Innovations at Scale for Community Access and Lasting Effects (inSCALE), is a Malaria Consortium project funded by the Bill & Melinda Gates Foundation. It is currently being implemented in Mozambique and Uganda with the support of the London School of Hygiene and Tropical Medicine and University College London's Centre for International Health and Development.

The aim of the project is to increase coverage of integrated community case management (ICCM), which provides community based-care for diarrhoea, pneumonia and malaria. This is achieved through training community based agents (CBAs) to diagnose and treat these three main childhood illnesses.

InSCALE aims to demonstrate that coverage and impact of government-led ICCM programmes can be extended if innovative solutions can be found for critical limitations, such as motivation and retention of community health workers. Once feasible and acceptable solutions are identified, these can be used to increase the coverage of ICCM and improve its quality so that more children under five have prompt access to appropriate treatment.

Several low income countries across Africa are incorporating scale-up of integrated community case management (ICCM) into their formal health plans as a way of counteracting weak health infrastructure and low levels of access to quality care in rural areas. Mozambique and Uganda are among these countries. Community based agents (CBAs) are being used as the conduit for the provision of ICCM, however poor supervision of CBAs by formal health authorities, a lack of motivation among CBAs, and low levels of availability and usage of data hamper the effective progression of CBA programmes.

Building on the work of the Canadian International Development Agency (CIDA) ICCM project being implemented by Malaria Consortium in Mozambique and Uganda, inSCALE will aim to demonstrate that government led ICCM can be rapidly expanded without compromising on quality, leading to a sustained increase in the number of children receiving timely and appropriate treatment for diarrhoea, pneumonia and malaria.