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Community case management of childhood illness in sub-Saharan Africa - findings from a cross-sectional survey on policy and
Kumanan Rasanathan,Maria Muñiz,Salina Bakshi,Meghan Kumar,Agnes Solano,Wanjiku Kariuki,Asha George,Mariame Sylla,Mark Young,Theresa Diaz +9 more
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TLDR
In this article, a cross-sectional, descriptive, quantitative survey amongst technical officers in Ministries of Health and UNICEF offices in sub-Saharan Africa was conducted to provide an overview of the status in 2013 of CCM 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.read more
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Implementation research: new imperatives and opportunities in global health.
Sally Theobald,Neal Brandes,Margaret Gyapong,Sameh El-Saharty,Enola K. Proctor,Theresa Diaz,Samuel Wanji,Soraya Elloker,Joanna Raven,Helen Elsey,Sushil Bharal,David L. Pelletier,David H. Peters +12 more
TL;DR: The case studies reveal the complex adaptive nature of health systems, emphasise the importance of understanding context, and highlight the role of multidisciplinary, rigorous, and adaptive processes that allow for course correction to ensure interventions have an impact.
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Who is a community health worker? – a systematic review of definitions
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Towards a grand convergence for child survival and health: A strategic review of options for the future building on lessons learnt from IMNCI.
TL;DR: This strategic review provides direction to the global child health community on how to better assist countries to deliver the best possible strategies to help each child survive and thrive.
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Reducing neonatal deaths in South Africa: Progress and challenges
TL;DR: If SA is to meet the SDG target, special attention should be given to the availability of high-impact interventions, providing an adequate number of appropriately trained healthcare providers and a more active role played by ward-based community health workers and district clinical specialist teams.
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Proactive community case management and child survival in periurban Mali
Ari Johnson,Oumar Thiero,Oumar Thiero,Caroline Whidden,Belco Poudiougou,Djoumé Diakité,Fousséni Traoré,Salif Samaké,Diakalia Koné,Ibrahim Cissé,Kassoum Kayentao +10 more
TL;DR: This 7-year interrupted time series study measured early access to care and under-five mortality over the course of a proactive community case management (ProCCM) intervention in periurban Mali to elucidate the mechanisms of action and generalizability of ProCCM.
References
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Achieving child survival goals: potential contribution of community health workers
Andy Haines,David Sanders,David Sanders,Uta Lehmann,Alexander K. Rowe,Joy E Lawn,Steve Jan,Steve Jan,Damian G. Walker,Damian G. Walker,Zulfiqar A Bhutta +10 more
TL;DR: In this article, community health workers can undertake various tasks, including case management of childhood illnesses (eg, pneumonia, malaria, and neonatal sepsis) and delivery of preventive interventions such as immunisation, promotion of healthy behaviour, and mobilisation of communities.
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TL;DR: An acceleration of the pace of progress is urgently required to achieve the Sustainable Development Goal (SDG) target on child survival particularly in high mortality countries in sub-Saharan Africa.
Levels and trends in child mortality. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation (IGME). Report 2015.
You D,Hug L,Ejdemyr S,Beise J +3 more
TL;DR: The Sustainable Development Goals (SDGs) as mentioned in this paper targets to end preventable deaths of newborns and children under five years of age by 2030, with all countries aiming to reduce neonatal mortality to at least as low as 12 deaths per 1000 live births and under-five mortality to 25 deaths per thousand live births.
Journal ArticleDOI
The female community health volunteer programme in Nepal: Decision makers’ perceptions of volunteerism, payment and other incentives
TL;DR: It may not be useful to promote a generic range of incentives, such as wages, to improve community health worker programme sustainability, and programmes should ensure that the context-specific expectations of community health workers, programme managers, and policy makers are in alignment if low attrition and high performance are to be achieved.
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World Health Organization/United Nations Children's Fund Joint Statement on Integrated Community Case Management: An Equity-Focused Strategy to Improve Access to Essential Treatment Services for Children
TL;DR: This statement presents the latest evidence for integrated community case management of childhood illness, describes the necessary program elements and support tools for effective implementation, and lays out actions that countries and partners can take to support the implementation of integratedcommunity case management at scale.
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