Integrated Community Case Management (iCCM)

Programmatic experience shows that an integrated strategy can be effective in achieving high treatment coverage and delivering high-quality care to sick children in the community.1

Photo of a man administering healthcare to a child on a woman's lap.
Photo credit: Fernando Fidelis/MCSP, Muecate District, Nampula Province, Mozambique
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Want to learn how to institutionalize iCCM within your national health system? Check out our iCCM Institutionalization Toolkit including key resources, guidance from country experiences, research and tools.

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What is iCCM?

Integrated Community Case Management (iCCM) is a strategy to train, support, and supply community health workers (CHW) to provide diagnostic, treatment, and referral services for three common, treatable, and curable childhood illnesses: malaria, pneumonia, and diarrhea. Young children are especially vulnerable to these illnesses, and iCCM offers caregivers in these hard-to-reach communities a way to help children under five get the treatment they need before it is too late.2 iCCM has become one of the key global health strategies recognized by stakeholders across the health system. When well-designed and implemented, an iCCM program expands access to life saving interventions for vulnerable populations living in settings with poor access to health care.

Why iCCM?

Over the last decade or so, key global stakeholders working with country level partners and Ministries of Health in high burden countries have been successful in bringing in policy change, with the majority of the countries approving iCCM as a key strategy to deliver life-saving interventions to remote and inaccessible communities. However, implementation at scale shows mixed results, with very few countries able to cover a significant proportion of the iCCM target areas. Also, most countries still rely on donor support to fund their iCCM programs, which has resulted in limited implementation coverage. Many countries that have scaled up iCCM also struggle to maintain an acceptable level of service integration and quality. There is a huge unfinished agenda that includes, most importantly, weak global guidance and national governance, and weak integration and implementation quality. Addressing these issues will require continued global level coordination and support to help countries achieve their goal of quality implementation of iCCM at scale. To be effective, iCCM must be ministry-led, adequately resourced and managed, with long-term commitments of support from partners. National ownership of the iCCM strategy requires that countries plan and adequately budget for iCCM implementation, including domestic funding sources for health.

The set of resources presented below was collated by the Child Health Task Force subgroup for Institutionalizing iCCM and the U.S. President’s Malaria Initiative (PMI) Impact Malaria. They are meant to guide national and subnational policymakers in their journey towards institutionalization as well as provide information for implementers engaged in iCCM programs at the country and community levels.

Icon of spotlights Featured Resource

Advocacy Brief: Achieving Impact at Scale - New Funding Opportunities for Integrated Community Case Management of Childhood Illnesses (iCCM) through the Global Fund

Costing and Financing

This brief, developed by the iCCM Task Team, includes key messages advocating for the inclusion of iCCM, non-malaria commodities, and other systems strengthening for child health in country Global Fund proposals. The resource is available in English, Portuguese, and French.

Computer icon Resources

These resources are grouped using the components in the iCCM benchmark framework developed by USAID.³ For more iCCM resources, see this list in the Child Health Task Force Resource Library.

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Child Survival Action Planning and Costing

This Child Survival Action plan template can help countries develop a medium term plan for prioritized actions to reduce child mortality. This includes example content from Sierra Leone.

Human Resources Service Delivery and Referral Supervision and Performance Quality Assurance

This is a Facilitator Guide for Outpatient Clinical Practice (IMNCI). This guide includes clinical practice objectives, a schedule of sessions, and information on the role of facilitator during outpatient sessions along with other relevant information.

Human Resources Service Delivery and Referral Supervision and Performance Quality Assurance

This is an IMNCI facilitator guide for inpatient clinical practice. It includes information on inpatient clinical practice objectives, a schedule of clinical practice sessions, and the role of the inpatient instructor, along with other relevant information for facilitators. 

Human Resources Service Delivery and Referral

An open-access training that builds CHWs’ skills in identifying signs of common childhood illnesses, caring for sick children at home, and referring families to health facilities when needed.

Children between two months and five years of age die mainly from illnesses that can often be treated or prevented. According to UNICEF, pneumonia, diarrhea, and malaria were responsible for approximately 30% of global deaths among children under age five in 2019.

Coordination and Policy Setting

The iCCM Institutionalization Assessment Tool can help you assess a country’s current phase of maturity across the drivers of iCCM institutionalization.

Coordination and Policy Setting

This is a tool in the Institutionalizing iCCM Toolkit designed to analyze potential stakeholders for implementing and scaling iCCM in their country. 

Communication and Social Mobilization

Use this worksheet to summarize any identified key drivers of change, whether these are viewed as
enabling or inhibiting forces. This worksheet can be updated following any new process of
gathering relevant information or reflecting with other interested stakeholders. Identification of
key drivers of change within a country context will help to inform priorities and strategies for
strategic partnering and advocacy.

Coordination and Policy Setting

This tool can be used by individual stakeholders to develop their own organization’s plans to contribute to policy influencing or by a group of interested stakeholders working together to influence policy to advance iCCM institutionalization. More complex frameworks can be used to outline detailed strategies and plans, but this tool aims to serve as a sufficient starting point for stakeholder(s) to outline and commit to taking practical action. Starting small, with the resources and time available, so that influencing opportunities are not missed.

Coordination and Policy Setting

In addition to mapping the current policy environment regarding iCCM, we can consider using the Policy Analysis Framework to better understand the situation.

This framework asks us to consider:

  • The context, or why we need the policy
  • The content, or what the policy is
  • The process, or how the policy will come to be
  • The actors, or who will enact the policy
Coordination and Policy Setting

Use the Mapping Policy Environment Tool to document the findings of your analysis on the gaps and constraints, and opportunities for iCCM institutionalization.