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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Policy challenges facing integrated community case management in Sub-Saharan Africa.
Tropical medicine & international health : TM & IH, Volume 19, No. 7, Year 2014
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Description
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. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Authors & Co-Authors
Bennett, Sara C.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
George, Asha S.
Unknown Affiliation
Rodríguez, Daniela Cristina
Unknown Affiliation
Konaté, Mamadou
Unknown Affiliation
Dalglish, Sarah L.
Unknown Affiliation
Juma, Pamela A.
Unknown Affiliation
Namakhoma, Ireen
Unknown Affiliation
Banda, Hastings Thomas
Unknown Affiliation
Chilundo, Baltazar G.M.
Unknown Affiliation
Mariano, Alda R.E.
Unknown Affiliation
Cliff, Julie L.
Unknown Affiliation
Statistics
Citations: 59
Authors: 11
Affiliations: 1
Identifiers
Doi:
10.1111/tmi.12319
ISSN:
13653156
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Case Study
Study Approach
Qualitative
Study Locations
Burkina Faso
Kenya
Malawi
Mali
Mozambique
Niger