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.

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Policy, Program, and Operational Learnings Report of iCCM/CMAM Integration

Service Delivery and Referral Communication and Social Mobilization M&E and Health Information Systems

USAID-funded MOMENTUM Country and Global Leadership developed this report in September 2021 to share learnings and programmatic experiences of integrating community-based management of acute malnutrition (CMAM) and integrated community case management (iCCM). The report presents key findings from a literature review of peer-reviewed articles, technical documents, program reports, consultative meeting proceedings, and global and national guidelines that focus on integrating these strategies.

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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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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.

Communication and Social Mobilization

This Save the Children white paper focuses on the detection of and response to indications of significant performance problems in global health program efforts. The paper presents findings from a series of interviews with global health leaders with substantial on the-ground experience, including with iCCM programs.

Service Delivery and Referral

This article in the Malaria Journal presents a case study in maximizing the impact of community case management of malaria through the proactive CCM approach in Senegal.

Recommended Citation: Gaye, S., Kibler, J., Ndiaye, J.L. et al. Proactive community case management in Senegal 2014–2016: a case study in maximizing the impact of community case management of malaria. Malar J 19, 166 (2020).

Service Delivery and Referral Communication and Social Mobilization

This article co-authored by the MRC Centre for Global Infectious Disease Analysis and Malaria Consortium presents evidence from an analysis of Demographic and Health Surveys data from 21 countries in the period 2010 to 2018.

Service Delivery and Referral

Analysis of continuity of essential services in several “well-supported” CHW programs, which include iCCM

Service Delivery and Referral Communication and Social Mobilization

The conflict in Yemen has devastated the health system, with only 51% of health facilities classified as fully functional and 19.7 million people lacking access to health care. To address the urgent need for primary health care services in rural communities, Save the Children launched an iCCM program in Lahj and Taiz Governorates. A qualitative study was conducted to document the challenges to iCCM service delivery and to aid in developing strategies for overcoming service delivery bottlenecks in conflict-affected rural areas.

Service Delivery and Referral Communication and Social Mobilization M&E and Health Information Systems

To better understand the barriers and enabling factors for community-based service delivery through CHWs, UNICEF, Save the Children, and the International Rescue Committee have collaborated to conduct a number of studies to document experiences with CHW services in humanitarian settings in low- and middle-income countries. Retrospective case studies were carried out in Guinea, Liberia, and Sierra Leone (Ebola outbreak); South Sudan (conflict); Bangladesh (flooding); and Yemen (conflict).

Service Delivery and Referral Communication and Social Mobilization M&E and Health Information Systems

Review of published and grey literature designed to contribute to a growing evidence base on implementation of CCM interventions in humanitarian settings and documentation of lessons learned with the goal of improving delivery of essential services to the most vulnerable populations.