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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iCCM of Acute Malnutrition Into Child Survival Programs (Concern Worldwide)

Service Delivery and Referral

This document discusses Concern Worldwide's experience of integrated community case management of acute malnutrition in childhood survival programs in Rwanda. 

Current scientific evidence for iCCM in Africa_Diaz, et al. (Journal of Global Health, 2014)

Coordination and Policy Setting

Journal article about the use of integrated community case management to deliver pneumonia, malaria, and diarrhea treatments to children under 5.

Benefits of Integrating Malaria Case Management and iCCM (UNICEF, 2015)

Coordination and Policy Setting

Poster showing the advantages of integrating IMCM and iCCM.

Nutrition iCCM and SAM Concept Note (2016)

Coordination and Policy Setting Costing and Financing Service Delivery and Referral

This is a Concept Note that looks at ways to increase the child survival rate of childhood illnesses by incorporating community treatment of acute malnutrition. Note looks at ways that the integrated Community Case Management of childhood illness is a strategy to identify and treat pneumonia, diarrhoea, and malaria in a holistic manner in community settings.  

The Big Picture: iCCM Financing Task Teams Overview of Progress to Date - Young (UNICEF,2016)

Coordination and Policy Setting Costing and Financing Service Delivery and Referral M&E and Health Information Systems

This PowerPoint presentation discusses progress that UNICEF's integrated community case management Financing Task Team has undertaken. The 26-slide deck looks at the team's achievements, challenges, and lessons learned.

 

Cost and cost-effectiveness of iCCM implementation in Mozambique, where interventions enhance APE performance - Kallader, Kasteng (inSCALE,2016)

Costing and Financing

Brief report showing the cost and cost-effectiveness of iCCM implementation in Mozambique, focusing on interventions to enhance APE performance, motivation, and retention. The findings show the cost per appropriately treated case in the intervention arm compared to the control arm.

 

iCCM of Childhood Infection Saves Lives in Hard-to-Reach Communities in Nicaragua (Operations Research Subgroup, 2016)

Service Delivery and Referral M&E and Health Information Systems

Brief report on integrated community case management program’s impact among children aged 2-59 months in 120 hard-to-reach remote Nicaraguan communities during 2007 – 2013. Researchers used program monitoring data from brigadistas’ registers and supervision checklists, while mortality data was derived from annual censuses conducted by the Ministry of Health of Nicaragua.

Scoping Brief - ICCM Indicators in DHIS2 - MCSP (2016)

Coordination and Policy Setting M&E and Health Information Systems

This is an informal scoping paper done by USAID's Maternal and Child Survival Program focusing on opportunities to integrate community case management monitoring indicators into national-level health information system reporting structures using DHIS2 in 14 countries.

Scoping Paper: Opportunities to Incorporate iCCM Indicators into DHIS2 (MCSP, 2016)

M&E and Health Information Systems

This paper discusses a rapid, informal review performed by the M&E Subgroup of the iCCM Task Force. The review was completed in order to identify opportunities to integrate iCCM indicators from the community level into national HMIS using the DHIS2 platform in 14 countries.

iCCM FTT Final Meeting Presentation: GF NFM Lessons Learned (November 2016)

Costing and Financing Communication and Social Mobilization

Presented at the final meeting of the iCCM Financing Task Team. The presentation covered updates on the work of the FTT, key accomplishments, and lessons learned.

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