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Introduction Programme Science (PS) and community‐led monitoring (CLM) intersect in unexpected and promising ways. This commentary examines a CLM initiative in Malawi and South Africa to highlight the crucial role of CLM in bolstering the PS framework. By leveraging data sources often overlooked by conventional research and evaluation approaches, CLM emerges as a pivotal element in enhancing programme effectiveness. This paper delineates the fundamental principles of CLM, presents programme outcomes derived from CLM methodologies and contextualizes these findings within the broader framework of PS. Discussion The Citizen Science Project implements CLM continuously at 33 health facilities: 14 in Malawi (eight in Kasungu District and six in Dedza District), and 19 in South Africa (all in the West Rand District), representing a total catchment area of 989,848 people. Monitoring indicators are developed in an iterative process with community groups. The indicators are unique to each country, but both focus on the uptake of health services (quantitative) and barriers to access (qualitative). Monthly clinic records surveys capture 34 indicators in Malawi and 20 in South Africa and are supplemented by qualitative interviews with care recipients and healthcare workers. Qualitative interviews provide additional granularity and help confirm and explain the more macro trends in service coverage as described in quantitative data. The resulting data analysis reveals key themes that help stakeholders and decision‐makers to solve problems collaboratively. Noteworthy outcomes include a substantial increase in multi‐month dispensing of antiretroviral therapy (ART) during COVID‐19 (from 6% to 31%) with a subsequent recovery surpassing of HIV service benchmarks in Malawi post‐pandemic. Conclusions While quantifying direct impact remains challenging due to the project's design, CLM proves to be a robust methodology that generates credible data and produces impactful outcomes. Its potential extends beyond the health sector, empowering community leadership and fostering interventions aligned with community needs. As CLM continues to evolve, its integration into PS promises to improve relevance, quality and impact across diverse disciplines.

Introduction Despite international commitment to achieving the end of HIV as a public health threat, progress is off‐track and existing gaps have been exacerbated by COVID‐19's collision with existing pandemics. Born out of models of political accountability and historical healthcare advocacy led by people living with HIV, community‐led monitoring (CLM) of health service delivery holds potential as a social accountability model to increase the accessibility and quality of health systems. However, the effectiveness of the CLM model in strengthening accountability and improving service delivery relies on its alignment with evidence‐based principles for social accountability mechanisms. We propose a set of unifying principles for CLM to support the impact on the quality and availability of health services. Discussion Building on the social accountability literature, core CLM implementation principles are defined. CLM programmes include a community‐led and independent data collection effort, in which the data tools and methodology are designed by service users and communities most vulnerable to, and most impacted by, service quality. Data are collected routinely, with an emphasis on prioritizing and protecting respondents, and are then be used to conduct routine and community‐led advocacy, with the aim of increasing duty‐bearer accountability to service users. CLM efforts should represent a broad and collective community response, led independently by impacted communities, incorporating both data collection and advocacy, and should be understood as a long‐term approach to building meaningful engagement in systems‐wide improvements rather than discrete interventions. Conclusions The CLM model is an important social accountability mechanism for improving the responsiveness of critical health services and systems to communities. By establishing a collective understanding of CLM principles, this model paves the way for improved proliferation of CLM with fidelity of implementation approaches to core principles, rigorous examinations of CLM implementation approaches, impact assessments and evaluations of CLM's influence on service quality improvement.

Introduction Community‐led monitoring (CLM) for HIV is a technique implemented by local community‐led organizations and groups that systematically gather data about HIV services to advocate for improvement. This review was conducted to explore fields other than HIV where CLM or similar approaches have been used, and to identify methods and tools used to monitor the effectiveness of such approaches. Methods Using a systematic search in PubMed®, Embase® and Web of Science™, we identified publications describing community involvement in the monitoring of public services. We searched for English‐language, peer‐reviewed articles and s published from inception until 7 March 2024 with search terms covering two broad areas: “community‐led monitoring” and “impact/effectiveness.” We double‐screened titles and s and single‐extracted data on publication type, region and geographic location, field, programme goals, the methods used to monitor the programme, indicators used for monitoring and the frequency with which the programme was monitored. In addition, a web search was conducted to identify relevant grey literature. Results We identified 282 records, of which 28 publications were included. Additionally, 24 documents were included through a search of grey literature. Seven peer‐reviewed publications related to HIV CLM, 10 were from other health services and 11 were from monitoring of natural resources. No peer‐reviewed publications documented results from routine evaluations of CLM programmes or described a monitoring framework for CLM. Common themes identified across different fields were the role of multi‐stakeholder collaboration as an enabling factor for community monitoring, challenges in sustainability due to fragmented funding and the inability of existing evaluation approaches to capture the longer‐term impact of community monitoring. Discussion Having a robust monitoring and evaluation system is essential for improving CLM programme operations and demonstrating impact. However, demonstrating the impact of community‐led advocacy efforts is complex and more research is needed to assess longer‐term impacts. Monitoring of locally led adaptation programmes for climate resilience offers useful examples of impact assessments. Conclusions The synthesized findings and lessons from this scoping review have been used, along with consultations with CLM implementers, to develop a guide to monitor outcomes and impact of HIV CLM programmes.

Introduction In 2023, the Ugandan government enacted the Anti‐Homosexuality Act (AHA), which included expanded and intensified criminal penalties for consensual same‐sex relations. While arrests, harassment and violence have been reported, evidence of the AHA's impact on HIV healthcare delivery is limited. Community‐led monitoring (CLM) is an accountability mechanism that uses community‐gathered evidence to advocate for improved healthcare quality and is well‐positioned to describe changes in access and quality of care. Methods Data from the CLM programme in Uganda were used to identify changes in healthcare delivery and use related to the AHA. As part of the CLM programme, routine survey data were collected from clients and managers in 320 public health facilities and 50 drop‐in centres (DICs) from 2022 to 2024. Survey data were analysed using a difference‐in‐differences logistic model to measure changes in indicator measures before and after the AHA was signed into law. Seven semi‐structured individual interviews were conducted with DIC facility managers, deductively coded and thematically analysed. Results In public health facilities and DICs, the proportion of respondents identified as men who have sex with men (MSM) declined significantly after AHA. In facilities, all categories of key populations (KPs) reported high levels of discrimination. After the AHA, MSM reported significant reductions in key HIV‐related services compared to other populations, including lower rates of pre‐exposure prophylaxis (PrEP) counselling, lower participation in support groups and having fewer friendly staff interactions. In DICs, all types of clients were less likely to be referred to health facilities, receive PrEP and find the DIC easy to access after the AHA was signed. DIC managers described experiencing harassment, violence and staffing challenges due to AHA, which they responded to by leveraging partnerships with local and global allies, providing virtual services, and seeking registration as full‐service clinics. Conclusions Data from the Uganda CLM programme provide an early view of the impact of the AHA on service delivery in public health facilities and DICs. While DICs and health facilities developed strategies to build resiliency and adapt, the AHA created significant barriers to care. These findings provide empirical warnings of the barriers experienced by KPs when accessing healthcare services in a criminalized context.

Objectives: Community-led monitoring (CLM) is an emerging approach that empowers local communities to actively participate in data collection and decision-making processes within the health system. The research aimed to explore stakeholder perceptions of CLM data and establish a CLM Data Value Chain, covering data collection and its impact. Methods: Qualitative data were collected from stakeholders engaged in health programs in South Africa. Data analysis involved a collaborative workshop that integrated elements of affinity diagramming, thematic analysis, and the systematic coding process outlined in Giorgi’s method. The workshop fostered joint identification, co-creation of knowledge, and collaborative analysis in developing the data value chain. Results: The findings showed that CLM data enabled community-level analysis, fostering program advocacy and local collaboration. It enhanced program redesign, operational efficiency, and rapid response capabilities. Context-specific solutions emerged through the CLM Data Value Chain, promoting sustainable and efficient program implementation. Conclusion: CLM is a powerful tool for improving program implementation, quality, and advocacy in South African healthcare. It strengthens accountability, trust, and transparency by involving local communities in data-driven decision-making. CLM addresses context-specific challenges and tailors interventions to local needs.

In Northern Canada, climate change has led to many acute and interrelated health and environmental impacts experienced among Inuit populations. Community-based monitoring, in which community members participate in monitoring initiatives using various forms of technology, is a key strategy increasingly used to detect, monitor and respond to climate change impacts. To better understand the landscape of existing environmental and health monitoring programmes mobilising different technologies and operating in the North we conducted a review that used environmental scan methodologies to explore and contextualise these programmes. We consulted with academic researchers with experience in community-led monitoring, conducted systematic searches of grey and peer-reviewed literature, and conducted a secondary search for environment-health mobile-phone applications. Following specific criteria, we identified 18 monitoring programmes using information and communication technologies in the North, and three global monitoring mobile-phone applications, which cumulatively monitored 74 environment and health indicators. Several themes emerged, including the need for: (1) community leadership, (2) indicators of environment and/or human health and (3) innovative technology. This synthesis supports the development of community-led, environment-health monitoring programmes that use innovative technology to monitor and share information related to the health implications of climate change in and around Indigenous communities throughout the Circumpolar North.

Locally led adaptation (LLA) has recently gained importance against top-down planning practices that often exclude the lived realities and priorities of local communities and create injustices at the local level. The promise of LLA is that adaptation would be defined, prioritised, designed, monitored, and evaluated by local communities themselves, enabling a shift in power to local stakeholders, resulting in more effective adaptation interventions. Critical reflections on the intersections of power and justice in LLA are, however, lacking. This article offers a nuanced understanding of the power and justice considerations required to make LLA useful for local communities and institutions, and to resolve the tensions between LLA and other development priorities. It also contributes to a further refinement of LLA methodologies and practices to better realise its promises. Ultimately, we argue that the utility of the LLA framing in promoting climate justice and empowering local actors needs to be tested empirically.

Citizen science can play an important role in bat research and conservation, providing valuable ecological data while engaging the public in bat research and monitoring efforts. We conducted a scoping review of peer‐reviewed literature to assess: who is studying or using citizen science for bat research and where; what methods are used in citizen science research for bats; and whether research on bat citizen science has demonstrated impact on participant engagement and scientific outcomes. Fifty‐one bat citizen science projects were published between 2014 and 2025. University‐led research constitutes 68% (n = 26), underscoring the increasing recognition of citizen science within academic research. However, significant geographical gaps persist, with 67% (n = 35) of studies conducted in Europe, 19% (n = 10) in North America, and limited representation from Africa, Asia, South America and Oceania. Acoustic surveys dominate bat citizen science, accounting for 63% (n = 32) of studies. A lack of region‐specific automated acoustic classifiers potentially hinders expansion into biodiversity‐rich regions. Studies also varied in their evaluation of participant engagement and conservation outcomes, highlighting a need for more consistent reporting and stronger links between research and conservation action. Practical implications. Addressing geographic and methodological gaps requires broader institutional collaboration, including partnerships with not‐for‐profit organisations, museums and government agencies. Such collaborations can strengthen links between public participation, scientific outcomes and conservation action, and in turn, increase support for bat conservation, habitat protection and biodiversity policy objectives. The Christmas Island flying‐fox (Pteropus natalis), a critically endangered island endemic, represents the global conservation importance of bats and the diversity of monitoring approaches used in bat research. A scoping review of 51 studies (2014–2025) found that bat citizen science is growing ‐ while largely using acoustic methods and concentrated in a few regions, this highlights substantial opportunities to expand monitoring and methods across biodiverse areas and a wider range of bat species. Broader institutional collaboration and stronger links between public engagement and conservation outcomes will help realise the full potential of bat citizen science.

Clean water and sanitation are essential for human development. Governments, international and national aid organizations have implemented water, sanitation, and hygiene (WASH) projects worldwide, notably in low- and middle-income countries. However, the majority of such projects experience failure. As a result, 2.4 billion people worldwide are deprived of improved WASH services. Research revealing how WASH projects can be sustained and which factors need to be considered is crucial. Despite the gap and its importance, existing studies on the sustainability assessment of WASH projects are limited. This study attempted to assess and compare the sustainability of WASH projects in Myanmar that used the Community Led Total Sanitation (CLTS) and Participatory Hygiene and Sanitation Transformation (PHAST) approaches with the “Sustainability Check” developed by The United Nations Children’s Fund (UNICEF). This research also evaluated the extent to which WASH projects contributed to the Myanmar National WASH Strategy. The study results show that both CLTS and PHAST project operations fully met the sustainability standards regarding accessibility and intra-village equity. Other sustainability indicators, such as water quality, use of sanitation facilities, and handwashing facilities, were at or above 85% and had already met the 2025 national targets. In contrast, handwashing practices have reached the 2030 national targets. The findings revealed that technical factors, institutional factors (at the community level), social, financial, and sanitation factors contributed to WASH project sustainability. The results also highlight the need for strengthening collaboration with local government to ensure that communities receive post-implementation support from local authorities, to encourage community participation and foster sense of ownership, to empower community-based bodies for O&M and monitoring of water and sanitation facilities, to integrate appropriate behavioral change activities, and to align with the National WASH Strategy. This study would be beneficial for WASH practitioners to ensure the inclusion of factors that support sustainability in the execution of future WASH projects. Graphical abstract

Climate change impacts on population health and wellbeing are spatially and socially distributed, and shape place-based capacities, constraints, and priorities for climate change adaptation. Inuit across the Circumpolar North have called for public health monitoring and response systems that integrate environmental and human health data, and provide localized information to support place-based adaptation strategies. The goal of this research was to qualitatively characterize how Inuit in Rigolet, Nunatsiavut, Labrador, Canada, identify, interpret, and use environmental and climatic observations to make decisions that will protect and promote their health and wellbeing in the context of climate change. Inuit community research leads conducted in-depth, semi-structured interviews with Rigolet Inuit to identify and contextualize environmental and climatic observations that were important for monitoring. Under the direction of community research leads, qualitative data from interviews were analyzed by the core research team using constant-comparative thematic analysis methods to ensure emergent findings were grounded in the voices and perspectives of Rigolet Inuit. Rigolet Inuit considered all climatic and environmental observations to be connected and emphasized the importance of collective, intergenerational knowledge in understanding and adapting to current and future climate change. The ways that Rigolet Inuit interpreted and used these observations for making decisions depended on perceived relevance and importance of observations, trustworthiness of information, and personal thresholds for risks. Knowledge shared by Rigolet Inuit demonstrated the nuanced, relational nature of how climatic and environmental observations are identified, interpreted, and used in decision-making for place-based climate change adaptation. It is important to prioritize these place-based and locally validated ways of knowing and learning about the land in the development of integrated monitoring systems to inform adaptation strategies that are based on a community’s existing resilience and creativity, and premised on relationships among people and places. In so doing, we can identify entry points for improving the ways in which monitoring systems function to link environment and health data, and inform robust, evidence-based adaptation strategies and policies.