Brief: Treating Children Close to Home Common Approach Evidence Synthesis

Primary healthcare isn’t reaching large numbers of the poorest people. Treating Children Close to Home (Integrated Community Case Management -iCCM) is our common approach to addressing this problem. By training people in communities to detect and treat common childhood illness, such as malaria, pneumonia and diarrhoea, we can empower remote communities with little or no access to facility-based services to provide their own healthcare.

In 2022, the Common Approach was reviewed to provide a comprehensive overview of the current iCCM knowledge base, grounded in evidence generated and lessons learned since the last synthesis in 2019. The synthesis aimed to identify key findings, highlight gaps in the literature, and offer recommendations for future research and practice.

Key findings include:

1. Effectiveness: iCCM contributed to a 10% reduction in under-five mortality in Niger, the Democratic Republic of Congo, Malawi, and Mozambique.
2. Acceptability: High utilization of iCCM services in countries like Nigeria indicates strong community acceptance.
3. Safety/Risk: Quality of care remains a proxy for safety, with challenges such as medicine stockouts and CHW absenteeism affecting outcomes.
4. Equity: iCCM effectively reaches underserved communities, improving health equity.
5. Scalability: Successful scale-up requires contextual adaptation, with varied outcomes across different settings.
6. Cost-effectiveness: iCCM is a cost-effective strategy, though its impact is threatened by low coverage and quality issues.

This brief concludes with recommendations for enhancing iCCM implementation, including boosting community engagement, ensuring CHW availability, improving quality of care, securing medicine supply, fostering CHW-facility collaboration, and promoting government ownership.