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Community Case Management Essentials Ttreatingreating Common Childhood Illnesses in the Community

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Community Case Management Essentials Ttreatingreating Common Childhood Illnesses in the Community Community Case Management Essentials TTreatingreating Common Childhood Illnesses in the Community a guide for program managers Table of Contents Foreword ���������������������������������������������������������������������� i Acknowledgments ������������������������������������������������������������ iii List of Acronyms and Abbreviations ������������������������������������������ v Section I: Introduction to Community Case Management and This Guide . 1 Community case management: a proven strategy to increase use of evidence-based child survival interventions in communities ��������������1 CORE Group fosters collaborative action and learning to Purpose of the guide ��������������������������������������������������������2 improve and expand community-focused public health Overview of CCM �����������������������������������������������������������4 practices. Established in 1997 in Washington D.C., CORE Group is an independent 501(c)3 organization, and home of the Community Health Network, which brings together CORE The rationale for CCM is strong ���������������������������������������������6 Group member organizations, scholars, advocates and donors to support the health of Strong evidence supports the effectiveness and quality of CCM �������������10 underserved mothers, children, and communities around the world. Despite international endorsement and supporting evidence, questions still remain about CCM ������������������������������������������������13 This document was made possible by support from the Using a results framework for decision-making about CCM �����������������15 Child Survival and Health Grants Program within the Bureau of Global Health, U.S. Agency for International Ten things to remember in planning and managing CCM �������������������18 Development (USAID), under cooperative agreement GHS-A-00-05-00006-00; and Toolkit: resources for an introduction to CCM �������������������������������20 through the USAID-funded Maternal Child Health Integrated Program (MCHIP), Cooperative Agreement GHS-A-00-08-0002-00. This publication does not necessarily Section II: Analyzing the Situation to Make Decisions ����������������������23 represent the view or opinion of USAID. It may be reproduced if credit is properly given. A situation analysis provides information for planning a new CCM effort or improving an existing one �������������������������������������������23 Recommended Citation Decide if the conditions are right for investing resources in conducting a situation analysis ����������������������������������������������������23 CORE Group, Save the Children, BASICS and MCHIP, 2010. Community Case Management Essentials: Treating Common Childhood Illnesses in the Community. A Guide for Decide which specific settings (districts) might be appropriate for CCM Program Managers. Washington, D.C. and conducting a situation analysis ������������������������������������25 Overview of a situation analysis ��������������������������������������������25 Abstract Step 1. Define the purpose and objectives ����������������������������������27 The leading causes of death among children under five years of age are well understood— Step 2. Become familiar with critical matters in planning a situation yet efforts to protect the children most at risk have not kept pace with global goals. But now analysis ���������������������������������������������������������������27 a growing body of evidence supports a new approach that may make a dent in childhood Step 3. Define the scope of the situation analysis: basic, intermediate, deaths from the biggest killers: pneumonia, diarrhea, malaria, newborn infection and or comprehensive �����������������������������������������������������30 malnutrition. Known as Community Case Management of Sick Children (CCM), this Step 4. Review existing data and collect new information for each approach sends community-based health workers out to find, diagnose, and successfully element of the expanded results framework ����������������������������32 treat sick children, in partnership with their families. Step 5. Analyze and interpret data ������������������������������������������37 Inspired by the classic Immunization Essentials, this guide methodically documents what is Step 6. Disseminate findings �����������������������������������������������38 known about CCM and how to make it work. First, health program managers are introduced Step 7. Incorporate stakeholder feedback �����������������������������������39 to the basics. Then, CCM Essentials walks its readers through the process of designing and managing a high-quality CCM program. The ultimate result: lives of newborns, infants and Step 8. Prepare an action plan in response to findings ����������������������39 children saved around the world. Toolkit: resources for a situation analysis for CCM ��������������������������44 Section III: Enabling a Supportive Social and Policy Environment ����������75 Remember that good quality of care increases demand ��������������������207 Overview and definitions ���������������������������������������������������75 Monitor and evaluate demand ��������������������������������������������208 Strategies, interventions, and activities to promote an enabled social Toolkit: resources for increasing demand ����������������������������������209 and policy environment ������������������������������������������������78 Section VII: Increasing Use of CCM Interventions �������������������������211 Begin to create the environment for policy change and programmatic Did the strategies, interventions, and activities for all four intermediate institutionalization through advocacy ����������������������������������78 results lead to increased use? �����������������������������������������211 Obtain support at the district level �����������������������������������������85 Expanding use of CCM: scaling up ����������������������������������������216 Develop organizational capacities ������������������������������������������87 Toolkit: resources for increasing use of CCM �������������������������������219 Create partnerships with communities to increase access, quality, demand, and the likelihood of sustainability ����������������������������88 Section VIII: Future Directions of CCM �������������������������������������221 Consider financial viability for sustainability from the beginning �������������95 Old questions needing new answers ���������������������������������������221 Monitor the environment �������������������������������������������������100 Current debates ����������������������������������������������������������222 Toolkit: resources for enabling a supportive environment ������������������100 The role of new technologies ����������������������������������������������222 Section IV: Increasing Access to and Availability of CCM Services Evolving epidemiology ����������������������������������������������������223 and Supplies ����������������������������������������������������������������109 Global networks ����������������������������������������������������������223 Overview and definitions ��������������������������������������������������109 References �������������������������������������������������������������������225 Strategies, interventions, and activities to increase access and availability ��112 Selecting CCM interventions: integrated or not? ���������������������������113 Establishing CHWs �������������������������������������������������������123 List of Boxes Ensuring medicines and supplies for CCM ���������������������������������134 Box 1: Evidence-based curative child survival interventions used in CCM �����������������4 Building a community-based referral system ������������������������������148 Box 2: Who are the CCM workers? ��������������������������������������������������5 Monitor and evaluate access and availability �������������������������������157 Box 3: CCM brings cost savings in Honduras �����������������������������������������8 Box 4: Growing momentum for CCM in sub-Saharan Africa ����������������������������9 Toolkit: resources for increasing access ������������������������������������159 Box 5: More evidence of the quality of CHW performance from Senegal �����������������11 Section V: Increasing the Quality of CCM ����������������������������������163 Box 6: WHO and UNICEF develop training package for CHWs on caring for sick children Overview and definitions ��������������������������������������������������163 in the community ������������������������������������������������������������13 Strategies, interventions, and activities for increasing quality ���������������166 Box 7: Using the results framework to explore barriers to access �����������������������17 Box 8: Definitions: guidelines, algorithms, and protocols ������������������������������18 Develop job aids that correspond to country guidelines ��������������������168 Box 9: Calculating the potential benefits of CCM �������������������������������������24 Build in supervision from the start ����������������������������������������172 Box 10: Analysis and interpretation of quantitative data �������������������������������38 Plan CHW training based on the CHW responsibilities (job description) ����181 Box 11: More practical tips for situation-analysis teams �������������������������������43 Engage the community in improving the quality of CCM programs ���������190 Box 12: Messages for advocating for CCM ������������������������������������������81 Monitor quality and use the information to improve the program �����������190
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