Community Case Management of Childhood Illnesses: Policy and Implementation in Countdown to 2015 Countries/ Gestion Communautaire Des Cas De Maladies Infantiles: Politique et Mise En Oeuvre Dans Les Pays Compte a Rebours Vers 2015/ Gestion Comunitaria De Casos De Enfermedades Infantiles: Planes De Accion Y Puesta En Practica En Los Paises De la Iniciativa «Cuenta Atras Para 2015»

By de Sousa, Alexandra; Tiedje, Kathryn E. et al. | Bulletin of the World Health Organization, March 2012 | Go to article overview

Community Case Management of Childhood Illnesses: Policy and Implementation in Countdown to 2015 Countries/ Gestion Communautaire Des Cas De Maladies Infantiles: Politique et Mise En Oeuvre Dans Les Pays Compte a Rebours Vers 2015/ Gestion Comunitaria De Casos De Enfermedades Infantiles: Planes De Accion Y Puesta En Practica En Los Paises De la Iniciativa «Cuenta Atras Para 2015»


de Sousa, Alexandra, Tiedje, Kathryn E., Recht, Judith, Bjelic, Ivana, Hamer, Davidson H., Bulletin of the World Health Organization


Introduction

The community case management (CCM) of childhood illnesses--defined here as the community-level provision to children of curative treatments for diarrhoea, pneumonia, malaria and/or neonatal infections by community health workers (CHWs)--is a strategy with the potential to accelerate progress towards meeting Millennium Development Goal 4 (i.e. the reduction of child mortality by two thirds between 1990 and 2015). (1) Unless their current rates of decline in child mortality accelerate, most African countries will not achieve such a reduction until 2065. (2) A major constraint is the weakness of national health systems, (3,4) especially the shortage of human resources. CCM could increase the number of care providers at the community level. Task shifting has been used in low-resource settings since the late 1960s. After the Alma-Ata declaration in 1978, attention turned to primaryhealth-care services. (5) The allocation of tasks to the least costly health worker has since often been applied effectively at the community level. (6) Compared with other approaches to health care, the provision of services at the community level is likely to reach not only more people but also the populations most in need, thus improving equity. (7-10)

Although the mortality rate in children under the age of 5 years has declined by 28% since 1990, (11,12) infectious diseases still contribute to 68% of deaths among such children.(13) Of the 5.9 million children under 5 who die of infectious diseases each year, about 3.6 million are neonates.(14) The major causes of deaths among children under 5 are pneumonia (18%), diarrhoea (15%), malaria (8%) and neonatal infections, including sepsis (6%). (15) Each of these killers has, however, at least one proven effective treatment: artemisinin-based combination therapy (ACT) for malaria; low-osmolarity oral rehydration solutions (ORS) and zinc for diarrhoea; and antibiotics for pneumonia and neonatal infections. If coverage of these interventions were universal, with community-based delivery of half of the interventions, it has been estimated that the annual number of deaths among children under 5 would fall by 63%. (2,16) The greatest improvements would probably be seen in sub-Saharan Africa, where pneumonia, diarrhoea and malaria account for more than half of all childhood deaths.(13) If such interventions are to be delivered well, however, there have to be good national policies, including effective CCM policies.

In 2010, to identify gaps in CCM policies and understand the current status of CCM implementation, we conducted a survey on the CCM of malaria, pneumonia, diarrhoea and neonatal infections in the 68 countries prioritized by the Countdown to 2015 initiative in 2008 (list available at: http://www.countdown2015mnch.org/reports-publications/ 2010country-profiles/2008-country-profiles) (17); together, these Countdown priority countries account for about 97% of maternal, neonatal and child deaths worldwide each year. To our knowledge, this was the first comprehensive survey on the CCM of childhood illnesses since a survey of the CCM of pneumonia in 57 African or Asian countries in 2008. (18) The results presented here provide a basis for future advocacy work, resource mobilization, programme support and evidence generation.

Methods

Survey description

A 26-item questionnaire on the CCM of malaria, pneumonia, diarrhoea and neonatal infections was pre-tested in Pakistan and Senegal and then distributed, in 2009 or 2010, to the relevant policy-makers and implementers in the 68 Countdown priority countries. The questionnaire addressed the status of CCM policies, implementation and plans; the concerns of the CCM implementers and policy-makers; CHW activities, training manuals, lengths of training; referral policies and remuneration; and drug policies and availability. In an attempt to enhance the quality of the data collected, the questionnaire included multiple questions on the same topic and was sent to two, three or four individuals in each country. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Community Case Management of Childhood Illnesses: Policy and Implementation in Countdown to 2015 Countries/ Gestion Communautaire Des Cas De Maladies Infantiles: Politique et Mise En Oeuvre Dans Les Pays Compte a Rebours Vers 2015/ Gestion Comunitaria De Casos De Enfermedades Infantiles: Planes De Accion Y Puesta En Practica En Los Paises De la Iniciativa «Cuenta Atras Para 2015»
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.