Pepfar Watch

Ritshidze project publicly releases community-led monitoring tools & guidelines

Original press release published on the Ritshidze website here.

The Ritshidze project today released a new website with resource toolkits on how it uses community-led monitoring to improve the quality of HIV and TB service delivery. Ritshidze — one of the most extensive community-led clinic monitoring systems — was developed by networks of People Living with HIV in South Africa to hold government and aid agencies to account to fix our broken public healthcare system. Through Ritshidze, community members systematically collect data at local clinics that is analysed, and then used to generate solutions to problems that are put to decision makers for action.

“We have the prevention and treatment tools to halt South Africa’s HIV crisis, but it continues when people living with HIV are pushed out of care or avoid it in the first place because of conditions in the health system and the ways we are treated. These can be fixed, and they must be fixed urgently — whether it’s long queues, being shouted at, or being sent home without medication, we are documenting the problems and holding leaders accountable for fixing them,” said Sibongile Tshabalala, from the Treatment Action Campaign (TAC).

“The project is extremely ambitious in reach — through our community monitors and networks of members, Ritshidze monitors more than 400 clinics across 8 provinces in South Africa. These facilities account for almost half of all people on HIV treatment. Given the scale of the health crisis, we need a system that can reach as many provinces, clinics, and people living with HIV as possible — empowering our communities to monitor the health services we receive and to advocate for the changes needed,” said Thandi Maluka, from Positive Women’s Network (PWN).

The Ritshidze project is committed to sharing its model with activists around the world, beginning by making its project guidebook and monitoring tools publicly available on its website today. The guidebook walks through each step in Ritshidze’s model — gathering evidence, analysing the data, generating solutions, engaging duty bearers, and advocating for change — with detailed guidance and step-by-step instructions for carrying out the actions needed at every point in the process.

“In Ritshidze we collect data in clinics and the community through the use of a standardised set of monitoring tools. The tools capture observations as well as the perspectives of both healthcare users and healthcare providers like facility managers and pharmacists, in order to identify the main challenges found at the clinic and the underlying reasons for them,” said Bishop David Nhlapo, from the South African Network of Religious Leaders living with and/or Affected by HIV/AIDS (SANERELA+).

“The data collected through Ritshidze points to major challenges that can be acted on by duty-bearers — issues like medicine stockouts, shortages of healthcare workers, confidentiality violations, buildings that are falling apart and equipment that is missing. As activists, we have fought these issues for years. Yet the crisis in our public healthcare system is only getting worse,” said Ntswaki Mosia, from the National Association of People Living with HIV (NAPWA SA).

“Ritshidze gives communities the tools and techniques to monitor the quality of HIV, TB and other health services provided at clinics and quickly escalate problems to decision makers at clinic and district levels in order to advocate for change,” said Sello Mokhalipi, from Positive Action Campaign. “Community-led data collection that leads to the implementation of community-generated solutions can bring about meaningful changes in our clinics.”

The Ritshidze project is being implemented by organisations representing people living with HIV including the Treatment Action Campaign (TAC), the National Association of People Living with HIV (NAPWA), Positive Action Campaign, Positive Women’s Network (PWN) and the South African Network of Religious Leaders Living with and affected by HIV/AIDS (SANERELA+) — in alliance with Health Global Access Project (Health GAP), the Foundation for AIDS Research (amfAR), and Georgetown University’s O’Neill Institute for National and Global Health Law.

The new website is a resource for communities and activists who wish to engage in community-led monitoring to gather first-hand data about the state of health service delivery and use that data to advocate for improvements. The model was developed by people living with HIV in South Africa and first implemented in late 2018.

The Ritshidze project is supported by the Centers for Disease Control (CDC), USAID, and UNAIDS to engage in community-led monitoring in South Africa.



Ngqabutho Mpofu (Treatment Action Campaign) +27 72 225 9675 |

Lotti Rutter (Health GAP) | +27 82 065 5842 |