Insights from community case management data in six sub-Saharan African countries

• Published in: The American journal of tropical medicine and hygiene 2012-11, Vol.87 (5 Suppl), p.144-150
• Main Authors: Laínez, Yolanda Barberá, Wittcoff, Alison, Mohamud, Amina Issa, Amendola, Paul, Perry, Henry B, D'Harcourt, Emmanuel
• Format: Article
• Language: English
• Subjects: Africa South of the Sahara; Amoxicillin - therapeutic use; Case Management; Community Health Services; Community Health Workers; Databases, Factual; Diarrhea - drug therapy; Electrolytes - therapeutic use; Government Programs; Health Facilities; Health Policy; Humans; Pneumonia - drug therapy; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use; Zinc - therapeutic use
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.2012.12-0106

There is strong research evidence that community case management (CCM) programs can significantly reduce mortality. There is less evidence, however, on how to implement CCM effectively either from research or regular program data. We analyzed monitoring data from CCM programs supported by the International Rescue Committee (IRC), covering over 2 million treatments provided from 2004 to 2011 in six countries by 12,181 community health workers (CHWs). Our analysis yielded several findings of direct relevance to planners and managers. CCM programs seem to increase access to treatment, although diarrhea coverage remains low. In one country, the size of the catchment area was correlated with use, and increased supervision was temporally and strongly associated with improved quality. Planners should use routine data to guide CCM program planning. Programs should treat all three conditions from the outset. Other priorities should include use of diarrhea treatment and insurance of adequate supervision.