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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Report on iCCM Task Force Indicators Final- (USAID/MCHIP et al., 2013)

Coordination and Policy Setting Human Resources M&E and Health Information Systems

This inter-agency report examines the list of 48 proposed indicators that guide governments and partners in monitoring and evaluating national integrated case community management programs.

iCCM in Ethiopia: Implementation, Strength, and Quality of Care - (AJTMH, 2014)

Human Resources Service Delivery and Referral

Pneumonia, diarrhea, and malaria are among the leading causes of mortality in children younger than 5 years old. Report looks at ways to effectively prevent these diseases in Ethiopia using integrated community case management.
 

Financing: iCCM Update - (Mark Young/UNICEF, 2014)

Coordination and Policy Setting Costing and Financing

This presentation gives an update on the integrated community case management Financing Task Team's update. It looks at their core activities, country work, and global coordination. 

Power and Pro-poor Policies: The Case of iCCM in Niger - (Daniela C. Rodriguez et al., 2015)

Coordination and Policy Setting Service Delivery and Referral

This report examines the three dimensions of power in policy-making: political authority, financial resources and technical expertise, and how it relates to integrated community case management (iCCM) in Niger.

iCCM in Malawi: An Analysis of Innovation and Institutional Characteristics for Policy Adoption - (Daniela C. Rodriguez et al., 2015)

Coordination and Policy Setting Human Resources Service Delivery and Referral

Through a retrospective case study, this report explores critical issues in implementation that arose during policy formulation through the lens of the innovation of integrated community case management (iCCM) and of the institutions involved in the policy process.

iCCM for Childhood Illnesses: Explaining Policy Resistance in Kenya - (Pamela A. Juma et al., 2015)

Coordination and Policy Setting Human Resources Service Delivery and Referral

This report analysed integrated community case management (iCCM) policy development in Kenya and in particular the types of decision-making criteria used by Kenyan policy-makers in considering whether to advance iCCM policy.

iCCM Policy Analysis: Strategic Contributions to Understanding its Character, Design and Scale up in Sub-Saharan Africa - (Asha George, et al., 2015)

Coordination and Policy Setting Human Resources Service Delivery and Referral

Report examines how policy analysis can inform how integrated community case management (iCCM) is framed, tailored for national health systems, and how to foster accountability and learn from iCCM.

Altogether Now: Understanding the Role of International Organizations in iCCM Policy Transfer - (Sara Bennett et al., 2015)

Coordination and Policy Setting Human Resources Service Delivery and Referral

Report looks at policy transfer theories that explain how policy ideas move across time and geography and offer an approach to understanding waves of policy change, a common phenomenon in global health. Four primary mechanisms for the transfer of policies from global to national levels are posited: learning, coercion, socialization, and competition.

Epistemic Communities in Global Health and the Development of Child Survival Policy: A Case Study of iCCM - (Sarah L. Dalglish et al., 2015)

Coordination and Policy Setting Service Delivery and Referral

This report describes the evolution of integrated community case management (iCCM) at the global level using the theory of epistemic communities first outlined by Haas, which explains how international policy coordination on technical issues takes place via transnational expert networks. The report draws from in-depth interviews with global policy-makers.

Policy Analysis: Important for Improving iCCM Implementation; essential for success of global health efforts - (Kumanan Rasanathan, 2015)

Coordination and Policy Setting

This report focuses on integrated community case management (iCCM) policy development and implementation, the history of primary health care, and the role of community health workers (CHWs). iCCM, while supported by the existence of joint statements and normative guidelines, is not enacted in a vacuum. Its implementation is affected by the nature of existing health worker cadres and how iCCM services are delivered.

1 WHO, UNICEF Joint Statement 2012
2 Integrated Community Case Management (iCCM), World Vision International
3 iCCM Indicators Guide