Background

The leading causes of mortality globally in children younger than five years of age (under‐fives), and particularly in the regions of sub‐Saharan Africa (SSA) and Southern Asia, in 2018 were infectious diseases, including pneumonia (15%), diarrhoea (8%), malaria (5%) and newborn sepsis (7%) (UNICEF 2019). Nutrition‐related factors contributed to 45% of under‐five deaths (UNICEF 2019).

World Health Organization (WHO) and United Nations Children’s Fund (UNICEF), in collaboration with other development partners, have developed an approach – now known as integrated community case management (iCCM) – to bring treatment services for children ‘closer to home’. The iCCM approach provides integrated case management services for two or more illnesses – including diarrhoea, pneumonia, malaria, severe acute malnutrition or neonatal sepsis – among under‐fives at community level (i.e. outside of healthcare facilities) by lay health workers where there is limited access to health facility‐based case management services (WHO/UNICEF 2012).

Objectives

To assess the effects of the integrated community case management (iCCM) strategy on coverage of appropriate treatment for childhood illness by an appropriate provider, quality of care, case load or severity of illness at health facilities, mortality, adverse events and coverage of careseeking for children younger than five years of age in low‐ and middle‐income countries….more