Mariame Sylla

Bio: Mariame Sylla is an academic researcher from UNICEF. The author has contributed to research in topics: Community health & Service delivery framework. The author has an hindex of 5, co-authored 9 publications receiving 438 citations.

Community case management of childhood illness in sub-Saharan Africa - findings from a cross-sectional survey on policy and implementation.

Abstract: BACKGROUND: Community case management (CCM) involves training supporting and supplying community health workers (CHWs) to assess classify and manage sick children with limited access to care at health facilities in their communities. This paper aims to provide an overview of the status in 2013 of CCM policy and implementation in sub-Saharan African countries. METHODS: We undertook a cross-sectional descriptive quantitative survey amongst technical officers in Ministries of Health and UNICEF offices in 2013. The survey aim was to describe CCM policy and implementation in 45 countries in sub-Saharan Africa focusing on: CHW profile CHW activities and financing. RESULTS: 42 countries responded. 35 countries in sub-Saharan Africa reported implementing CCM for diarrhoea 33 for malaria 28 for pneumonia 6 for neonatal sepsis 31 for malnutrition and 28 for integrated CCM (treatment of 3 conditions: diarrhoea malaria and pneumonia) - an increase since 2010. In 27 countries volunteers were providing CCM compared to 14 countries with paid CHWs. User fees persisted for CCM in 6 countries and mark-ups on commodities in 10 countries. Most countries had a national policy memo or written guidelines for CCM implementation for diarrhoea malaria and pneumonia with 20 countries having this for neonatal sepsis. Most countries plan gradual expansion of CCM but many countries plans were dependent on development partners. A large group of countries had no plans for CCM for neonatal sepsis. CONCLUSION: 28 countries in sub-Saharan Africa now report implementing CCM for pneumonia diarrhoea and malaria or "iCCM". Most countries have developed some sort of written basis for CCM activities yet the scale of implementation varies widely so a focus on implementation is now required including monitoring and evaluation of performance quality and impact. There is also scope for expansion for newborn care. Key issues include financing and sustainability (with development partners still providing most funding) gaps in data on CCM activities and the persistence of user fees and mark-ups in several countries. National health management information systems should also incorporate CCM activities.

Cost-effectiveness of trachoma control in seven world regions.

Abstract: Background/aims: The fight against blinding trachoma is being addressed with an integrated strategy of surgery, antibiotics, hygiene promotion, and environmental improvement—the SAFE strategy, but ...

Community case management of childhood illness in sub-Saharan Africa - findings from a cross-sectional survey on policy and

Abstract: Background Community case management (CCM) involves training, supporting, and supplying community health workers (CHWs) to assess, classify and manage sick children with limited access to care at health facilities, in their communities. This paper aims to provide an overview of the status in 2013 of CCM policy and implementation in sub–Saharan African countries. Methods We undertook a cross–sectional, descriptive, quantitative survey amongst technical officers in Ministries of Health and UNICEF offices in 2013. The survey aim was to describe CCM policy and implementation in 45 countries in sub–Saharan Africa, focusing on: CHW profile, CHW activities, and financing. Results 42 countries responded. 35 countries in sub–Saharan Africa reported implementing CCM for diarrhoea, 33 for malaria, 28 for pneumonia, 6 for neonatal sepsis, 31 for malnutrition and 28 for integrated CCM (treatment of 3 conditions: diarrhoea, malaria and pneumonia) – an increase since 2010. In 27 countries, volunteers were providing CCM, compared to 14 countries with paid CHWs. User fees persisted for CCM in 6 countries and mark–ups on commodities in 10 countries. Most countries had a national policy, memo or written guidelines for CCM implementation for diarrhoea, malaria and pneumonia, with 20 countries having this for neonatal sepsis. Most countries plan gradual expansion of CCM but many countries’ plans were dependent on development partners. A large group of countries had no plans for CCM for neonatal sepsis. Conclusion 28 countries in sub–Saharan Africa now report implementing CCM for pneumonia, diarrhoea and malaria, or “iCCM”. Most countries have developed some sort of written basis for CCM activities, yet the scale of implementation varies widely, so a focus on implementation is now required, including monitoring and evaluation of performance, quality and impact. There is also scope for expansion for newborn care. Key issues include financing and sustainability (with development partners still providing most funding), gaps in data on CCM activities, and the persistence of user fees and mark–ups in several countries. National health management information systems should also incorporate CCM activities.

Community health workers providing government community case management for child survival in sub-Saharan Africa: who are they and what are they expected to do?

Abstract: We describe community health workers (CHWs) in government community case management (CCM) programs for child survival across sub-Saharan Africa. In sub-Saharan Africa, 91% of 44 United Nations Children's Fund (UNICEF) offices responded to a cross-sectional survey in 2010. Frequencies describe CHW profiles and activities in government CCM programs (N = 29). Although a few programs paid CHWs a salary or conversely, rewarded CHWs purely on a non-financial basis, most programs combined financial and non-financial incentives and had training for 1 week. Not all programs allowed CHWs to provide zinc, use timers, dispense antibiotics, or use rapid diagnostic tests. Many CHWs undertake health promotion, but fewer CHWs provide soap, water treatment products, indoor residual spraying, or ready-to-use therapeutic foods. For newborn care, very few promote kangaroo care, and they do not provide antibiotics or resuscitation. Even if CHWs are as varied as the health systems in which they work, more work must be done in terms of the design and implementation of the CHW programs for them to realize their potential.