Integrated Community Case Management

Community case management (CCM) is a strategy to deliver life-saving curative interventions for common childhood illnesses such as malaria, particularly in areas where access to facility-based services is low.
 
Experts agree that 60% of the 9.7 million children who die annually could be spared if we just delivered the life-saving interventions that we already have to families that need them most. These interventions include: antibiotics for pneumonia, dysentery and newborn sepsis; antimalarials; and oral rehydration packets and zinc supplements for diarrhea. Unfortunately the use of these interventions is low in most developing countries because services that deliver them are not accessible, not available, not of good quality, and/or not demanded.
 
Preventive interventions can be electively scheduled. Curative interventions, on the other hand, must be continuously available (year-round, all day, every day) because children acquire infections unpredictably and can rapidly deteriorate and die without treatment. Hundreds of millions of people in developing countries, especially those in rural areas, live beyond the reach of facilities. Indeed, facilities only treat a small fraction of most sick children in developing countries. Preventive interventions, of course, are essential, but an incomplete solution because use and effectiveness will be imperfect. Curative services will remain a mainstay of disease control for the foreseeable future.
 
CCM strategies support Ministry of Health (MOH) partners to train community health workers (CHW) to assess, classify, treat, counsel, and sometimes (if feasible) refer children with signs of infection. CHWs are also trained to support, supervise and supply the workers, and to train families to recognize and seek care for signs that indicate serious disease.
 
Links to the county summaries where we are supporting/implementing CCM
 
Intermittent Preventive Treatment for Infants
WHO has set in motion the process of approving Intermittent Preventive Treatment for infants (IPTi) as an additional tool for malaria control. Ghana has adopted this strategy based on its inclusion among 19 countries where the IPTi Consortium tested the efficacy and safety of this approach. The IPTi Consortium found that IPTi delivery can feasibly be part of routine child immunization and recommends this platform. MCHIP is well placed to apply its extensive experience in IPTp policy development, capacity development, and performance quality improvement approaches to ensure IPTi implementation is successfully integrated into routine child health services, just as IPTp is integrated into routine ANC.
 
 
Community Engagement
Engaging communities to address malaria is a critical component for effective prevention and control. Communities are at the forefront of healthcare promotion and services for women, newborns and children. There participation in malaria prevention and control accelerates malaria programming especially for the most vulnerable including pregnant women and children under the age of five. Supporting local organizations in program design, monitoring, implementation, and evaluation is a cornerstone of these efforts. The President’s Malaria Initiative’s Malaria Communities Program (MCP) is leading these efforts in 12 countries.
               
Links to MCP grants program.
 
            Key MCHIP Malaria Activities

      • Technical leadership in global groups including: Roll Back Malaria-MIP Working Group and the CCM Task Force
      • Provide technical leadership to Ministries of Health
      • Integrate malaria implementation holistically and appropriately with maternal child health and HIV programs.
      • Strengthen health systems including human capacity development for in-service training and pre-service education
      • Improve quality of services using quality assurance management tool targets providers, managers, and supervisors
      • Increase community awareness and participation as well as linking communities and facility based care.
      • Administrative support to the President’s Malaria Initiative MCP as well as technical support to PMI field teams.
      • Technical assistance for MCP grantees to ensure organizations are best positioned to contribute to national malaria efforts in PMI focus countries.