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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Coordination and Policy Setting Human Resources Supply Chain Management

The iCCM Institutionalization Assessment Tool is a very useful tool for assessing your country’s starting point and tracking progress toward institutionalization.

Costing and Financing

This document presents a menu of technical assistance support that the iCCM Task Team can offer countries during their Global Fund proposal preparation process, as well as during grantmaking. The resource is available in English, Portuguese, and French.

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.

Costing and Financing

Completed example of a community health worker (CHW) programmatic gap table to be included in the Global Fund proposal.

Costing and Financing

These detailed instructions explain how to complete the Community Health Worker (CHW) Programmatic Gap Table (template here) as part of the Global Fund proposal (disease-specific and RSSH funding requests).

Costing and Financing

This document provides strategic guidance to applicants eligible for additional catalytic Matching Funds beyond the allocation amount for the 2023-2025 allocation period from the Global Fund.
 

Coordination and Policy Setting Costing and Financing Human Resources Supply Chain Management

Final report from the UNICEF and WHO consultative meeting for iCCM on 22-26 July 2019 in Addis Ababa, Ethiopia. 

Service Delivery and Referral

This Human Resources for Health article explores a strategic community health system partnership as one approach to improving CHW programming and performance in countries with or intending to mount large-scale CHW programmes.

Recommended Citation: Naimoli JF, Perry HB, Townsend JW, Frymus DE, McCaffery JA. Strategic partnering to improve community health worker programming and performance: features of a community-health system integrated approach. Hum Resour Health. 2015 Sep 1;13:46. doi: 10.1186/s12960-015-0041-3. PMID: 26323276; PMCID: PMC4556219.

Service Delivery and Referral Communication and Social Mobilization

This Global Public Health article offers three contributions to the literature: the development and application of an analytical framework to consider the institutionalisation process of CHWs; a historical analysis of the professional institutionalisation of CHW in Brazil; and the identification of the paradoxes that such institutionalisation faces: firstly, institutionalisation focused on improving CHW remuneration created difficulties in hiring and paying these professionals; when CHW are incorporated within state bureaucracy they start to lose their autonomy as com

Communication and Social Mobilization

This Cochrane Review aimed to assess the effects of integrated community case management (iCCM) for children under‐five in low‐ and middle‐income countries. The review authors collected and analysed all relevant studies to answer this question and found seven studies.