[Integrated Community Case Management - one piece of the puzzle to achieve the ambitious global goals for child health]

Abstract

Remarkable achievements have been made in global child health, with the global under-five mortality halved between 1990 and 2015. However almost 6 million children die every year before their 5th birthday; mostly due to preventable causes. Acknowledging that the clinical presentation of the sick child is complex and does not match individual guidelines of specific diseases, WHO and Unicef have developed an integrated approach for case management of the sick child by community health workers. The approach, called Integrated Community Case Management (iCCM), is meant to be used in areas lacking access to formal health care in low income settings. The concept has several strengths, such as linking the community to the health facilities, improving quality of care, promoting rational use of drugs, enabling health promotion and has been shown to reduce mortality in studies. However, due to barriers within the broader health system, iCCM has been difficult to implement in large-scale national programs. With the world stepping up its action to reach the Sustainable Development Goals (SDGs), community-based interventions such as iCCM promise to accelerate the progress when implementation is part of an approach to strengthen health systems.