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Sustaining Integrated Community Case Management to improve child health in Uganda

Dec 6, 2013

The Ministry of Health in partnership with Malaria Consortium held a meeting in Hoima in September 2013 named, “Meeting on Sustainability and Scalability of the ICCM Programme” to share and discuss the achievements and results from the implementation of the Integrated Community Case Management in 17 districts of mid-Western and Central Uganda and to discuss the sustainability of the programme.

Uganda is investing in Community Health workers, called Village Health Team members (VHTs), to promote good health practices in communities, as well as diagnose and treat malaria, pneumonia and diarrhoea in children under five at the community level. This strategy is known as Integrated Community Case Management (ICCM); studies have shown that VHTs, when trained in ICCM, can reduce child mortality caused by these three diseases by up to 60%. VHTs are helping Uganda towards achieving the Millenium Development Goals and this is a crucial moment in the final push before 2015. The results and lessons learned from the programme implemented by the Ministry of Health through the District Health Teams and with support from Malaria Consortium over the past three years are of great importance to the public health of the country.

Prior to the meeting, some key stakeholders, including representatives from the Ministry of Health, WHO, USAID and UNICEF visited VHTs as well as the health facilities they report to. This enabled participants to understand VHTs’ work, its impact on the community and the challenges they are facing. One of the main issues that arose was the provision of commodities through the national supply system, especially medicines for the three main childhood illnesses.

The meeting brought together key stakeholders from the central and local governments as well as donors representatives to discuss the lessons learned and the future direction for sustaining the impressive gains achieved as a result of the ICCM programme. Results have shown that the programme has greatly improved care seeking behaviour, with an increasing proportion of children being taken to a VHT or a health facility within 24 hours of the onset of symptoms (fever or cough). It has also greatly improved the access to appropriate treatment for malaria, pneumonia and diarrhoea.

“One of the key tasks of the Ministry of Health is to bring the services closer to the people to reduce the incidence of diseases that are preventable and treatable. The ICCM programme is part of this broader package” said the Honorable Minister of State for Primary Health Care, Dr. Sarah Opendi, in her opening speech.

The discussions focused, among other things, on how to ensure VHT motivation is maintained and the importance of community involvement in VHTs’ work. With more children being treated at community level and with the improved diagnosis limiting over-prescription of anti-malarials, health facilities in the intervention areas do not experience stock outs anymore and unused medicines are at risk of expiring. For this reason, redistribution of medicines that are expiring to VHTs is recommended.

“This meeting represents a crucial milestone for the implementation of the ICCM programme in the country. The programme has shown very promising results where it has been implemented and involvement of all stakeholders is now needed to sustain the benefits. Today, the Ministry of Health, the local governments and representatives from the Parliament have shown commitment to do what is in their power to support the VHTs and ensure they can continue saving lives in our communities” said Dr. Magumba, the Country Director of Malaria Consortium Uganda at the end of the meeting.

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