The main causes of preventable deaths in children under five each year are malaria, pneumonia, diarrhoea, neonatal conditions, and malnutrition. There are over 1.5 billion cases of childhood diarrhoeal diseases every year – caused by contaminated water or food, or by poor hygiene and sanitation practices. Nearly half of all deaths in children under five are linked to malnutrition.
Malaria Consortium has pioneered work on integrated community case management (iCCM), supporting the integrated treatment of common childhood illnesses including diarrhoea and malnutrition at the community level. We train community health workers (CHWs) to diagnose and treat under-fives for these illnesses and to refer cases of severe acute malnutrition (SAM) and complicated illness to treatment facilities. Through social behaviour change interventions, we advocate for good water, sanitation and hygiene (WASH) and nutrition practices. We also develop the capacity of health facility staff in using iCCM data for decision making.
Our childhood disease-related publications include journal articles from our cutting-edge operational and implementation research, project briefs, case studies, learning briefs, presentations and capacity statements about digital health and our work with communities and governments from several countries affected by pneumonia including Bangladesh, Cambodia, Myanmar, Nepal, Thailand, Uganda, South Sudan and Ethiopia.
Across malaria endemic regions of Asia and Africa, local volunteers and paid community health workers play a pivotal role in diagnosing and treating common childhood illnesses including diarrhoea in under-fives.
In practice: In Myanmar, we expanded iCCM, developing the skills of the country’s malaria volunteers to diagnose and treat common childhood illnesses including malnutrition and diarrhoea in under-fives. The project also improved supervision by basic health staff and enhanced supply chain management of rapid diagnostic tests and medicines from local health centres.
Improving personal hygiene by hand washing with soap can dramatically reduce the rates of diarrhoeal diseases.
In practice: Through community dialogues and village health clubs delivered as part a project in Uganda, we promoted disease prevention and treatment, and advocated for good WASH and nutrition practices to prevent diarrhoea and other waterborne diseases.
Improving access to basic health care for children suffering from diarrhoea, severe acute malnutrition and other childhood illnesses can reduce mortality in children under five.
In practice: In South Sudan, we implemented a project to improve access to basic healthcare for children suffering from diarrhoea, severe acute malnutrition and other childhood illnesses in three states: Northern Bahr el Ghazal, Western Bahr el Ghazal and Warrap.
Integrating delivery of vitamin A supplementation (VAS) into seasonal malaria chemoprevention (SMC) programmes can address coverage gaps, increase equitable access and reduce under-five mortality.
In practice: We recommend the scale-up of our integrated VAS and SMC campaign in Nigeria which was found to be feasible, occurred minimal incremental cost, and was accepted by implementers and communities.
With training and supportive supervision – non-clinical community health workers can treat severe acute malnutrition among children under five and refer complicated cases using simplified protocols.
In practice: In 2021, we published a study in BMC Health Services Research demonstrating that non-clinical community health workers in Nigeria can treat severe acute malnutrition among children under-five and refer complicated cases using simplified protocols as part of an iCCM programme.