Institutionalizing integrated community case management (iCCM) is critical to ensuring children in hard-to-reach communities survive and thrive. The iCCM Institutionalization Toolkit is a resource for country stakeholders, including policymakers, national program managers, staff of technical agencies, professional associations, and non-governmental organizations working to institutionalize iCCM within their national health systems. The toolkit includes a repository of existing resources, guidance from relevant country experiences and research as well as tools to support stakeholders in assessing their country context, identifying priorities and devising strategies to advance iCCM institutionalization. It is a flexible resource that can be used across a range of country contexts at various stages of iCCM introduction, scale-up and institutionalization.
Toolkit Modules
Development Process
The toolkit was developed by the U.S. President's Malaria Initiative (PMI) Impact Malaria Project in collaboration with the Child Health Task Force. Guidance and input was provided throughout by the iCCM Institutionalization Toolkit Advisory Group, composed of members of the iCCM subgroup, especially those working at a country level including ministry of health officials.
Development of the iCCM Institutionalization Toolkit was informed by a critical review of iCCM literature to understand how institutionalization of iCCM has been conceptualized and defined; identify existing tools, guidelines and frameworks; and identify gaps in resources or tools. Based on this work, the team proposed a definition and framework for iCCM institutionalization. Consultations with members of the iCCM subgroup and with purposefully selected country stakeholders were conducted to receive feedback and gather insight into country stakeholder experiences in implementing and working towards institutionalization of iCCM. These findings are summarized in the Preparatory Phase Report.
Toolkit Advisory Group
- Ajay Gambhir, National Board for Quality Promotion (NABQP), India
- Amsalu Zeleke, WHO/Ethiopia
- Anaclet Ngabonzima, JSI/USA, MOMENTUM Integrated Health Resilience
- Annē Linn, USAID/HQ, iCCM Subgroup Co-Chair
- Camlus Odhus, UNICEF/Kenya
- Dyness Kasungami, JSI/USA, Child Health Task Force Secretariat
- Ephraim Kumi Senkyire, Ministry of Health Ghana
- Humphreys Nsona, Ministry of Health, Malawi, iCCM Subgroup Co-Chair
- Megan Christensen, UNICEF/HQ, iCCM Subgroup Co-Chair
- Nefra Faltas, USAID/HQ
- Seynabou Gaye Faye, Ministry of Health, Senegal
- Tigist Daniel, Ministry of Health, Ethiopia
- Yvette Ribaira, JSI/MOMENTUM Integrated Health Resilience
Resources from the Toolkit
- Module 1: Introduction
iCCM Guiding Documents
- Community Case Management Essentials: Treating Common Childhood Illness in the Community
- WHO/UNICEF Joint Statement on Integrated Community Case Management
iCCM Essential Components
- A Health Systems Approach to Integrated Community Case Management of Childhood Illness: Methods and Tools
- Indicator Guide: Monitoring and Evaluating Integrated Community Case Management
Scale-up Resources
- Scaling Up: From Vision to Large Scale Change—Tools for Practitioners
- Supporting Country-Led Efforts to Systematically Scale-up and Sustain Reproductive, Maternal, Newborn, Child and Adolescent Health Interventions: Scale-up Coordinator’s Guide
- Scale-up as if Impact Mattered: Learning and Adaptation as the Essential (Often Missing) Ingredient
iCCM Institutionalization
- Institutionalization of Integrated Community Case Management into National Health Systems in Low- and Middle-Income Countries: A Scoping Review of the Literature
- Institutionalizing Integrated Community Case Management (iCCM) to End Preventable Child Deaths
- Development of a Toolkit for Institutionalization of Integrated Community Case Management (iCCM), Preparatory Phase Report, 8th April 2022
- Module 2: Preparing for iCCM Institutionalization
- Scaling Up: From Vision to Large Scale Change—Tools for Practitioners
- iCCM Institutionalization Assessment Tool
- Drivers of Change Analysis Tool
- Stakeholder Analysis Tool
- Identifying Strategic Partnerships Tool
- Formulating an Advocacy Plan Tool
- Save the Children Advocacy Course and Toolkit
- Unicef’s Advocacy Course and Toolkit
- Module 3: Core Values
Case Study Materials & References
- Epistemic communities in global health and the development of child survival policy: A case study of iCCM. Health Policy and Planning
- Sustaining quality of healthcare: Institutionalization of quality assurance
- Effect of pneumonia case management on mortality in neonates, infants, and preschool children: a meta-analysis of community-based trials
Tools
- Module 4: Leadership & Governance
Case Study Materials & References
- The role of governance in implementing sustainable global health interventions: review of health system integration for integrated community case management (iCCM) of childhood illness
- Integrated Community Case Management (iCCM) in Sub-Saharan Africa: Successes and Challenges with Access, Speed, and Quality
- Governance for Health in the 21st Century
- District health teams’ readiness to institutionalize integrated community case management in the Uganda local health systems: A repeated qualitative study
- Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso
- Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso
- The role of governance in implementing sustainable global health interventions: review of health system integration for integrated community case management (iCCM) of childhood illness
- Integrated Community Case Management (iCCM) in Sub-Saharan Africa: Successes and Challenges with Access, Speed, and Quality
Tools
- Module 5: Policy
- iCCM policy analysis: strategic contributions to understanding its character, design and scale up in sub-Saharan Africa
- Policy challenges facing integrated community case management in Sub-Saharan Africa
- Evidence-informed policymaking in practice: country-level examples of use of evidence for iCCM policy
- How do decision-makers use evidence in community health policy and financing decisions? A qualitative study and conceptual framework in four African countries
- Mapping Policy Environment Tool
- Policy Analysis Framework Tool
- Policy Influencing Action Plan Tool
- Sound choices: enhancing capacity for evidence-informed health policy
- Evidence, policy, impact. WHO guide for evidence-informed decision-making
- Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso
- Integrated community case management in Malawi: an analysis of innovation and institutional characteristics for policy adoption
- Integrated community case management for childhood illnesses: explaining policy resistance in Kenya
- Module 6: Resourcing
- Community Health Worker Master List (CHWML)
- The Community Health Worker (CHW) Coverage and Capacity Tool (C3)
- Financing Alliance for Health Community Health Financing Compendium
- Community Health Worker Assessment and Improvement Matrix (CHW AIM)
- Institutionalization of integrated community case management into national health systems in low-and middle-income countries: a scoping review of the literature
- The Lancet Global Health Commission on financing primary health care: putting people at the centre
- Developing Investment Cases for Transformative Results Toolkit
- Lives Saved Tool
- Community Health Planning and Costing Tool (Version 2.0)
- Modelling the Cost of Community Health Services in Malawi: The Results of Piloting a New Planning and Costing Tool.
- iCCM Gap Analysis Tool
- Financing Community Health Programs for Scale and Sustainability
- Strengthening Primary Health Care through Community Health Workers: Closing the $2 Billion Gap
- Developing and Strengthening Community Health Worker Programs at Scale Handbook
- WHO Guideline on Health Policy and System Support to Optimize Community Health Worker Programmes
- Optimising geographical accessibility to primary health care: a geospatial analysis of community health posts and community health workers in Niger
- Quantification of Health Commodities: Community Case Management Products Companion Guide
- Making Products Available in the Community: A Manager’s Tool to Improving Community Health Supply Chains
- Supply Chain Models and Considerations for Community-Based Distribution Programs: A Program Manager’s Guide
- Supply Chain Management Tools for CHWs: Getting the Data You Need to Manage Stocks
- Module 7: iCCM Essential Components
Overall References
- Community health worker assessment and improvement matrix (CHW AIM): Updated program functionality matrix for optimizing community health programs.
- Indicator Guide: Monitoring and Evaluating Integrated Community Case Management
- A health systems approach to integrated community case management of childhood illness: methods and tools.
- WHO guideline on health policy and system support to optimize community health worker programmes
Coordination and Policy Setting
- Community health workers at the dawn of a new era: 2. Planning, coordination, and partnerships.
- Policy challenges facing integrated community case management in Sub-Saharan Africa.
- iCCM policy analysis: strategic contributions to understanding its character, design and scale up in sub-Saharan Africa.
- Integrated Community Case Management: (iCCM) Evidence Review Symposium – Lessons Learned Document
- Community health workers at the dawn of a new era: 3. Programme governance.
- WHO guideline on health policy and system support to optimize community health worker programmes.
Costing and Financing
- Strengthening Primary Health Care through Community Health Workers: Investment Case and Financing Recommendations.
- Financing Community Health Programs for Scale and Sustainability.
- Creating evidence for better health financing decisions.
- Community health planning and costing tool (version 2.0) handbook: To help managers develop effective, sustainable, and comprehensive community health services.
- Strengthening Primary Health Care Through Community Health Workers: Closing the $2 Billion Gap.
Human Resources
- A conceptual framework for measuring community health workforce performance within primary health care systems.
- Applying the Community Health Worker Coverage and Capacity Tool for Time-Use Modeling for Program Planning in Rwanda and Zanzibar.
- Landscape Analysis of National Community Health Worker Programs in 22 of 25 USAID Priority Maternal and Child Health Countries.
- User Guide for the Community Health Worker Coverage and Capacity Tool. Published by the USAID Maternal and Child Survival Program.
Supply Chain Management
- Integrated Community Case Management: (iCCM) Evidence Review Symposium – Lessons Learned Document
- Making Products Available in the Community: A Manager’s Tool to Improving Community Health Supply Chains.
- The Pathway to Supply Chain Sustainability: A Planning Tool for Scaling and Institutionalizing Innovations within Public Sector Supply Chains.
Service Delivery and Referral
- Updated Program Functionality Matrix for Optimizing Community Health Programs.
- Community Case Management Essentials: Treating Common Childhood Illnesses in the Community. A Guide for Program Managers.
- Community Health Worker Assessment and Improvement Matrix (CHW AIM): A Toolkit for Improving Community Health Worker Programs and Services.
- A Comprehensive Description of Three National Community Health Worker Programs and Their Contributions to Maternal and Child Health and Primary Health Care: Case Studies from Latin America (Brazil), Africa (Ethiopia), and Asia (Nepal).
- Developing and strengthening community health worker programs at scale: a reference guide and case studies for program managers and policymakers.
- Caring for Newborns and Children in the Community: Planning Handbook for Programme Managers and Planners.
Communications and Social Mobilization
- How to Mobilize Communities for Improved Maternal and Newborn Health.
- The Community Score Card (CSC): A generic guide for implementing CARE’s CSC process to improve quality of services.
- Updated Program Functionality Matrix for Optimizing Community Health Programs. December 2018.
- Integrated Community Case Management: (iCCM) Evidence Review Symposium – Lessons Learned Document
Supervision and Quality Assurance
- Updated Program Functionality Matrix for Optimizing Community Health Programs.
- Community Case Management Essentials: Treating Common Childhood Illnesses in the Community. A Guide for Program Managers.
- Community Health Worker Assessment and Improvement Matrix (CHW AIM): A Toolkit for Improving Community Health Worker Programs and Services.
- Community health workers at the dawn of a new era: 10. Programme performance and its assessment.
- A Comprehensive Description of Three National Community Health Worker Programs and Their Contributions to Maternal and Child Health and Primary Health Care: Case Studies from Latin America (Brazil), Africa (Ethiopia), and Asia (Nepal).
Monitoring and Evaluation and Health Information Systems
- A conceptual framework for measuring community health workforce performance within primary health care systems.
- Updated Program Functionality Matrix for Optimizing Community Health Programs.
- Community Health Worker Assessment and Improvement Matrix (CHW AIM): A Toolkit for Improving Community Health Worker Programs and Services.
- Routine monitoring systems for integrated community case management programs: Lessons from 18 countries in sub-Saharan Africa.
- A health systems approach to integrated community case management of childhood illness: methods and tools.
- Indicator Guide: Monitoring and Evaluating Integrated Community Case Management
- A Comprehensive Description of Three National Community Health Worker Programs and Their Contributions to Maternal and Child Health and Primary Health Care: Case Studies from Latin America (Brazil), Africa (Ethiopia), and Asia (Nepal).
- Module 8: Assessing Progress