Leadership and Learning

Global Leadership
To advocate for iCCM  as an effective strategy to reach the most at-risk children, MCHIP provided technical assistance through the CCM Task Force and also served as the Secretariat, providing leadership and management to the Task Force and its 5 subgroups. Examples of activities that MCHIP supported through the Secretariat role included the establishment of an iCCM Indicator Reference Book to guide countries in the selection of appropriate iCCM indicators and coordinated operations research efforts including the publication of a iCCM Journal Supplement and a child health and nutrition research initiative (CHNRI) process to establish a prioritized research agenda for iCCM at the global and national level. (For more on MCHIP’s work with the CCM TF, please refer to the CCM section.)

As more countries initiate iCCM programs, there is an increasing body of knowledge regarding program design, implementation and impact. MCHIP committed to facilitating that this learning was effectively disseminated to both enhance current programs and to inform the development of future programming. Together with UNICEF and other partners, MCHIP organized an iCCM Evidence Summit, which brought together CCM implementers from more than 20 countries to share the most recent evidence.

To increase attention at global and national levels on diarrhea and pneumonia, MCHIP participated actively in the Diarrhea and Pneumonia Working Group, which supported accelerated treatment scale-up in 10 high-burden countries.

Program Learning

  • MCHIP conducted thorough reviews of CCM programs in the Democratic Republic of Congo (DRC) and Senegal. To pull out cross-cutting facilitating and constraining factors facing CCM programs in the DRC, Senegal and Malawi, MCHIP developed a synthesis of the programmatic and policy achievements and barriers to highlight cross-cutting lessons learned.
  • MCHIP and other partners from the CCM Task Force published a Special Supplement to the American Journal of Tropical Medicine and Hygiene on Integrated Community Case Management in October 2012. This online open access supplement was distributed widely among CCM stakeholders, including those at country levels, and contributes significantly to the global body of evidence on iCCM programs.
  • Through the study “Care-seeking for Childhood Illness: a Multi Country Analysis,” MCHIP analyzed care-seeking behaviors from over 40 DHS data sets and provided case studies illustrating how care-seeking patterns impact the success of various program approaches. The first analysis of its kind, this study highlights the importance of understanding the care-seeking context of a particular country or district before designing programs to ensure that our investments will reach our targeted beneficiaries.
  • MCHIP worked closely with the President’s Malaria Initiative (PMI) to conduct an assessment of training and supervision tools for malaria case management within the context of Integrated Management of Childhood Illness (IMCI). Mainly focused at the clinical level, the review assesses the extent to which IMCI training and supervision tools that are currently used in PMI countries include WHO recommendations.

How did MCHIP Child Health address equity?
iCCM is a package of interventions that inherently address equity by ensuring access to lifesaving treatment for children that previously did not have access to health services. By globally advocating for iCCM, and by introducing and expanding iCCM at the country level, MCHIP ensured that all children have access to health services and essential treatments.

How did MCHIP Child Health address scale?
MCHIP made significant investments in supporting scale up of iCCM, both within individual countries (ensuring that larger proportions of the population have access to iCCM) and at the global level (ensuring that an increasing number of governments of high-burden countries are aware of iCCM and have access to the resources they need to adopt iCCM). At the country level, MCHIP committed to supporting national coordination mechanisms in every country as a way to promote country ownership, leverage resources, help partners coordinate geographic coverage, and accelerate scale up. To help share lessons learned, MCHIP finalized a CCM Synthesis Report, which highlights cross-cutting issues facing iCCM programs at scale.

How did MCHIP Child Health address community?
iCCM is an extension of high-impact child health interventions to the community level, which reflects the needs and realities facing many hard-to-reach communities. MCHIP not only worked with CHWs as a mechanism to strengthen the community and improve child health outcomes, but also for community mobilization and empowerment. MCHIP recognized that the first step to saving a child’s life lies in the caregiver’s ability to recognize danger signs that require the attention of a health provider. Working with community members and child caregivers to promote behaviors that protect and save children was a key component of MCHIP’s work in iCCM, and in establishing improved diarrheal disease programs.

How did MCHIP Child Health address quality?
MCHIP worked closely with global partners and national governments to ensure that child health policies and guidelines include the most recent treatment guidelines, and that health workers at both facility and community levels have the job aides and training required to deliver high-quality child health services. For example, in Guinea and Zimbabwe, MCHIP introduced the Standards-based Management and Recognition (SBM-R) process with adapted standards specific to Integrated Management of Neonatal and Childhood Illness. The SBM-R process facilitates health workers’ measurement of their own progress at meeting targeted standards of care.