More than two million children die from diarrhoea and pneumonia each year; over 90% of these deaths occur in sub-Saharan Africa and South-East Asia. According to a new UNICEF report, a third of these deaths could be averted by 2015 if national coverage of cost- effective interventions for pneumonia and diarrhoea are raised to the level of the richest 20 per cent in the highest mortality countries.
It is clear that these diseases disproportionately affect the most poor and vulnerable children. Both diseases are preventable and treatable, through following basic preventive measures such as hand-washing with soap and basic sanitation as well as treating rapidly with antibiotics for pneumonia and oral rehydration solutions and zinc for diarrhoea.
“Integrated community case management (ICCM) provides an opportunity to reach the poorest children in the most remote areas using community health workers to provide health education around prevention, as well as diagnosing and treating diarrhoea and pneumonia,” says Karin Källander, Malaria Consortium inSCALE programme coordinator. “Evidence shows that providing an integrated strategy against common childhood diseases such as diarrhoea, pneumonia and malaria can have a huge effect on improving the quality of care for all three.”
According to the UNICEF report there is evidence to support the use of ICCM as an intervention which can improve child health. It highlights the need for information and research on how to retain, supervise and motivate community health workers as well as on extensive monitoring and evaluation and continued operational research.
Malaria Consortium is implementing ICCM programmes in Mozambique, South Sudan, Uganda and Zambia with support from the Canadian International Development Agency, Planet Wheeler and UNICEF. The organisation’s work is based on research-generated evidence for continuous programme improvement and in-depth monitoring and evaluation of all programmes. Based on this, the inSCALE project, a collaboration between Malaria Consortium, the London School of Hygiene and Tropical Medicine and University College London, supported by the Bill & Melinda Gates Foundation is conducting operational research on community health worker motivation and performance . inSCALE is using a cluster randomised control trial in Mozambique and Uganda to research the impact of innovative solutions, such as mobile phone aided data submission, feedback and supervision, on increasing the quality of ICCM through supportive supervision to increase motivation.
Quality ICCM, aimed at increasing equity in the communities, is one of a number of interventions which when scaled-up can have a significant effect on reducing diarrhoea and pneumonia and tackling childhood mortality.
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