Community Case Management

 Dr. Palazuelos, Partners in Health, and Dr.

Task-sharing expands the responsibilities of low-cadre health workers and allows them to share these responsibilities with highly qualified healthcare providers in an effort to best utilize available human resources. This study is part of a larger community-based trial evaluating the acceptability of community treatment for severe pre-eclampsia and examines the prospect for task-sharing among community health extension workers (CHEW) for the detection of early signs of pre-eclampsia in Ogun State, Nigeria. 

An estimated 276 Pakistani women die for every 100,000 live births; with eclampsia accounting for about 10% of these deaths. Community health workers contribute to the existing health system in Pakistan under the banner of the Lady Health Worker (LHW) Programme and are responsible for providing a comprehensive package of antenatal services. However, there is a need to increase focus on early identification and promote diagnosis of pre-eclampsia in community settings, since women with mild pre-eclampsia often present without symptoms.

In 2012, 6.6 million children under age five died worldwide, most from diseases with known means of prevention and treatment. A delivery gap persists between well-validated methods for child survival and equitable, timely access to those methods. A health systems strengthening intervention was implemented in peri-urban Mali designed to improve child survival by improving rapid access to prevention and treatment.

Integrated community case management (iCCM) trains village health workers (VHWs) to provide treatment to the most common childhood diseases in Uganda, including malaria, pneumonia, and diarrhea. One of iCCM’s key features is a referral system for treatment at health facilities, but these referrals are difficult to monitor. A study was conducted to evaluate the referral system by reviewing quantitative data sources, revealing that a need for improvement.

Integrated community case management (iCCM) relies on community health workers (CHWs) managing children with malaria, pneumonia, diarrhoea, and referring children when management is not possible. This study sought to establish the cost per sick child referred to seek care from a higher-level health facility by a CHW and to estimate caregivers’ willingness to pay (WTP) for a referral. 

Humanitarian crises are often marked by large-scale, externally funded, and vertically managed responses. National health systems, already weak, are often bypassed by international organizations in the interest of rapid response to save lives. There is growing recognition, however, of the importance of employing more sustainable approaches through existing health system infrastructure to ensure services continue as the emergency subsides and organizations and their resource flows end.

Malaria Consortium has had extensive experience designing, developing, implementing and evaluating a variety of job aids. An integral part of our work is to strengthen capacity and improve the performance of health workers to be able to prevent, diagnose, treat and care for groups most at risk of malaria and other communicable diseases.

This study provides evidence on rational use of antibiotics for treatment of pneumonia symptoms to inform future implementation of integrated community case management (iCCM), safeguarding effectiveness of current treatments whilst continuing to maximise access to care.