COMDIS-HSD

Comparing iCCM in Rural and Peri-Urban Villages in Uganda

March 2012 - December 2014

Integrated community case management (iCCM) is a strategy that involves training members of a community to identify, treat and, when necessary, refer children under five years of age, who have one of three key childhood illnesses: primarily malaria, diarrhoea and pneumonia. The aim is to bring treatment closer to those who need it most, but have little or no access to appropriate healthcare.

For children aged 1-59 months, malaria accounts for 24 percent of deaths in Uganda, while diarrhoeal and respiratory infections each account for between 16-17 percent. In 2010, the Ugandan government adopted the iCCM strategy for malaria, diarrhoea, pneumonia and newborn health to reduce childhood morbidity and mortality. These conditions can be easily treated, but delays in accessing care and receiving appropriate treatment mean that they can be fatal.

Initially, rural areas of Uganda were given priority in implementing and scaling-up iCCM, as access to healthcare is limited. However, iCCM has also been implemented more recently in peri-urban settings, which have high populations and some of the highest child mortality rates in Uganda. At present, the iCCM implementation guidelines are the same irrespective of context, and research is needed to establish if this is appropriate, or whether they should be tailored to these different contexts.

Malaria Consortium has therefore been conducting a study to compare iCCM in both rural and peri-urban settings in Uganda. In conducting this research, Malaria Consortium aims to produce a series of recommendations for future improvements to iCCM in rural and peri-urban settings. The study found that iCCM was perceived as an effective, well-utilised strategy in peri-urban areas. To maximise the positive impact on health service delivery in peri-urban areas, iCCM should be complemented by tailored sensitisation approaches and community engagement strategies.