Unintended consequences of community-based monitoring systems : lessons from an HIV prevention intervention for sex workers in south India

Studies have examined whether community-based monitoring systems impact desired program outcomes, but few provide field-based evidence on the implementation process itself. This paper fills the gap using ethnographic data on the community-based monitoring tools developed by an HIV prevention NGO for sex workers in south India. The tool was well conceptualized, with potential to enhance community participation in program design. Yet, despite best intentions, our findings show that the quantification process undermined community ownership, discredited existing and locally informed sex work practices and, rather than empowering, monitoring became a means to discipline and judge sex worker peer educators.