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DRC-IHP: Plans de communication, positionnement et de marquage

Integrated Community Case Management in DRC

October 10, 2013

Dr. Narcisse Embeke

Child Health Senior Technical Advisor

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Outline

• Background

• What is i-CCM?

• Key achievements

• Challenges

• Next steps

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IHP and DRC OverviewThe Integrated Health Project supports 80 health zones, covering a population of 12,186,559. About 2,437,312 are children under the age of five.

•70% of the total population live in rural areas.

•A large portion of the population does not have access to health services.

•25% average rate of curative services in DRC, 38% in IHP-supported health zones.

•Community health workers fill many of the gaps in health services. Many health zones are difficult to

reach due to: : geographic inaccessibility : insecurity and armed conflict

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Background

Source: A Promise Renewed: Action Framework. MOH DRC 2013

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What is i-CCM?

Integrated Community Case Management: i-CCM benefits villages or communities where access to health care is limited or

difficult to obtain. A pair of trained and supervised community health workers (CHW) provides basic

care for the community. In some cases, the CHWs provide care directly to children in their homes. CHWs provide care from their own homes using medical supplies and data

management tools provided by IHP.

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Community Health Workers’ Activities in Community Care Sites

Preventive

•Encourage the community to seek health services

•Provide vaccination sites

•Provide family planning services

Curative

•Case management for diarrhea, pneumonia, and malaria cases

•Refer and accompany community members to health centers, in serious cases

Promotional

•Identify and refer malnutrition cases

•Conduct home visits

•Conduct community sessions to promote health-seeking behaviors

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Demographics

Provinces IHP

Coordination office

No. of i-CCM sites

Population covered by i-CCM

No. of children under 5 covered

by i-CCM

Sud KivuBukavu 65 105,300 21,060

Uvira 15 39,900 7,980

Katanga 

Kamina 45 115,825 23,165

Kolwezi 42 34,830 6,966

Kasaï Oriental  

Mwene Ditu 62 65,455 13,091

Tshumbe 51 77,800 15,560

Kole 8 11,150 2,230

Kasaï Occidental Luiza38 90,835

18,167

TOTAL  326 541,095

108,219

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Results

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Results

Malaria(n=444)

Diarrhea (n=128)

Pneumonia(n=116)

Cough(n=77)

Dangers signs(n=12)

% of case correctly assessed 100 98 98 99 100

% of case correctly categorized 100 98 98 99 92

% of case correctlytreated 95 96 96 77 92

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Case management quality evaluation in Kanda Kanda Health Zone Q2Y3 IHP

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Results: Collaborative Approach

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Incentives and motivation for CHWs

• Supervision • Post-training follow-up• Bicycles to facilitate household visits• Recognition from the community

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Justine’s story

Justine during a home visit with a father and his son

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Challenges• Low level of ownership of the community care site

approach among provincial and district health administrations, as well as at the health zone level.

• Lack of integration of data collected at care sites into the national health records held by the health zones and the provinces.

• Frequent stock outs of medications and other supplies.

• Weak links between the health system and the community, particularly between the health zone and community care sites. Many care providers do not view community care sites as viable first-line health sites and often fail to restock them with supplies.

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Next steps

• Scale up the i-CCM sites.

• Regularly evaluate the data quality from care sites.

• Continue discussions with the Ministry of Health in order to integrate data from care sites into the national health information system.

• Share key achievements of community care sites, and lessons learned, with implementing partners and the Ministry of Health.

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DRC-IHP: Plans de communication, positionnement et de marquage

Thank you for your attention and participation.