Community Case Management Essentials: Treating Common Childhood Illnesses in the Community - A Guide for Program Managers

This document provides programme guidance, including tools and standardised indicators, for designing, implementing, and evaluating Community Case Management (CCM), which is a strategy to deliver interventions for common childhood illnesses, particularly where there is little access to facility-based services. CCM programmes deliver interventions for diarrhoea, malaria, pneumonia, newborn care, and acute severe malnutrition at the community level while aiming to improve services at first-level health facilities. This guide is a collaborative effort which engaged more than 60 writers, editors, and steering committee members who contributed to the growing experience, evidence, and guidance around CCM for treating common childhood illnesses in the community. The guide documents what is known about CCM and how to make it work. First, health programme managers are introduced to the basics. Then, CCM Essentials describes the process of designing and managing a CCM programme.

The purpose of CCM Essentials is to provide operational guidance to design, plan, implement, monitor, and/or advocate for CCM that responds to local needs. It is a “how-to” guide for programmes, rather than a source of clinical guidance.

As stated in the Foreword: "A number of countries - Nepal, Pakistan, Honduras, Senegal, and others - now have well-established national CCM programs whose experience and approaches are reflected in this publication. We know with certainty, for example, that well-trained, supervised and supported community health workers (CHWs) - literate or even illiterate - can successfully diagnose child pneumonia, malaria, or diarrhoea and provide effective treatment. We know from several countries’ at-scale experience that this approach actually increases the total numbers of children receiving appropriate treatment when they need it, rather than just changing the place where they get treatment. Operations research in Nepal has clearly demonstrated that allowing trained CHWs to provide treatment is far more successful in increasing appropriate care than just allowing them to refer cases. Studies of quality of care provided by well-trained CHWs implementing CCM indicate that this quality can equal or even exceed the quality of care often documented in public health facilities. The presence of trained health workers in communities themselves can increase not just the availability of services, but the knowledge and willingness of families to seek appropriate care."

Contents include:

• Section I: Introduction to Community Case Management and This Guide
  
• Section II: Analysing the Situation to Make Decisions
  
• Section III: Enabling a Supportive Social and Policy Environment
  
• Section IV: Increasing Access to and Availability of CCM Services and Supplies
  
• Section V: Increasing the Quality of CCM
  
• Section VI: Increasing Demand for CCM Services and Related Behaviours
  
• Section VII: Increasing Use of CCM Interventions