Health workers may know where the gaps are in Karamoja’s healthcare system, but those who live with those gaps every day often understand them best. That idea was at the heart of a regional dialogue held in Soroti last week, where more than 160 representatives from government, civil society organizations, health facilities and community groups met to discuss how local people can play a greater role in improving health services across the Karamoja sub-region. The meeting focused on findings from the third cycle of Community-Led Monitoring (CLM), conducted between January and June 2026, which highlighted both the challenges communities continue to face and the progress already achieved through citizen feedback. The one-day symposium, organized by Doctors with Africa CUAMM with funding from the Global Fund through The AIDS Support Organization (TASO), brought together participants from Abim, Amudat, Kotido and Moroto districts. At the centre of the discussions was Community-Led Monitoring, an approach that gives ordinary citizens a direct role in assessing the quality of health services available in their communities. Instead of relying solely on official inspections, residents collect information on issues such as the availability of medicines, staffing levels, access to health facilities and the quality of care. They then share those findings with health workers and district leaders to identify practical solutions. Supporters of the approach say it strengthens accountability because communities are no longer passive recipients of healthcare but active partners in improving it. TASO Executive Director Dr Bernard Etukoit Michael said the programme is changing the relationship between communities and the health system. “The key issue is that this process is community-led and community-owned. Communities collect their own evidence, analyse it and propose solutions. It is a level of engagement we have never had before in our health system,” he said. The programme is being implemented through four community-based organisations: Abim Women Together in Development Initiative Uganda, Nakere Rural Women Activists, Hope for Karamoja Children Foundation. Together, they monitor services related to HIV, tuberculosis, malaria, maternal and child health, sexual and reproductive health, gender-based violence and other essential healthcare services. Presentations during the symposium revealed that many health facilities across Karamoja continue to face similar problems. Communities reported shortages of health workers, frequent stock-outs of essential medicines, poor road networks, inadequate accommodation for medical staff, limited emergency equipment, poor sanitation infrastructure and long distances that patients must travel to reach health facilities. These challenges often delay treatment and reduce access to quality healthcare, particularly for vulnerable groups such as pregnant women, children and people living with chronic illnesses. In neighbouring Kapelebyong District, where the Teso Women Empowerment Development Organisation (TEWEDO) is implementing Community-Led Monitoring, the findings highlighted just how difficult access to healthcare remains. The organisation reported that 78 per cent of residents walk more than five kilometres to reach a health facility, while many facilities also struggle with staff shortages, inadequate medical supplies, limited patient beds and insufficient operating budgets. Despite these challenges, TEWEDO pointed to several improvements that followed community feedback. These included the renovation of the placenta pit at Ajeleik Health Centre II, installation of piped water at Acowa Health Centre III, provision of a motorcycle to Akoromit Health Centre III and construction of new sanitation facilities. The examples demonstrated how community monitoring can lead to tangible improvements when local concerns are acted upon. Other organizations, including Orwadai PCU Community Development Centre and the Support Orphans and Women Initiative (SOWI), echoed similar concerns. They called for better patient care, more reliable supplies of essential medicines, stronger maternal health services and continuous training for health workers. District leaders said the programme is also improving planning. Moroto District Health Officer Dr James Lemukol said community feedback had helped health officials better understand the movement patterns of nomadic communities, making it easier to take health services closer to people who would otherwise struggle to access care. “Communities are the final beneficiaries of health services. Their feedback helps us understand their needs and adjust service delivery accordingly. In Moroto, Community-Led Monitoring has helped us better understand the movement patterns of our nomadic communities, allowing us to take services closer to them,” he said. Kotido Chief Administrative Officer Oyuku Ocen Emmanuel described Community-Led Monitoring as an important accountability tool that helps local governments identify both strengths and weaknesses in service delivery. “It helps us identify where the gaps are and where we are performing well. The recommendations guide our planning, and I believe this approach can also improve service delivery in sectors beyond health,” he said.The post Karamoja communities step up to fix health care appeared first on The Observer Media Ltd.