Institutionalizing integrated community case management (iCCM) to end preventable child deaths: a technical consultation and country action planning, 22-26 July 2019, Addis Ababa: web annex: summary tables with recommendations of high burden to high impact (HBHI) countries for scaling up integrated community case management

Web Annex. Summary tables with recommendations of High burden to high impact (HBHI) countries for scaling up integrated community case management Institutionalizing integrated community case management (iCCM) to end preventable child deaths A technical consultation and country action planning 22-26 July 2019, Addis Ababa Institutionalizing integrated community case management (iCCM) to end preventable child deaths: a technical consultation and country action planning, 22-26 July 2019, Addis Ababa. Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management ISBN (WHO) 978-92-4-000876-2 (electronic version) © World Health Organization and the United Nations Children’s Fund (UNICEF), 2020 This joint report reflects the activities of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO or UNICEF endorses any specific organization, products or services. The unauthorized use of the WHO or UNICEF names or logos is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO) or the United Nations Children’s Fund (UNICEF). Neither WHO nor UNICEF are responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization (http://www.wipo.int/amc/en/mediation/rules). Suggested citation. Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management. In: Institutionalizing integrated community case management (iCCM) to end preventable child deaths: a technical consultation and country action planning, 22-26 July 2019, Addis Ababa. Geneva: World Health Organization and the United Nations Children’s Fund (UNICEF), 2020. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. UNICEF and WHO Photographs. UNICEF and WHO photographs are copyrighted and are not to be reproduced in any medium without obtaining prior written permission. Permissions may be granted for one-time use in a context that accurately represents the real situation and identity of all human beings depicted. UNICEF and WHO photographs are not to be used in any commercial context; content may not be digitally altered to change meaning or context; assets may not be archived by any non-WHO or non-UNICEF entity. Requests for permission to reproduce UNICEF photographs should be addressed to UNICEF, Division of Communication, 3 United Nations Plaza, New York 10017, USA (email: nyhqdoc.permit@unicef.org). Requests for permission to reproduce WHO photographs should be addressed to: http://www.who.int/about/licensing/copyright_form/en/ General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO or UNICEF concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO or UNICEF in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The figures included in this report have been estimated by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (www.washdata.org) to ensure compatibility; thus, they are not necessarily the official statistics of the concerned country, area or territory, which may use alternative methods. All reasonable precautions have been taken by WHO and UNICEF to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO or UNICEF be liable for damages arising from its use. Contents Burkina Faso 1 Cameroon 2 Chad 3 Democratic Republic of the Congo 4 Ethiopia 5 Ghana 6 Mali 7 Mozambique 8 Niger 9 Nigeria 10 Sierra Leone 11 Uganda 12 United Republic of Tanzania 13 iii

1Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management BU RK IN A FA SO CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • An nu al s ta te m en t o n co m m un ity h ea lth • C H W m ot iv at io n in te gr at ed in lo ca l a ut ho rit y bu dg et s • C re at io n of a lo ca l de ve lo pm en t f un d • N at io na l c om m un ity h ea lth fo ru m a nd g en er al s ta te s • Q ua nt ifi ca tio n of o ra l re hy dr at io n sa lts , z in c an d am ox ic ill in b y qu an tifi ca tio n co m m itt ee fo r a rte m isi ni n- ba se d co m bi na tio n th er ap y an d ot he r i np ut s • Sc al in g- up m H ea lth (b en efi ts an d in pu ts ) • D as hb oa rd s de ve lo pe d at a ll le ve ls • As se ss m en t o f w or kl oa d of C om m un ity B eh av io ur C ha ng e w or ke rs • Ev al ua tio n of im pa ct • Re vi se th e pr ofi le o f t he C om m un ity B eh av io ur C ha ng e w or ke rs • G ui de to o rie nt lo ca l co m m un iti es o n of C H W pa ck ag e • Pl an fo r p as sa ge to b ud ge te d sc al e • W or ks ho p to d iss em in at e st ra te gi c pl an • Re vi ta liz e re gi on al co m m itt ee s • C on tra ct s be tw ee n C H W s an d co m m un iti es • O ra l r eh yd ra tio n sa lts , z in c an d am ox ic ill in in te gr at ed in qu an tifi ca tio n an d m on ito rin g co m m itt ee fo r a rte m isi ni n- ba se d co m bi na tio n th er ap y an d in pu ts fr om o th er pr og ra m m es • Pr ep ar e a bu dg et ed s ca lin g- up p la n • Fi na nc ia l a cc om pa ni m en t • Al ig nm en t o f p ar tn er s w ith na tio na l p la ns • M ak e to ol s, do cu m en ts a nd re co m m en da tio ns a va ila bl e to c ou nt rie s in a s yn ch ro ni ze d w ay in F re nc h an d En gl ish • Re so ur ce m ob ili za tio n Institutionalizing integrated community case management (iCCM) to end preventable child deaths A technical consultation and country action planning, 22-26 July 2019, Addis Ababa 2 CA M ER O O N CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • Pr io rit iz e ar ea s w ith h ig h ch ild m or ta lit y • W rit e a le tte r t o a se ni or a ut ho rit y to a dv oc at e fo r p ub lic c om m itm en t to re du ci ng n at io na l c hi ld m or ta lit y Id en tif y ch am pi on s at a ll le ve ls • D ev el op a n ad vo ca cy s tra te gy w ith a n ac tio n pl an • O rg an iz e an e ve nt to in cr ea se p ol iti ca l in te re st in c hi ld h ea lth , a nd la un ch a na tio na l c om m un ic at io n ca m pa ig n • In te gr at ed a pp ro ac h fo r c hi ld h ea lth an d m al ar ia : • M ap p ar tn er s an d re so ur ce s fo r c hi ld he al th D ev el op a n in ve st m en t r ec or d on c om m un ity b as ed in te rv en tio ns (IS D C ) • D ev el op th e IS D C n at io na l s tra te gi c pl an • In ve st in s er vi ce d el iv er y, in cl ud in g iC C M (h um an re so ur ce s, co m m od iti es an d op er at io ns ): D ev el op IS D C tra in in g cu rr ic ul a fo r b as ic h um an re so ur ce s • Tr ai ni ng In st itu tio na liz e C H W s an d th ei r s ta tu s Im pl em en t a ct io ns in th e • hu m an re so ur ce s de ve lo pm en t p la n U pd at e C H W m ap pi ng • C om m un ity e ng ag em en t A pp ro ac h al l st ru ct ur es th at c ol la bo ra te w ith to w n ha lls (e .g . A ss oc ia tio n of C om m un es an d U ni te d C iti es o f C am er oo n) , a nd in vo lv e th em • Fo rm c om m un ity o pi ni on le ad er s, he ad s of h ou se ho ld s ac co rd in g to so ci oc ul tu ra l c on te xt S tre ng th en ac co un ta bi lit y of p ol iti ca l a nd ad m in ist ra tiv e au th or iti es Su rv ei lla nc e of iC C M , t ra ck in g pr og re ss , o ut co m e an d im pa ct : • Ev al ua te c om m un ity h ea lth ac tiv iti es S tre ng th en s ys te m fo r c ol le ct in g, a na ly sin g an d tra ns m itt in g co m m un ity d at a. In te gr at e co m m un ity d at a in to D H IS 2 • U se o f r ou tin e he al th fa ci lit y an d co m m un ity d at a on d ise as e tre nd s an d co m m od ity tr ac ki ng : • Se t u p da ta w ar eh ou se o n iC C M • Pr ov id e in ce nt iv es c ol le ct in g • hi gh -q ua lit y da ta o n th e D H IS 2 pl at fo rm b y he al th d ist ric t St re ng th en a bi lit y of d at a fo ca l po in ts to a na ly se d at a on th e D H IS 2 pl at fo rm O rg an iz e da ta va lid at io n w or ks ho ps a t a ll le ve ls • Au di t d at a qu al ity S et u p a da ta an al ys is pl at fo rm o n iC C M O th er s ou rc es o f d at a: • C re at e an im pl em en ta tio n re se ar ch p la n to fi ll in fo rm at io n ga ps (l og ist ic s m an ag em en t in fo rm at io n sy st em ) • M ic ro st ra tifi ca tio n to ta rg et in te rv en tio ns , i nc lu di ng iC C M : C on du ct n at io na l s tra tifi ca tio n to ta rg et iC C M in te rv en tio ns w ith D H IS 2 an d m ul tip le in di ca to r cl us te r s ur ve ys Po lic y iss ue s (e xi st en ce & u se ): • El ab or at e st an da rd op er at in g pr oc ed ur es fo r pr oc es s sa fe ty m an ag em en t, in cl ud in g co st re co ve ry a nd or de rin g of • am ox ic ill in , o ra l r eh yd ra tio n sa lts a nd z in c • D efi ne s up pl y ch ai n m an ag em en t s ys te m fo r a ll le ve ls • Le ng th en tr ai ni ng d ur at io n fro m 10 d ay s an d in cl ud e pr ac tic al s es sio ns • In te gr at io n in to n at io na l he al th s ec to r d ev el op m en t pl an : • In cl ud e IS D C o n ag en da of th e th em at ic g ro up o n ch ild h ea lth O pe ra tio na liz e w or ki ng g ro up s on re gi on al in ve st m en t • C rit er ia fo r i CC M p rio riz at io n an d op er at io na liz at io n U pd at e cr ite ria fo r pr io rit iz at io n of a re as fo r iC C M if ro m d at a re po sit or y Po lic y di ss em in at io n & us e: • Tr ai ni ng , s up er vi sio n an d m en to rin g fo r i CC M in h ea lth fa ci lit ie s an d co m m un iti es Im pr ov e di ss em in at io n an d up ta ke o f g lo ba l p ol ic ie s th ro ug h w eb sit es , p ol ic y do cu m en ts a nd d ur in g m ee tin gs Le ad er sh ip a nd m an ag em en t: • A dd iC C M to th e ag en da o f jo in t s te er in g an d ad vo ca cy m on ito rin g co m m itt ee s fo r re so ur ce m ob ili za tio n an d en ga ge m en t o f s ta ke ho ld er s in p ar tn er s ec to rs • Jo in t p la nn in g to a cc el er at e re du ct io n of c hi ld m or ta lit y (h um an re so ur ce s, fin an ce , su pp ly c ha in m an ag em en t, co m m un ity a nd h ea lth fa ci lit y re fe rr al ) • Re so ur ce a llo ca tio n fo r I SD C op tim iz ed th ro ug h G FF in ve st m en t c as e • St re ng th en c om m un ic at io n an d co lla bo ra tio n am on g al l st ak eh ol de rs (c om m itt ee s, co or di na tio n m ee tin gs , ci rc ul ar le tte rs , s oc ia l m ed ia ) • Im pr ov e m an ag em en t o f C H W a nt im al ar ia l a ct iv iti es • Al ig nm en t o f p ar tn er s D iss em in at io n of n at io na l po lic y to p ar tn er s Im pr ov e op er at io na l c oo rd in at io n of pa rt ne rs • Pr ov id e te ch ni ca l as sis ta nc e to u pd at e gu id el in es , s ta nd ar ds an d op er at io na l st an da rd s, co nd uc t re vi ew s an d se t u p da ta re po sit or y • Pr ep ar e a m em or an du m fo r te ch ni ca l a nd fi na nc ia l pa rt ne rs to s up po rt ad vo ca cy , w ith W H O st an da rd s do cu m en ts • G en er at e ev id en ce b y H BH I i nt eg ra tio n an d th e iC C M a pp ro ac h in fo ur p ilo t d ist ric ts Im pr ov e op er at io na l co or di na tio n an d al ig nm en t o f p ar tn er s • Fi na nc ia l ac co m pa ni m en t • Ad vo ca te fo r a n ac co un ta bi lit y fra m ew or k at a ll le ve ls 3Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management CH AD CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • C om m un ity h ea lth s tra te gy 20 15 –2 01 8 pr op os ed p ilo t iC C M im pl em en ta tio n. • U N IC EF a nd S w itz er la nd ar e su pp or tin g a m en to rin g in iti at iv e fo r i CC M in tw o di st ric ts (G or e an d Be ss ao ) fo r 1 2 m on th s (o ng oi ng ). • Th e ou tc om es o f t he iC C M pi lo t p ro je ct w ill b e us ed to u pd at e th e na tio na l co m m un ity h ea lth s tra te gy . • H om e m an ag em en t i n tw o re gi on s (M oy en C ha ri an d M an do ul ) a lso a t p ilo t s ta ge . • C hi ld -f rie nd ly c om m un ity in iti at iv e is pr om ot in g co m m un ity p ar tic ip at io n an d en ga ge m en t. • Su bo pt im al ro ut in e he al th m an ag em en t i nf or m at io n sy st em , l ac k of lo gi st ic s m an ag em en t i nf or m at io n sy st em . • D at a co lle ct io n in p ro je ct in a pa ra lle l s ys te m . • Ev al ua tio n an d le ss on s le ar nt fro m p ilo t p ro je ct w ill b e us ed to u pd at e co m m un ity h ea lth st ra te gy fo r n ex t 3 y ea rs , in cl ud in g cr ite ria fo r s ca lin g up c om m un ity c ur at iv e se rv ic es . • Es ta bl ish c om m un ity h ea lth te ch ni ca l w or ki ng g ro up fo r p la nn in g, re so ur ce m ob ili za tio n, d iss em in at io n, im pl em en ta tio n, m on ito rin g an d ev al ua tio n. • St re ng th en c ap ac ity o f M in ist ry o f H ea lth to m an ag e an d im pl em en t t he P H C , in cl ud in g co m m un ity h ea lth pr og ra m m es . Institutionalizing integrated community case management (iCCM) to end preventable child deaths A technical consultation and country action planning, 22-26 July 2019, Addis Ababa 4 DE M O CR AT IC R EP UB LI C O F TH E CO NG O CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • An al ys e ga ps in in te gr at ed m an ag em en t o f s ev er e ch ild ho od d ise as es a nd m at er na l h ea lth • D ev el op a n in ve st m en t fra m ew or k to d em on st ra te ga in o f i nv es tin g in c hi ld a nd m at er na l h ea lth • Pr ep ar e at tra ct iv e m es sa ge s fro m a na ly sis a nd in ve st m en t f ra m ew or k to at tra ct p ol iti ca l c om m itm en t • Id en tif y ch an ne ls an d ch am pi on s to c on ve y m es sa ge s • C om pl em en t c om m un ity in fo rm at io n in D H IS 2 w ith a m od ul e fo r o th er a sp ec ts o f ch ild h ea lth • Im pr ov e co m pl et en es s an d qu al ity o f c om m un ity d at a in D H IS 2 . • M ic ro -s tra tifi ca tio n to d et er m in e ty pe s of in te rv en tio n by s tra tu m • St re ng th en c ap ac ity in d at a an al ys is at a ll le ve ls • St re ng th en o pe ra tio na l re se ar ch to o bt ai n re lia bl e da ta fo r d ec isi on -m ak in g • Im pr ov e av ai la bi lit y of m ea ns fo r fi gh tin g ch ild ho od di se as es • Ab ol ish ta xe s on m ea ns fo r fig ht in g ch ild ho od d ise as es • Pr om ot e lo ca l p ro du ce rs o f m ea ns to c om ba t m al ar ia an d di ar rh oe a • Es ta bl ish c om pe ns at io n an d re te nt io n m ec ha ni sm s fo r co m m un ity w or ke rs • Re vi ta liz e th em at ic g ro up s an d gi ve th em re so ur ce s to fu nc tio n at a ll le ve ls • Ex te nd p riv at e se ct or th em at ic g ro up to c om ba t c hi ld ho od d ise as es • D ev el op a nd fi na nc e pl an fo r di ss em in at in g po lic ie s an d st ra te gi es • Es ta bl ish e ar ly w ar ni ng o f r isk s of di sr up tio ns a nd e m er ge nc y su pp ly • Ex em pt m ea ns fo r fi gh tin g ch ild ho od di se as es fr om ta xe s In st itu tio na liz e co m m un ity re la ys in th e he al th sy st em • Pl an c om pe ns at io n fo r c om m un ity re la ys in lo ca l a nd p ro vi nc ia l b ud ge ts • Se t u p co nt ex t- sp ec ifi c tra ns po rt fo r re fe rr al o f c as es fr om c om m un iti es to he al th c en tre s • Su pp or t t he fi gh t a ga in st m al ar ia by a llo ca tin g co un te rp ar t f un ds ac co rd in g to e xp ec te d re su lts • Es ta bl ish a n at io na l o r p ro vi nc ia l co un ci l f or th e fig ht a ga in st in fa nt m or ta lit y at ta ch ed to th e Pr es id en cy of th e Re pu bl ic • Re vi ta liz e an d in st itu tio na liz e th e ne tw or k of n at io na l a nd p ro vi nc ia l pa rli am en ta ria ns fo r t he fi gh t ag ai ns t m al ar ia in th e so ci oc ul tu ra l co m m iss io n Lo ca l p ar tn er s: • W or k in a c on so rt iu m to g ai n po lit ic al c om m itm en t a t a ll le ve ls • O rg an iz e a jo in t a dv oc ac y m iss io n to th e Pr es id en cy of th e Re pu bl ic to o bt ai n its co m m itm en t • Pr ov id e te ch ni ca l s up po rt to th em at ic g ro up s • Al ig n w ith th e co un tr y’ s po lic ie s • St re ng th en in te rc ha ng ea bi lit y of in pu ts am on g pa rt ne rs • Su pp or t g ov er nm en t i n bu ild in g ca pa ci ty fo r d at a an al ys is • Su pp or t o pe ra tio na l re se ar ch G lo ba l p ar tn er s: • H el p co un tr ie s to co nt ex tu al iz e gu id el in es to fig ht c hi ld ho od d ise as es ac co rd in g to re al iti es in th e fie ld 5Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management ET HI O PI A CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • H ea lth e xt en sio n pl at fo rm an d go od p ol iti ca l w ill • Pl an fo r o pt im iz at io n of he al th e xt en sio n pa ck ag e in pr ep ar at io n • G oo d in te gr at io n at a ll le ve ls, pa rt ic ul ar ly h ea lth fa ci lit ie s, di st ric ts , p ro cu re m en t a nd su pp ly m an ag em en t, tra in in g, pl an ni ng • Pr io rit iz at io n of in te rv en tio ns ba se d on d at a: p re va le nc e of c hi ld ho od il ln es se s e. g. pn eu m on ia , g ui de fo r in te rv en tio ns • C on ce rn a bo ut s us ta in ab le fin an ci ng fo r I CC M a nd IC C M co m m od iti es • H ea lth e xt en sio n w or ke r at tr iti on is c ha lle ng e (e xp ec te d to b e ad dr es se d by o pt im iz at io n of p ac ka ge , ca rr ie r d ev el op m en t) • IC C M u pt ak e to b e im pr ov ed th ro ug h in no va tiv e de m an d cr ea tio n st ra te gy • IC C M tr ai ni ng in cl ud ed in cu rr ic ul um a nd p re se rv ic e • H ea lth e xt en sio n pa ck ag e to b e ad ap te d fo r p as to ra l co m m un iti es • D H IS 2 ad dr es se s al l I CC M co m po ne nt s: 9 5% c ov er ag e at he al th c en tre s • D at a lo st in tr an sit io n fro m h ea lth m an ag em en t in fo rm at io n sy st em to D H IS -2 • Re tro sp ec tiv e da ta re qu ire d. • Lo gi st ic s m an ag em en t in fo rm at io n sy st em re qu ire d fo r p ro gr am m e m an ag er s to q ua nt ify s to ck s in h ea lth fa ci lit ie s • M ic ro st ra tifi ca tio n do ne in he al th fa ci lit ie s (b y m or bi di ty , ad m iss io n an d m or ta lit y) • An al ys is, d at a us e, c ap ac ity - bu ild in g re qu ire d in d ist ric ts • Im pl em en ta tio n re se ar ch o n ne w bo rn s an d yo un g ch ild re n (e nh an ce d pn eu m on ia di ag no sis , s er io us b ac te ria l in fe ct io n, K an ga ro o m ot he r ca re , a ss es sm en t o f h ea lth ex te ns io n pa ck ag e, A RI D A) • C oo rd in at io n st re ng th en ed am on g di re ct or at es in M in ist ry o f H ea lth fo r m at er na l, ne w bo rn a nd ch ild h ea lth , h ea lth e xt en sio n pa ck ag e, P H C , m al ar ia , di se as e pr ev en tio n an d co nt ro l • Bl an ke t c ov er ag e of IC C M en ha nc ed b y co m m un ity - ba se d ne w bo rn c ar e pr og ra m m e • C om m od ity d ist rib ut io n ba se d on c on su m pt io n an d bu rd en . • Pr io rit iz at io n fo r h ar d- to - re ac h an d hi gh -b ur de n co m m un iti es re qu ire s fu rt he r an al ys is an d va lid at io n • Im pr ov em en t r eq ui re d fo r es tim at io n of c hi ld ho od ill ne ss b ur de n (p ne um on ia , di ar rh oe a) fo r d ru g qu an tifi ca tio n • La ck o f i nc id en t d at a on ch ild ho od il ln es se s • H ea lth e xt en sio n w or ke rs fo llo w th e gu id el in es w el l • Jo in t p la nn in g to re du ce c hi ld m or ta lit y • D el ay ed p ro cu re m en t a nd la ck o f l oc al p ro du ct io n of es se nt ia l d ru gs • Bo tto m –u p pl an ni ng • C om m un ity e ng ag em en t sh ou ld b e st re ng th en ed • G oo d pa rt ne r a lig nm en t • M or e pa rt ne rs re qu ire d • C oo rd in at io n am on g M in ist ry of H ea lth d ire ct or ie s sh ou ld be s tre ng th en ed • C ap ac ity -b ui ld in g in d at a us e an d an al ys is in d ist ric ts • Pr oc ur em en t l ea d tim e sh ou ld b e re du ce d by ea rly p la nn in g, s im pl ifi ed bu re au cr ac y, lo ca l p ro du ct io n of e ss en tia l d ru gs • In cr ea se d pa rt ne r in vo lv em en t i n te ch ni ca l su pp or t a nd d oc um en ta tio n • IC C M fi na nc in g fro m d on or s, an d in cr ea se d om es tic fin an ci ng fo r c hi ld h ea lth • Fi na liz e op tim iz at io n of h ea lth ex te ns io n pa ck ag e st ra te gy • St re ng th en P H C li nk ag es • Im pr ov e IC C M u pt ak e by in no va tiv e de m an d cr ea tio n st ra te gy a nd c om m un ity en ga ge m en t • Im pr ov e IC C M q ua lit y by qu al ity im pr ov em en t i ni tia tiv e (m H ea lth , e - co m m un ity he al th in fo rm at io n sy st em , in no va tio n, m en to rs hi p an d co ac hi ng ) Institutionalizing integrated community case management (iCCM) to end preventable child deaths A technical consultation and country action planning, 22-26 July 2019, Addis Ababa 6 G HA NA CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • St ro ng , t op –d ow n m an da te re qu ire d fo r I CC M a s a na tio na l p rio rit y (i. e. fr om Pr es id en t) to a ct iv at e st ak eh ol de rs to s up po rt th e na tio na l c hi ld h ea lth p ol ic y • Th e Fi rs t L ad y to a ct a s a ch am pi on fo r c hi ld h ea lth to ra ise a w ar en es s of c hi ld m or ta lit y • N at io na l m al ar ia p ro gr am m e to m ak e cl ea r p ro po sa l fo r u se o f 0 .5 % of D ist ric t As se m bl y C om m on F un d m al ar ia a llo ca tio n; p re se nt ly de ci de d by D ire ct or o f P ub lic H ea lth (a nd D ire ct or o f F am ily H ea lth ; a pp ro va l b y D ire ct or - G en er al ; e ng ag e D ire ct or o f Po lic y, Pl an ni ng , M on ito rin g an d Ev al ua tio n; g o to d ist ric ts • En co ur ag e lo ca l m an uf ac tu re of e ss en tia l i CC M co m m od iti es (l in ks to N at io na l H ea lth In su ra nc e sc he m e) • Pl ac e lo ca l g ov er nm en t a t t he ce nt re • Lo ca l g ov er nm en t pa rt ne rs hi p fo r h ea lth : di st ric t a ss em bl ie s to s up po rt C om m un ity -b as ed H ea lth Pl an ni ng a nd S er vi ce s by a 0. 5% a llo ca tio n to m al ar ia , an d es ta bl ish a cc ou nt ab ili ty m ec ha ni sm • Ad di tio na l f un ds (e .g . 2 % D isa bi lit y C om m on F un d) co ul d be le ve ra ge d to su pp or t i CC M • Po lic y tra ns la tio n an d gu id an ce : D efi ni tio n an d un de rs ta nd in g of iC C M a nd its re la tio n to C om m un ity - ba se d H ea lth P la nn in g an d Se rv ic es m us t b e co ns ist en t at n at io na l, re gi on al , d ist ric t an d, c rit ic al ly , c om m un ity le ve ls • C ol la bo ra tio n: W H O a nd U N IC EF s ho ul d br in g pa rt ne rs (G FF , K O IC A, JIC A, th e U S Ag en cy fo r In te rn at io na l D ev el op m en t, G F, no ng ov er nm en ta l or ga ni za tio ns , e tc ) t og et he r to e st ab lis h a cl ea r f un di ng pl an fo r C om m un ity -b as ed H ea lth P la nn in g an d Se rv ic es (w hi ch m us t i nc lu de iC C M ) to d et er m in e w ha t t he y w ill fu nd in iC C M , w he re , h ow th e fu nd s w ill b e m ov ed a nd u se d an d ho w to s ca le u p • Re co m m en da tio n to W H O an d do no rs : l ea d by e xa m pl e an d as a n in te gr at ed or ga ni za tio n fo r e .g . m al ar ia , ch ild h ea lth a nd P H C • Re co m m en da tio n to G F: re vi ew o bj ec tio n to fu nd in g on -m al ar ia iC C M co m m od iti es 7Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management M AL I CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • Te n- ye ar h ea lth a nd s oc ia l de ve lo pm en t p la n (2 01 4– 20 23 ); Fr ee h ea lth re fo rm w ith te ch ni ca l c om m iss io n • In te gr at ed a pp ro ac h to c hi ld ca re (c lin ic al a nd c om m un ity le ve ls (iC C M ) • St ra te gi c pl an s: H ea lth co m m un ic at io n; p al u • M as te r p la n fo r s up pl y an d di st rib ut io n of m ed ic in es an d na tio na l l ist o f e ss en tia l m ed ic in es . • C om m un ity e ng ag ed h ea lth co m m un ic at io n • W ee kl y an al ys is pr es en te d to co un ci l o f m in ist er s (p al u) a nd co rr ec tiv e ac tio n ta ke n D H IS 2 st ra tifi ed to c om m un ity le ve l • M ap pi ng o f e ss en tia l co m m un ity c ar e • G ui de s av ai la bl e • D iss em in at io n of d oc um en ts to o pe ra tio na l l ev el • Le ad er sh ip o f H ea lth D ire ct or at e th ro ug h he al th fa ci lit ie s, re gu la tio n an d co m m un ity h ea lth • Te ch ni ca l c om m itt ee (M in ist ry of H ea lth a nd e xe cu tiv es of te ch ni ca l a nd fi na nc ia l pa rt ne rs ). • St ee rin g co m m itt ee : Se cr et ar y- G en er al M in ist ry of H ea lth a nd S oc ia l A ffa irs , ce nt ra l s tr uc tu re s, ci vi l so ci et y, no ng ov er nm en ta l or ga ni za tio ns m un ic ip al iti es , na tio na l f ed er at io n of co m m un ity h ea lth a ss oc ia tio n an d te ch ni ca l a nd fi na nc ia l pa rt ne rs . • Re co m m en da tio ns fo r M in ist ry o f H ea lth , G ov er nm en t a nd p ar tn er s: Im pr ov e re po rt in g sy st em : da ta c ol le ct io n an d co rr ec t us e of h ea lth s of tw ar e • St at e co m m itm en t t o re m un er at io n of C H W s • Ad vo ca cy to m ob ile o pe ra to rs fo r f ul l I nt er ne t c ov er ag e • O rg an iz e su pe rv isi on o f ag en ts tr ai ne d in D H IS 2 so ftw ar e • U se a ll po ss ib le c ha nn el s (e .g . m ee tin gs ) t o di ss em in at e do cu m en ts Se iz e ot he r op po rt un iti es to h ol d co or di na tio n m ee tin gs • M ap s ta ke ho ld er s at a ll le ve ls Pa rt ne rs m us t: • C om pl y w ith th e co un tr y’ s al ig nm en t p ol ic y. • Pr ov id e th e re qu ire d su pp or t Institutionalizing integrated community case management (iCCM) to end preventable child deaths A technical consultation and country action planning, 22-26 July 2019, Addis Ababa 8 M O ZA M BI Q UE CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • H ig h ch ild m or ta lit y fro m m al ar ia , d ia rr ho ea , pn eu m on ia , H IV in fe ct io n, m al nu tr iti on . N ew bo rn h ea lth pr io rit iz ed • In te gr at ed m an ag em en t of c hi ld ho od a nd n ew bo rn ill ne ss in a ll he al th fa ci lit ie s C hi ld h ea lth fa ci lit ie s de liv er pr ev en tiv e an d cu ra tiv e se rv ic es fo r m al ar ia . • G ov er nm en t i nv es tm en t in h um an re so ur ce s an d co m m od iti es fo r P H C ; ho w ev er , i CC M m ai nl y do no r de pe nd en t • C om m un ity e ng ag em en t p ar t of h ea lth p ro m ot io n st ra te gy po lic y, w ith tw o ap pr oa ch : en ga ge m en t t o im pr ov e PH C se rv ic es a t h ea lth fa ci lit ie s an d en ga ge m en t t o im pr ov e co m m un ity h ea lth . N ot su ffi ci en tly a ut on om ou s an d ra re ly a dd re ss es a ll lo ca l pr ob le m s. • Pr og re ss in ro ut in e iC C M d at a co lle ct ed a nd u se d in th e he al th s ys te m . S til l d iffi cu lty in co lle ct in g he al th fa ci lit y da ta on p ne um on ia . M at er na l an d ch ild h ea lth d ep ar tm en t sh ou ld in co rp or at e da ta in th e he al th m an ag em en t in fo rm at io n sy st em . • Po pu la tio n- ba se d su rv ey s co nd uc te d to a ss es s ou tc om es a nd im pa ct s • D at a us ed to tr ac k di se as e tre nd s an d m al ar ia co m m od iti es . N o tra ck in g fo r di ar rh oe a an d pn eu m on ia . • Su rv ey s an d re se ar ch : h ea lth fa ci lit y su rv ey • N o m ic ro -s tra tifi ca tio n at d ist ric t l ev el . M ac ro - st ra tifi ca tio n o nl y fo r m al ar ia • G ui da nc e on m ai ns tre am in g iC C M in to C H W p ol ic y In te gr at ed in to th e he al th po lic y an d na tio na l s tra te gi c pl an i CC M p rio rit iz ed in ar ea s 8– 25 k m fr om h ea lth fa ci lit ie s • C H W p ol ic y di ss em in at ed . Pr io rit iz at io n of iC C M s ho ul d be c la rifi ed • Pu bl ic h ea lth d ep ar tm en t le ad s an d co or di na te s PH C in te rv en tio n at a ll le ve ls Jo in t p la nn in g at a ll le ve ls at an nu al p la nn in g m ee tin g C ha lle ng es : • H um an re so ur ce p la nn in g no t lin ke d to s er vi ce d el iv er y • Fi na nc in g se cu re d th ro ug h G F, re pr od uc tiv e, m at er na l, ne w bo rn a nd c hi ld h ea lth in ve st m en t c as e an d G FF • C H W a re n ot p ar t o f h ea lth sy st em o r p ub lic s ec to r pa yr ol l • St oc k- ou ts o f c om m od iti es • Re fe rr al s ys te m la ck s tra ns po rt sy st em , t ra ck in g of a rr iv al s at h ea lth fa ci lit y, ca pa ci ty o f h ea lth fa ci lit y to m an ag e ca se s • Re so ur ce s fo r s up er vi sio n (h um an re so ur ce , t ra ns po rt, fu el ) • Pa rt ne rs a re a lig ne d w ith G ov er nm en t. • Fi na liz e po lic y re vi ew fo r C H W s • En su re d at a on p ne um on ia ar e in h ea lth m an ag em en t in fo rm at io n sy st em to im pr ov e qu an tifi ca tio n of co m m od iti es • O pt im iz e iC C M m ed ic in es k it to a vo id s to ck -o ut s • Su pp or t c om m un ity co m m itt ee s in im pr ov in g re fe rr al s ys te m • En su re fi na nc ia l s up po rt to iC C M to fi ll al l im pl em en ta tio n ga ps • Su pp or t r es ou rc e m ob ili za tio n to m ak e iC C M a p rio rit y in na tio na l i nv es tm en ts • Sh ar e ex pe rie nc es o f w ha t w or ks a nd to ol s • Te ch ni ca l a ss ist an ce to im pr ov e pr oc ur em en t a nd lo gi st ic s 9Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management NI G ER CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • In su ffi ci en t i de nt ifi ca tio n of a re as w ith h ig h in fa nt m or ta lit y • Ar ea s th at a re d iffi cu lt to ac ce ss • N at io na l s tra te gi c pl an fo r co m m un ity h ea lth a lig ne d w ith h ea lth d ev el op m en t p la n • In te gr at ed p ac ka ge b as ed o n ch ild s ur vi va l p la ns , I CC M • Fr ee c ar e • Fi na nc ia l m ot iv at io n of 10 0 00 FC FA p er m on th ; 5 0% S ta te an d 50 % Pr es id en tia l T as k Fo rc e • Re co gn iti on o f “ re la is co m m un au ta ire s” b y de cr ee • N at io na l S tra te gi c Su pp ly Pl an : S ta te , M in ist ry o f Fi na nc e, U N IC EF , P M I, W or ld Ba nk ) • C om m un ity p ar tic ip at io n in he al th c om m itt ee s • Se as on al m al ar ia ch em op re ve nt io n • Re la is co m m un au ta ire s • In st itu tio na liz e re la is co m m un au ta ire s in co m m un iti es • Pr ov id e in fo rm al h el p to re la is co m m un au ta ire s • Su pe rv isi on o f r el ai s co m m un au ta ire s at a ll le ve ls C ol le ct io n an d su pe rv isi on to ol s • C oo rd in at io n m ee tin g • St ud ie s on q ua lit y of c ar e • Ev al ua tio n of im pa ct : 3 8% re du ct io n in m or ta lit y of ch ild re n un de r 5 y ea rs in Ra C E pr oj ec t a re as • In te gr at io n of c om m un ity ep id em io lo gi ca l d at a in to D H SI 2 • La st D em og ra ph ic a nd H ea lth S ur ve y in 2 01 2 • P ar tia l m ap pi ng o f r el ai s co m m un au ta ire s • N at io na l S tra te gy fo r C om m un ity -b as e d In te gr at ed H ea lth In te rv en tio ns (2 01 2) • N at io na l M al ar ia C on tro l Po lic y • N at io na l C om m un ity En ga ge m en t S tra te gy • iC C M S tra te gy S ca lin g Pl an (2 01 7– 20 21 ) • O rie nt at io n an d Re fe re nc e G ui de o n C om m un ity D ev el op m en t R el ay (2 01 7) • N at io na l s tra te gi c pl an fo r co m m un ity h ea lth b ei ng va lid at ed • IC C M p rio rit iz at io n cr ite ria in n at io na l s tra te gi c pl an fo r co m m un ity h ea lth • N at io na l d iss em in at io n • D ire ct or sh ip s of O rg an iz at io n of C ar e an d of M at er na l a nd C hi ld H ea lth • N at io na l m ul tis ec to ra l co m m itt ee fo r c om m un ity - ba se d in te rv en tio ns • D ec en tra liz ed h ea lth co m m itt ee s • Fr am ew or k fo r c on su lta tio n of h ea lth s ec to r t ec hn ic al a nd fin an ci al p ar tn er s on m al ar ia st ra te gi c pl an a t a ll le ve ls • In vo lv em en t o f t ec hn ic al an d fin an ci al p ar tn er s in de ve lo pm en t o f n at io na l st ra te gi c pl an fo r c om m un ity he al th • Pl an ni ng a re so ur ce m ob ili za tio n ro un dt ab le • Id en tif y ar ea s w ith h ig h in fa nt m or ta lit y ra te s Id en tif y ar ea s of d iffi cu lt ac ce ss • In cl ud e H BH I a nd IC C M in o pe ra tio na l p la n of th e na tio na l s tra te gi c pl an fo r co m m un ity h ea lth • Va lid at e an d di ss em in at e na tio na l s tra te gi c pl an fo r co m m un ity h ea lth • M ec ha ni sm to m ot iv at e re la is co m m un au ta ire s • Re vi ta liz e vi lla ge h ea lth co m m itt ee s • Ac ce le ra te in te gr at io n of ep id em io lo gi ca l d at a an d co m m un ity in pu t i nt o D H SI 2 • St re ng th en a dv oc ac y fo r H BH I a nd IC C M fu nd in g to Pa rli am en t • C on du ct h ou se ho ld s ur ve ys • C on tin ue m ap pi ng re la is co m m un au ta ire s • St re ng th en c oo rd in at io n an d al ig nm en t o f I CC M p ar tn er s • En su re e ffe ct iv e St at e sh ar e of fi na nc in g m ot iv at io n of re la is co m m un au ta ire s • Su pp or t o rg an iz at io n of th e re so ur ce m ob ili za tio n ro un dt ab le • Su pp or t r ea liz at io n of m ic ro st ra tifi ca tio n of IC C M in te rv en tio ns • Su pp or t c om pl et io n of ho us eh ol d su rv ey s Institutionalizing integrated community case management (iCCM) to end preventable child deaths A technical consultation and country action planning, 22-26 July 2019, Addis Ababa 10 NI G ER IA CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • iC C M s ho ul d be a n ex te ns io n of P H C –M in ist ry o f H ea lth iC C M T as k Fo rc e on M al ar ia an d Re pr od uc tiv e, M at er na l, N ew bo rn , C hi ld , A do le sc en t H ea lth • In cr ea se a dv oc ac y to S ta te G ov er nm en t f or o w ne rs hi p an d pr io rit iz at io n of P H C pa ck ag e of in te rv en tio ns in cl ud in g iC C M (M in ist ry o f H ea lth /N at io na l P rim ar y H ea lth C ar e D ev el op m en t • G ov er nm en t t o cr ea te b ud ge t lin e to e ns ur e co ns ist en t i CC M co m m od iti es (p ro cu re m en t, di st rib ut io n an d ca pa ci ty - bu ild in g) • Va lid at e ta x on a nt im al ar ia l an d Am ox ic ill in d isp er sib le ta bl et s: F ed er al G ov er nm en t • En ga ge p riv at e se ct or fo r di st rib ut io n: M in ist ry o f H ea lth , N at io na l P rim ar y H ea lth C ar e D ev el op m en t • Ex te rn al te ch ni ca l a ss ist an ce re qu ire d • In ve st m en t i n se rv ic e de liv er y D ev el op in ve st m en t c as e fo r i CC M (m ap pi ng a nd ne ed s as se ss m en t): M in ist ry of H ea lth , N at io na l P rim ar y H ea lth C ar e D ev el op m en t Ex te rn al te ch ni ca l a ss ist an ce re qu ire d • O pe ra tio na liz e co m m un ity he al th m an ag em en t in fo rm at io n sy st em (D H IS 2) • Sc al e up c om m un ity h ea lth m an ag em en t i nf or m at io n sy st em • U se d at a fo r p la nn in g an d de ci sio n- m ak in g in P H C a nd co m m un ity h ea lth • Id en tif y ar ea s of n ee d (h um an re so ur ce s, ac ce ss ) • Pr io rit iz e in te rv en tio ns • Fo re ca st a nd q ua nt ify co m m od iti es • Ex te rn al te ch ni ca l a ss ist an ce re qu ire d • Po lic y B et te r u nd er st an di ng of C om m un ity H ea lth Im pr ov em en t P la n fo r de liv er in g co m m un ity he al th s er vi ce s, in cl ud in g iC C M : M in ist ry o f H ea lth , N at io na l P rim ar y H ea lth C ar e D ev el op m en t • St at e go ve rn m en ts to a lig n w ith th e na tio na l e ss en tia l m ed ic in es li st : M in ist ry o f H ea lth , F oo d an d D ru g Se rv ic es • D iss em in at io n an d us e of po lic y • D iss em in at e an d pr om ot e us e of n at io na l g ui de lin es a nd to ol s fo r i CC M a t a ll le ve ls: M in ist ry o f H ea lth • C om m un ity s er vi ce d el iv er y • D ra w u p co st ed o pe ra tio na l pl an fo r r ep ro du ct iv e, m at er na l, ne w bo rn a nd c hi ld he al th a t P H C le ve l: St at e m in ist rie s of h ea lth , p rim ar y he al th c ar e de ve lo pm en t ag en ci es a nd p ar tn er s • Eff ec tiv e co or di na tio n an d pa rt ne rs hi p at a ll le ve ls (n at io na l, st at e an d lo ca l go ve rn m en t a re as ) • Te ch ni ca l w or ki ng g ro up s an d co m m itt ee s to b e fu nc tio na l at a ll le ve ls • St re ng th en s ta te a nd lo ca l g ov er nm en t l ea de rs ’ un de rs ta nd in g of th e co nc ep t of iC C M • Id en tif y ch am pi on s at a ll le ve ls to p ro m ot e iC C M • Re gu la r d em an ds fo r p er io di c re po rt s on a ct io n pl an s by hi gh er a ut ho rit ie s • M ap pi ng o f p ar tn er s in im pl em en tin g iC C M : su bn at io na l t o na tio na l • W or k w ith th e co un tr y in u se of th e H BH I a pp ro ac h in c hi ld he al th in te rv en tio ns 11Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management SI ER RA L EO NE CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • Pr es id en t c om m itt ed to re du ce m at er na l, in fa nt an d ch ild m or ta lit y an d to d el iv er h ea lth c ar e at co m m un ity le ve l • Tr an sla tio n of p ol iti ca l w ill : F re e he al th c ar e in iti at iv e Bi -p ar tis an po lit ic al s up po rt In cr ea sin g G ov er nm en t co nt rib ut io n: 10 % in 2 01 8, 30 % in 2 01 9, 5 0% fo r 2 02 0 • Pr io rit y ev id en ce d by G ov er nm en t b ud ge t l in e fo r c om m un ity h ea lth pr og ra m m es in n at io na l he al th b ud ge t • C re at io n of N at io na l M ed ic in es S up pl y Ag en cy as a n Ac t o f P ar lia m en t • St ro ng c ol la bo ra tio n an d re po rt in g: In te gr at io n of c om m un ity h ea lth in fo rm at io n sy st em in to D H IS 2 • An al ys is of d at a: G oo d an al ys is of d at a at ce nt ra l a nd d ist ric t l ev el s w ith a cc es s to D H IS 2 • Re vi ew o f d at a fro m d ist ric t h ea lth m an ag em en t t ea m • Pe rip he ra l h ea lth u ni t in c ha rg e of m on th ly m ee tin gs • C H W m on th ly m ee tin g w ith p er ip he ra l h ea lth un it • Pi lo t s tu dy o f d ig iti za tio n of c om m un ity h ea lth da ta in o ne d ist ric t • In te gr at io n of fo rm al pr iv at e se ct or d at a (li m ite d) in to D H IS 2 • M in ist ry h as p rio rit iz ed in te gr at io n of D H IS 2 an d lo gi st ic s m an ag em en t in fo rm at io n sy st em to re du ce d up lic at io n Po lic ie s co he re nt a nd in te rli nk ed : • N at io na l M ed iu m -t er m D ev el op m en t P la n (2 01 9– 20 23 ) N at io na l H ea lth Po lic y N at io na l S tra te gi c Pl an R ep ro du ct iv e, M at er na l, N ew bo rn an d C hi ld H ea lth P la n M al ar ia C on tro l S tra te gi c Pl an (2 01 6– 20 20 ) N at io na l C H W P ol ic y an d St ra te gy (2 01 6– 20 20 ) PH C O pe ra tio na l H an db oo k • St ra te gi es a re c os te d • St re ng th en d at a us e at lo w er le ve ls • St ro ng li nk s w ith in a nd am on g ce nt ra l a nd di st ric t d ire ct or at es a nd pr og ra m m es • Pe rm an en t C H W h ub w ith in D ire ct or at e of Pr im ar y H ea lth C ar e • Al so a t d ist ric t l ev el w ith de di ca te d iC C M /C H W fo ca l p oi nt s • St ee rin g co m m itt ee a t le ad er sh ip le ve l • D isc us sio ns a nd as se ss m en ts to im pr ov e jo in t p la nn in g fo r v ar io us co m m un ity h ea lth ac tiv iti es (C H W h ub , H IV in fe ct io n, tu be rc ul os is, m al ar ia ), lin ke d to O ne Bu dg et , O ne P la n, O ne M &E F ra m ew or k • D ev el op m en t C oo rd in at io n Fr am ew or k es ta bl ish ed • G ov er nm en t t o ab so rb C H W s in to h ea lth w or kf or ce • Al l n at io na l m al ar ia p ro gr am m es to e ns ur e in cl us io n of e lim in at io n ob je ct iv es in n at io na l m al ar ia s tra te gi c pl an s • Ex te ns io n of re so ur ce s an d te ch ni ca l s up po rt fro m H BH I t o co un tr ie s ou ts id e th e H BH I l ist , e sp ec ia lly th os e th at h av e be gu n sim ila r p ro ce ss es • Te ch ni ca l s up po rt w ith m ic ro st ra tifi ca tio n fo r op tim al ta rg et in g of re so ur ce s • St re ng th en in g of re gu la r s up er vi sio n in p er ip he ra l he al th u ni ts a nd c om m un iti es (c as ca de s up er vi sio n) • G ov er nm en t s te w ar ds hi p of d ig ita liz at io n of co m m un ity h ea lth in fo rm at io n sy st em a nd h ea lth fa ci lit y da ta , w ith li nk ag e to D H IS 2; in cl ud in g ro ad m ap • Re co m m en d su pp or t f or c on so lid at io n an d sc al in g up o f b es t p ra ct ic es a t C H W m on th ly m ee tin gs • St re ng th en d at a us e at lo w er le ve ls • En su re a lig nm en t o f N at io na l H ea lth P ol ic y Pl an (1 0 ye ar s) w ith N at io na l M ed iu m -t er m D ev el op m en t Pl an • Pe nd in g re vi sio n of m an y po lic ie s w ith m os t r ec en t ev id en ce • C al l f or m in ist rie s of h ea lth to e m ph as iz e di ss em in at io n an d po pu la riz at io n of p ol ic ie s • St re ng th en g ui da nc e an d po lic y fo r e ffe ct iv e re fe rr al d ow n to C H W le ve l • Su pp or t t o co un tr ie s fo r a lig nm en t o f g lo ba l w ith n at io na l p ol ic ie s, w ith e m ph as is on op er at io na liz at io n • Re co m m en da tio n fo r i nt eg ra tio n of IM C I a nd iC C M fo ca l p oi nt s in d ist ric ts to s up po rt ov er al l s ys te m s st re ng th en in g • Po lic y re qu ire d to a dd re ss re fe rr al s ys te m ho lis tic al ly (f ro m c om m un ity le ve l) • Li nk D ev el op m en t C oo pe ra tio n • Su pp or t s tre ng th en in g of a nd a lig nm en t w ith n at io na l h ea lth in fo rm at io n sy st em , in cl ud in g co m m un ity he al th in fo rm at io n sy st em Re co m m en d be tte r co or di na tio n of p ar tn er s w ith in C H W p ro gr am m e an d at d ire ct or at e le ve l Institutionalizing integrated community case management (iCCM) to end preventable child deaths A technical consultation and country action planning, 22-26 July 2019, Addis Ababa 12 UG AN DA CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS Po lit ic al a dv oc ac y st re ng th en ed : • To im pr ov e ra tio na liz at io n of re so ur ce a llo ca tio n an d us e to eq ui ta bl y ta rg et h ig h- bu rd en ar ea s (c hi ld m or bi di ty a nd m or ta lit y) • Tr an sla te p ol iti ca l c om m itm en t in to a ct io n In ce nt iv es to a ttr ac t hu m an re so ur ce s fo r h ar d- to -r ea ch , h ig h- bu rd en a re as In cl ud e C H W s in n at io na l he al th w or kf or ce , w ith ap pr op ria te re m un er at io n by th e G ov er nm en t • In cr ea se d om es tic re so ur ce s fo r i CC M c om m od iti es U pd at e th e m al ar ia b ill to in cl ud e H BH I a nd m as s ac tio n ag ai ns t m al ar ia , a nd fa st tr ac k its a pp ro va l b y Pa rli am en t t o in cl ud e a m al ar ia fu nd • U se o f d om es tic re so ur ce s fo r t ra in in g, s up er vi sio n, m on ito rin g an d ev al ua tio n of iC C M p ro gr am m e • U ga nd a Pa rli am en ta ry Fo ru m o n M ed ia to e ng ag e co m m un iti es in m as s ac tio n ag ai ns t m al ar ia a nd th e 22 ke y fa m ily c ar e pr ac tic es a t al l l ev el s • R el ig io us , c ul tu ra l a nd p riv at e se ct or a nd o th er s ec to rs to en ga ge in m as s ac tio n ag ai ns t m al ar ia a t c om m un ity le ve l • Fi na liz e th e m al ar ia d at a re po sit or y • O th er d at a sh ou ld b e co ns id er ed e .g . m or ta lit y da ta fr om ro ut in e sy st em s, fu nc tio na l a nd g eo gr ap hi ca l ac ce ss to s er vi ce s, nu tr iti on st at us , h ou se ho ld p ov er ty , re fu ge e an d ot he r e xc lu sio n fa ct or s • D isa gg re ga te d co m m un ity da ta fe d in to D H IS 2 fo r pl an ni ng , d ec isi on -m ak in g an d ad vo ca cy • D at a us e fo r e vi de nc e- ba se d pl an ni ng , m on ito rin g an d ad vo ca cy • Re gu la rly u pd at e m ic ro - st ra tifi ca tio n • Bu ild c ap ac ity fo r d at a an al ys is an d us e at a ll le ve ls • Re vi ew a nd p la nn in g m ee tin gs in d ist ric ts to tra ns la te d at a in to a ct io n • Pa ck ag e in fo rm at io n on H BH I an d m as s ac tio n ag ai ns t m al ar ia fo r a dv oc ac y at a ll le ve ls • M on ito rin g fra m ew or k fo r H BH I t o be li nk ed to Re pr od uc tiv e, M at er na l, N ew bo rn , C hi ld , A do le sc en t H ea lth m on ito rin g fra m ew or k (in cl ud in g pr oc es s m on ito rin g) • Fi na liz e an d di ss em in at e co m m un ity h ea lth s tra te gy an d fra m ew or k • Al ig n co m m un ity h ea lth st ra te gy a nd fr am ew or k w ith ex ist in g he al th p ol ic ie s an d st ra te gi es • D iss em in at e po lic y to e ve ry st ak eh ol de r t o in fo rm de ci sio n- m ak in g • D ev el op a n in ve st m en t c as e fo r I CC M , H BH I a nd m as s ac tio n ag ai ns t m al ar ia to pl an re so ur ce m ob ili za tio n in lin e w ith th e he al th fi na nc in g st ra te gy • St re ng th en c oo rd in at io n, w ith cl ea r l ea de rs hi p of iC C M in M in ist ry o f H ea lth a nd di st ric ts • In ce nt iv es to a ttr ac t h um an re so ur ce s to h ar d- to -r ea ch , hi gh -b ur de n ar ea s • In cl ud e C H W s in th e na tio na l he al th w or kf or ce , a nd G ov er nm en t t o re m un er at e th em a pp ro pr ia te ly M in ist ry o f H ea lth to : • In cl ud e C H W s in th e na tio na l he al th w or kf or ce a nd re m un er at e th em • Pr ov id e cl ea r g ui da nc e on le ad er sh ip a nd c oo rd in at io n of c om m un ity h ea lth pr og ra m m e • Se cu re u ni nt er ru pt ed s up pl y of iC C M c om m od iti es • D ev el op iC C M in ve st m en t ca se D efi ne M in ist ry of H ea lth p rio rit ie s in co m m un ity h ea lth a nd m al ar ia c le ar ly • O ffi ce o f t he P rim e M in ist er to co or di na te th e m ul tis ec to ra l re sp on se to c om m un ity he al th M in ist ry o f F in an ce to al lo ca te m or e re so ur ce s to th e he al th s ec to r a cc or di ng to th e in ve st m en t c as e • Pa rt ne rs to a lig n th ei r s up po rt to M in ist ry o f H ea lth p rio rit ie s an d st ra te gi es • G F to c on sid er fu nd in g no n- m al ar ia c om m od iti es fo r i CC M G FF to in cr ea se re so ur ce s fo r n at io na l s ca lin g up o f i CC M p ro gr am m e • Th e W or ld B an k an d G F to in cr ea se fu nd in g fo r h ea lth sy st em s st re ng th en in g, e .g . pr oc ur em en t a nd s up pl y m an ag em en t, co m m un ity he al th s ys te m s • U ni te d N at io ns p ar tn er s to s up po rt co un tr ie s in pr ep ar in g in ve st m en t c as es fo r i CC M Jo in t m iss io ns by g lo ba l p ar tn er s to co un tr ie s to a dv oc at e fo r in st itu tio na liz at io n of iC C M an d in cr ea se d om es tic re so ur ce s • Re gi on al s up po rt fo r m al ar ia pr og ra m m e re vi ew S up po rt fo r t he M al ar ia E lim in at io n St ra te gi c Pl an , t o in cl ud e H BI a nd m as s ac tio n ag ai ns t m al ar ia 13Web Annex. Summary tables with recommendations of “high burden to high impact” (HBHI) countries for scaling up integrated community case management UN IT ED R EP UB LI C O F TA NZ AN IA CO NT EX T/ ST AT US RE CO M M EN DA TI O NS PI LL AR 1. PO LI TI CA L W IL L PI LL AR 2 . ST RA TE G IC U SE O F IN FO RM AT IO N PI LL AR 3 . BE TT ER G UI DA NC E PI LL AR 4 . LE AD ER SH IP A ND CO O RD IN AT IO N M IN IS TR Y O F HE AL TH , G O VE RN M EN T PA RT NE RS • Fi na liz e th e ne w C H W m od el fo r n at io na l s ca lin g up . • D efi ne th e pa ck ag e of C H W se rv ic es , i nc lu di ng p re ve nt iv e, pr om ot iv e an d ba sic c ur at iv e se rv ic es . • Re vi ew p ol ic y do cu m en ts an d Im pl em en ta tio n gu id es to a lig n w ith th e ne w C H W m od el . • St re ng th en n ew bo rn a nd ch ild h ea lth te ch ni ca l w or ki ng su b- gr ou ps a nd th e N at io na l Te ch ni ca l A dv iso ry G ro up fo r co or di na tio n of c om m un ity - ba se d he al th p ro gr am m es , in cl ud in g iC C M . • Pr io rit iz e vi lla ge s w ith n o he al th fa ci lit at or s an d ha rd - to -r ea ch , r em ot e ar ea s fo r co m m un ity h ea lth s er vi ce s. • D ev el op to ol s fo r c ol le ct in g co m m un ity d at a, a nd a lig n w ith D H IS 2 p la tfo rm . • O pe ra tio na liz e ex ist in g C H W s in li ne w ith n ew ly re co m m en de d na tio na l C H W m od el w ith re ga rd to se le ct io n, tr ai ni ng , s er vi ce pa ck ag e, s up er vi sio n an d in ce nt iv es . • St re ng th en c om m un ity st ru ct ur es (v ill ag e he al th ca re r, vi lla ge s oc ia l se cu rit y, he al th fa ci lit y go ve rn in g bo ar d, v ill ag e ex ec ut iv e offi ce r) to s up po rt re co m m en de d na tio na l C H W m od el . • Al ig n co m m un ity d at a co lle ct io n w ith n at io na l h ea lth in fo rm at io n m ea su re m en t sy st em a nd D H IS 2 to o bt ai n da ta o n co m m un ity h ea lth an d co m m od iti es . • Li nk c om m un ity d at a on co m m od iti es to e -l og ist ic s m an ag em en t i nf or m at io n sy st em s to tr ac k ch ild h ea lth co m m od iti es . • En su re in te gr at ed s up po rt fo r s tra te gi c in fo rm at io n, co or di na tio n an d co m m od ity su pp lie s, bu ild in g on ex ist in g co un tr y sy st em s an d pr io rit ie s. • Su pp or t s tre ng th en in g of P H C fa ci lit ie s to m ee t i nc re as in g ne ed s of c om m un ity h ea lth sy st em s. • Su pp or t r es ou rc e m ob ili za tio n to fi ll ga ps in fu nd in g fo r c hi ld he al th s er vi ce s su ch a s no n- m al ar ia c om m od iti es .