Integrated Community Case Management

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Integrated Community Case Management (iCCM) of malaria, pneumonia and diarrhoea is a recently adopted strategy for the treatment of common childhood illness at community level by trained Community Health Workers since 2010. It addresses a gap in delivery of curative services to children below 5 years allowing:

  • prompt and accessible treatment of uncomplicated malaria, pneumonia and diarrhoea
  • identification of danger signs (convulsions, chest indrawing, unable to feed, vomiting everything, lethargy/unconsciousness) and pre-referral treatment
  • monitoring of newborns during the first week of life, counselling and referral if any problem identified.

Community health workers work in close collaboration with the health unit, to which they report and refer cases and from which they receive supplies and supervision.

Supplies provided to trained community health workers

ICCM commodities

  • Respiratory timers and Amoxicillin dispersible tablets for diagnosis and treatment of pneumonia
  • ORS sachets and Zinc tablets for treatment of diarrhoea
  • RDTs and ACTs for diagnosis and treatment of uncomplicated malaria
  • Rectal artesunate for pre referral treatment of complicated malaria.
  • Examination gloves
  • Dispensing envelopes
  • Registers, referral notes and sick job aids

Other commodities for community health workers

  • Other preventive treatments: used in prevention and treatment of common conditions and neglected topical diseases like albendazole,  azithromycin syrup and tablets, ivermectin, tetracycline eye ointment, praziquantel, COC.

Treatments prescribed by VHTs

TREATMENT

INDICATION

DOSES

Amoxicillin DT 250 mg

Pneumonia (cough < 21 days + increased respiratory rate)

2-11 months: 1 tab every 12 hours for 5 days RED PACK

1-5 years: 2 tab every 12 hours for 5 days GREEN PACK

Zinc Tablets and ORS

Diarrhoea < 14 days without blood

Zinc

2-6 months: ½ tab once a day for 10 days 

6 months to 5 years: 1 tab once a day for 10 days

ORS As much as the chid wants but at least ½ cup after each loose stool

ACT

Fever <7 days RDT positive

4 months-2 years: 1 tab

every 12 hours for 3 days (YELLOW PACK)

2-5 years: 2 tab every 12 hours for 3 days (BLUE PACK)

Rectal Artesunate

Fever and danger signs, prereferral

4-11 months: 1 capsule

1-3 years: 2 capsules

3-5 years: 3 capsules