UNICEF – Community case management of diarrhea, malaria and pneumonia

Community case management of diarrhea, malaria and pneumonia: Tracking science to policy and practice in sub-Saharan Africa, 2012.


Community case management (CCM) increases access to treatment to those beyond the reach of health facilities and has the potential to more equitably address the three largest causes of child mortality in sub-Saharan Africa: diarrhea, malaria and pneumonia.

Based on data from UNICEF country offices, we provide a profile of government policies and implementation of CCM diarrhea, pneumonia, and malaria for sick children aged 2 months-5 years across sub-Saharan Africa in 2010. This offers an aggregated analysis and disaggregated tables for subSaharan Africa and where possible we explain the status of outliers based on correspondence with UNICEF country offices. We also compare our findings with previous data collected by Countdown 2015 to describe trends in CCM pneumonia policy and implementation for sub-Saharan Africa. The following bullet points represent key findings.

  • The majority of governments in sub-Saharan Africa have policies supporting CCM of diarrhea, malaria or pneumonia, yet important exceptions remain. Moreover, even when supportive CCM policies exist, CCM programs are not always implemented, and far fewer are implemented at scale.
  • Even as CCM pneumonia lags the furthest behind, significant change has occurred. The number of countries in sub-Saharan Africa with supportive CCM pneumonia policies has more than doubled since 2005.
  • Governments’ concerns regarding implementation of CCM varied depending on whether they were implementing CCM pneumonia or not. Future efforts must address these specific concerns by supporting governments to strengthen key program elements, including planning, monitoring, supervision, logistics, financing and community ownership, and to make use of innovations such as rapid diagnostics tests and e-health technology to improve supervision, monitoring, continuity and quality of care.
  • Of the 29 governments that are implementing CCM in 2010, only 18 are implementing integrated CCM for all three diseases.

Governments and donors should capitalize on opportunities to strengthen integrated CCM by building on existing funding initiatives and community health worker cadres currently trained to treat only one disease.

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