can also influence policy and funding decisions. 

The way forward 

Community health projects play a vital role in bridging gaps in health services, addressing discrimination, and empowering underserved populations. However, to truly transform health outcomes, these projects must evolve from treating communities as recipients to recognizing them as co-creators of health solutions. By fostering inclusion, building capacity, and strengthening collaborations, we can create a more equitable and sustainable health landscape. 

As we reflect on the lessons from these projects, let us continue to champion community voices and invest in approaches that empower them to lead the charge in improving their health and well-being. 

This blog article was brought to you by HMST, highlighting our ongoing dedication to empowering communities and enhancing public health worldwide.