integrated community case management

{Photo credit: Brooke Huskey/MSH}Photo credit: Brooke Huskey/MSH

Many child deaths in developing countries are preventable: Children die from treatable conditions, such as pneumonia, diarrhea, and malaria, because families in rural, hard-to-reach, or conflict-ridden areas can’t access or afford the treatments. The Sustainable Development Goals (SDGs), launched in September 2015, set ambitious targets of ending preventable child deaths by 2030 and reducing mortality among children under age five to at least 25 per 1,000 live births.

Integrated community case management (iCCM) has been recognized as a key strategy for increasing access to essential treatments and meeting the objectives for children under five laid out in the SDGs. Integrated community case management entails training volunteer community health workers to serve as the first point of contact for medical treatment in remote areas, enabling them to recognize and treat common childhood illnesses. To be effective, community health workers must operate within a broader pharmaceutical system in which the needs for quality medicines and other health commodities are assured.

{Photo credit: Warren Zelman, Democratic Republic of the Congo}Photo credit: Warren Zelman, Democratic Republic of the Congo

This post originally appeared on the Frontline Health Workers Coalition blog.

I grew up in a village in northwestern Democratic Republic of the Congo (DRC), and although I’m now a doctor and live in Kinshasa, I remember those days well.

I know what it’s like to live 23 kilometers from the nearest health center and to navigate forests and floods to get there. I know how a lack of something simple like antibiotics can cause a quick death. I’ve lost many peers from the village over the years and a lot of family members.

In fact, that’s why I became a physician.

[Photo credit: Jane Briggs/MSH}Photo credit: Jane Briggs/MSH

This post originally appeared on SIAPSProgram.org.

Accounting for more than one million under-five deaths each year, pneumonia is the leading killer of children under the age of five worldwide, claiming more lives than AIDS, malaria, and tuberculosis combined. This year’s World Pneumonia Day (WPD) theme is “universal access to pneumonia prevention and care”.  In commemoration of WPD, child health advocates are calling for pneumonia control through proven interventions that protect against, prevent, and treat pneumonia. Through our work in community case management (CCM) and expanding access to amoxicillin, the US Agency for International Development (USAID)-funded, MSH-led Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program uses a systems-strengthening approach to expand universal access to pneumonia prevention and care.

 {Photo credit: MSH}Colin Gilmartin, Dr. San San Aye, Uzaib Saya, and David Collins present at HSR 2014.Photo credit: MSH

This post originally appeared on the MSH at the Third Global Symposium on Health Systems Research conference blog.

On September 30 – October 3, 2014, nearly 3,000 researchers, program managers, and policy makers convened in Cape Town, South Africa for the Third Health Systems Research Symposium (HSR2014) to review evidence and research focused on improving people-centered health systems and service delivery. A key component to strengthening health systems and improving health outcomes is through health care financing mechanisms.

 {Photo credit: MSH.}MSH representatives attend the iCCM Symposium. From left to right: Jean Fidele Ilunga Mubay (DRC Ministry of Health), David Collins, Pascaline Hareimana (MSH/Burundi), Papy Luntadila (MSH/DRC), Ciro Franco, Jane Briggs, Naia Embeke Narcisse (MSH/DRC), Colin Gilmartin, Zina Jarrah, Uzaib Saya.Photo credit: MSH.

In the absence of effective treatment and access to quality health services, diarrhea, malaria, and pneumonia remain the leading causes of child mortality in sub-Saharan Africa and cause nearly 44 percent of deaths worldwide in children under five years old. To improve access to life-saving treatment among children, many African countries have begun implementing and scaling-up integrated community case management (iCCM), a strategy that focuses on the delivery of timely and low-cost interventions at the community level by community health workers.

Understanding the potential impact and the importance of iCCM as an effective means to reduce child mortality, more than 400 researchers, donors, government, implementers, and partners representing 35 sub-Saharan African countries convened on March 3-5 in Accra, Ghana for the 2014 Integrated Community Case Management (iCCM) Evidence Review Symposium.

The objectives of the Symposium were to review the current state of the art and evidence of iCCM implementation and to assist African countries to integrate and take action on key iCCM findings presented during the evidence symposium. Among those in attendance were 10 Management Sciences for Health (MSH) representatives from Burundi, the Democratic Republic of the Congo, and the United States.

[A community health worker takes the temperature of a feverish baby.} {Photo credit: Zina Jarrah/MSH.}Photo credit: Zina Jarrah/MSH.

Management Sciences for Health (MSH) invites you to attend the following presentations by MSH staff at the Integrated Community Case Management (iCCM) Evidence Review Symposium in Accra, Ghana, hosted by UNICEF and partners March 3-5, 2014. All times are listed in GMT. For those who are unable to attend in person, presentations will be made available online during or after the Symposium.

Costs, Cost Effectiveness and Financing

Session 2: Tuesday, March 4 (11:00-12:30) – Committee Hall 1
Session 4: Tuesday, March 4 (15:15-16:45) – Main Hall

{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

Today, November 12, is World Pneumonia Day. Pneumonia is the leading cause of death among children under five, killing more children annually than AIDS, malaria, and tuberculosis combined. About 1.1 million children under five died of pneumonia last year, 99 percent in developing countries.

No child should die from pneumonia. Usually caused by bacteria or virus, pneumonia most often manifests in children as a cough and difficulty breathing. The global child health community has proven strategies to prevent and treat pneumonia including vaccines, immediate exclusive breastfeeding, handwashing with soap, access to sanitation, oral rehydration solution with zinc, safe water, amoxicillin, and vitamin A.

{Photo by Warren Zelman.}Photo by Warren Zelman.

This post also appeared on Gates Foundation's Impatient Optimists Blog and on Frontline Health Workers Coalition's website.

In a week and a half, as a team of our colleagues arrive in Ethiopia for this year’s International Conference on Family Planning, others will already be in Brazil for the Third Global Forum on Human Resources for Health. This year’s HRH Forum addresses universal health coverage (UHC), a concept which continues to gain momentum as the focus of global health efforts from institutions like the World Bank and World Health Organization (WHO).

It’s symbolic that these two meetings are happening half a world apart: as movements around family planning, health workforce and UHC have advanced, there has been too little dialogue and collaboration across these communities.

{Photo credit: MSH, South Africa.}Photo credit: MSH, South Africa.

The prospect that we may see the end of AIDS in our lifetime has never been greater. Over the last decade, the global HIV & AIDS community has achieved stunning successes, including a steady decrease in new HIV cases, a massive scale-up of antiretroviral therapy (ART), and proof that treatment is prevention. As we begin the XIX International AIDS Conference, we are also excited by new scientific advances in prevention and treatment, such as Option B+  for prevention of maternal-to-child transmission (PMTCT). As new possibilities develop, we must also build on the successes of the last decade. Only by "turning the tide together" through the simultaneous pursuit of new possibilities, leveraging of proven interventions for scale and sustainability, and strengthening of health systems overall, can we hope to reach our goal of ending the HIV & AIDS epidemic.

Three Afghan children. {Photo credit: MSH.}Photo credit: MSH.

About 7.6 million children under age five die each year of preventable causers; 3 million — 40 percent — are newborns (under 28 days old). Ninety-nine percent of these occur in developing countries; three-quarters are mainly due to preventable causes such as neonatal conditions, pneumonia, diarrhea, malaria, and measles. Many of these under-five deaths could be averted by known, affordable, low-technology interventions.

Any preventable child death is one too many.

Here are 10 important interventions for child survival --- a list that is by no means exhaustive:

  1. Exclusive breastfeeding

    Could keep 1.3 million infants from dying (including by preventing pneumonia)

  2. Long-lasting, insecticide-treated bednets

    Would save more than 500,000 children by preventing malaria

  3. Vaccines, such as PCV, Hib, and rotavirus

    Would help prevent common childhood illnesses, such as measles, and save children’s lives

  4. Micronutrient supplements, such as vitamin A and zinc

    Would fight malnutrition. (While not a direct cause of death, malnutrition contributes indirectly to more than one-third of these deaths.)

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