Policy challenges facing integrated community case management in Sub-Saharan Africa.

Sara Bennett, Asha George, Daniela Rodriguez, Jessica Shearer, Brahima Diallo, Mamadou Konate, Sarah Dalglish, Pamela Juma, Ireen Namakhoma, Hastings Banda, Baltazar Chilundo, Alda Mariano, Julie Cliff

Research output: Contribution to journalArticle

Abstract

To report an in-depth analysis of policy change for integrated community case management of childhood illness (iCCM) in six sub-Saharan African countries. We analysed how iCCM policies developed and the barriers and facilitators to policy change. Qualitative retrospective case studies drawing from document reviews, semi-structured interviews and in-country validation workshops were conducted in Burkina Faso, Kenya, Malawi, Mali, Mozambique and Niger. These countries were selected to maximise variation in iCCM policy status, community health worker (CHW) models and different African regions. Country iCCM policies evolved in an ad hoc fashion, but were substantially influenced by the history of primary health care and the nature of CHW programmes. Technical officers within Ministries of Health led iCCM policy change with support from international donors, but neither communities nor political leadership was mobilised. Concerns about achieving the Millennium Development Goals, together with recognition of the shortcomings of existing child health programmes, led to the adoption of iCCM policies. Availability of external financing played a critical role in facilitating policy change. iCCM policy change has been promoted by international agencies, but national governments have struggled to align iCCM with country health systems. Greater investment is needed in tailoring global policy initiatives to match country needs. High-level, political ownership of iCCM policies could facilitate policy change, as could clearer strategies for ensuring the long-term sustainability of such policies.

Original languageEnglish (US)
Pages (from-to)872-882
Number of pages11
JournalTropical Medicine and International Health
Volume19
Issue number7
DOIs
StatePublished - 2014

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Africa South of the Sahara
Case Management
Mozambique
Mali
International Agencies
Burkina Faso
Malawi
Niger
Federal Government
Ownership
Policy Making
Kenya
Health
Primary Health Care
Retrospective Studies
History
Tissue Donors
Interviews

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Policy challenges facing integrated community case management in Sub-Saharan Africa. / Bennett, Sara; George, Asha; Rodriguez, Daniela; Shearer, Jessica; Diallo, Brahima; Konate, Mamadou; Dalglish, Sarah; Juma, Pamela; Namakhoma, Ireen; Banda, Hastings; Chilundo, Baltazar; Mariano, Alda; Cliff, Julie.

In: Tropical Medicine and International Health, Vol. 19, No. 7, 2014, p. 872-882.

Research output: Contribution to journalArticle

Bennett, S, George, A, Rodriguez, D, Shearer, J, Diallo, B, Konate, M, Dalglish, S, Juma, P, Namakhoma, I, Banda, H, Chilundo, B, Mariano, A & Cliff, J 2014, 'Policy challenges facing integrated community case management in Sub-Saharan Africa.', Tropical Medicine and International Health, vol. 19, no. 7, pp. 872-882. https://doi.org/10.1111/tmi.12319
Bennett, Sara ; George, Asha ; Rodriguez, Daniela ; Shearer, Jessica ; Diallo, Brahima ; Konate, Mamadou ; Dalglish, Sarah ; Juma, Pamela ; Namakhoma, Ireen ; Banda, Hastings ; Chilundo, Baltazar ; Mariano, Alda ; Cliff, Julie. / Policy challenges facing integrated community case management in Sub-Saharan Africa. In: Tropical Medicine and International Health. 2014 ; Vol. 19, No. 7. pp. 872-882.
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