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Community Case Management: Opportunities, Challenges & Operational Research Priorities

Community Case Management: Opportunities, Challenges & Operational Research Priorities. Dr. Mark W. Young Senior Health Specialist Policy and Evidence UNICEF, New York. CCM - Opportunities.

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Community Case Management: Opportunities, Challenges & Operational Research Priorities

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  1. Community Case Management: Opportunities, Challenges & Operational Research Priorities Dr. Mark W. Young Senior Health Specialist Policy and Evidence UNICEF, New York

  2. CCM - Opportunities • Revival of the Child Survival agenda and revitalization of PHC – “the community as part of the health system” • Growing evidence on effectiveness of case management and potential impact of CCM on mortality reduction - International Journal of Epidemiology, Supplement 1 April 2010: • 70% reduction in mortality from CCM-pneumonia in U5s (Theodoratou et al); • ORS can reduce diarrhea mortality by up to 93% (Munos et al); • Zinc for diarrhea Rx can decrease diarrhea mortality by 23% (Fischer-Walker & Black) • Focus on Equity and diseases of poverty • Increased involvement of social marketing sector, private/informal sectors • Global Advocacy – GAPP and Diarrhea Reports

  3. CCM - Challenges • Policy adoption – allowing CHWs to diagnose and treat at the community level (esp. pneumonia) • Weak health systems – financial flows, HR/training, referral, commodities, monitoring and supervision • Different models of CCM and CHWs – e.g. length of training; paid vs. volunteer; connection to formal health system • CHWs managing multiple diseases – effectiveness of “integrated” CCM (up to 5 if newborn care & CMAM) • Costs of sustaining CCM services

  4. CCM Operational Research & Evaluation Agenda • How can CHWs be realistically supported to deliver CCM? • Optimum # of CHWs and pop. coverage, intervention load, and skill mix • How to measure and maintain quality of care for services delivered by CHWs • How to motivate/compensate and improve retention of CHWs • How to provide effective supervision for CHWs • How to ensure consistent and quality drug supply? • CCM in the face of changing epidemiology/disease patterns • Global CCM Task Force and Operational Research Group: • Policy advocacy, Fund-raising; Tools; Indicators; Research priorities Need to have good, rigorous evaluation of functioning and emerging CCM programs to document and disseminate good practice in order to inform scale-up

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