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October 8, 2025

“From Paper to Power”: How Community-Led Monitoring Is Re-shaping Cambodia’s HIV Response

On a humid morning in Phnom Penh, a peer monitor scrolls through a tablet, not a clipboard. With a few taps, a young transgender woman’s experience at a local clinic—welcoming staff, swift PrEP refill—flows into a live dashboard.

On a humid morning in Phnom Penh, a peer monitor scrolls through a tablet, not a clipboard. With a few taps, a young transgender woman’s experience at a local clinic—welcoming staff, swift PrEP refill—flows into a live dashboard. Within hours, her voice joins thousands of others across 12 provinces, forming a real-time picture of what’s working, what’s not, and what must change.

That is the promise—and practice—of Community-Led Monitoring (CLM) in Cambodia: communities most affected by HIV defining the questions, collecting the answers, and pressing for timely fixes.

A community engine with national reach

CLM in Cambodia is owned and led by people living with HIV (PLHIV) and key populations— men who have sex with men (MSM), transgender people (TG), entertainment workers (EW), people who use drugs (PWUD), and young key populations. Organized under the joint Forum of Networks (FoNPAM) and its district counterparts (DFoNPAM), community monitors generate structured, digital feedback across six thematic areas:

  • Prevention interventions
  • Care and treatment
  • Social protection
  • Gender-based violence
  • Stigma and discrimination
  • Mental health

Data once gathered on paper is now captured on mobile devices and visualized in a Power BI dashboard, then brought into regular forums with national and provincial authorities, service providers, and civil society to drive rapid course-corrections.

Since its start in 2020, CLM has evolved from a pilot into a national mechanism. Tools and guidelines were co-created with communities alongside the National AIDS Authority (NAA) and NCHADS, expanded from seven to twelve provinces, and embedded into formal feedback loops where decisions are made.

Why this matters now

Cambodia’s HIV response is widely recognized for treatment achievements and people-centred services. Yet the “last mile” remains—particularly for key populations, where testing and prevention gaps persist. CLM surfaces bottlenecks that only communities can see, and when patterns emerge, community leaders act quickly.

From data to decisions

What sets Cambodia’s CLM apart is what happens after data collection. FoNPAM and DFoNPAM convene multi-stakeholder forums— bringing together NAA, NCHADS, provincial health departments, service providers, UN partners, and civil society organizations— to review findings and jointly agree on solutions.

The dashboard transforms abstract “user experience” into concrete action: replenishing stocks, extending clinic hours, updating provider guidance, training staff on non-discrimination, and expanding access to social protection for PLHIV and key populations. Over time, regular data cycles create accountability— what was raised, what changed, and what still needs attention.

These ripple effects are tangible. CLM evidence has informed policy and program updates, supported integration into national strategies, and aligned responses with real-world barriers. Notably, findings on social protection helped entertainment workers advocate for simplified access to the Health Equity Fund— a practical gain for a highly vulnerable population.

Strengthening U=U and PrEP, one feedback loop at a time

Communities have embraced CLM as a lever to advance Undetectable = Untransmittable (U=U) and PrEP scale-up. CLM helps planners see where HIV testing surges should be paired with PrEP initiation, where missed appointments call for differentiated ART refills, and where stigma or gender-based violence undermines outcomes across the cascade.

What it took to get here

Progress required sustained investment in people and systems. Community monitors were trained in digital tools, interviewing, data use, advocacy, and ICT. HACC, as Secretariat, built the backbone— terms of reference, data quality checks, confidentiality safeguards, and clear processes for sharing findings and compensating monitors for their time.

Challenges were real: digital hesitancy, long questionnaires, intermittent internet access, staff turnover, and occasional resistance from providers. CLM responded by simplifying tools, supplying tablets, strengthening privacy protections, and reframing CLM as a shared quality-improvement process rather than a fault-finding exercise.

What changed because communities asked

  • Policy recognition and integration: CLM acknowledged as a credible, evidence-based tool and integrated into strategic and technical processes.
  • Practical access wins: Evidence-driven fixes to stock management, clinic schedules, and social protection enrolment.
  • Expanded reach: Growth from seven to twelve provinces, diversifying voices and strengthening representativeness.
  • A culture of problem-solving: Regular forums normalized evidence-driven dialogue between communities and authorities.

The road ahead

CLM’s next chapter is about depth and durability. Communities are calling for continued capacity-building, sustained investment in digital systems, and tighter integration with national monitoring frameworks— so community evidence sits alongside routine program data.

There is also momentum to adapt CLM beyond HIV— into vaccination, sexual and reproductive health, and emerging priorities—while updating thematic areas to reflect evolving needs, including gender and mental health.

At its core, CLM is not a project but a practice: ask those most affected; make it safe and easy to respond; bring evidence to the tables where decisions are made; report back to communities; then ask again. In Cambodia, that cycle is becoming habit— turning tablets into tools of dignity and dashboards into decisions that move the country closer to ending AIDS as a public health threat.

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