NCT02046018

Integrated Community Case Management (ICCM) Delivered by Village Health Teams in Bushenyi District in Uganda

Healthy Child Uganda: Can Village Health Volunteers Trained in Integrated Community Case Management of Childhood Illness Improve Access to Care for Africa's Most Vulnerable Children?

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 5,000 (actual)
• Sponsor: Healthy Child Uganda · Academic / Other
• Sex: All
• Age: 59 Months
• Healthy volunteers: Accepted

Summary

In Sub-Saharan Africa (SSA), many children die from diarrhoea, acute respiratory illness (ARI) and malaria, despite well- recognized, inexpensive and highly effective treatments, since health access and human resources are limited. Healthy Child Uganda (HCU) is a Ugandan-Canadian partnership that since 2003, has developed, implemented and evaluated a Village Health Volunteer (VHV) program in 175 rural villages. Volunteers, selected by peers, provide health education and refer sick children. Volunteer retention (94%) and significant decreases in child deaths are remarkable. Now, HCU wonders whether VHV scope can extend to provide treatment for sick children using Oral Rehydration Salts (ORS)/Zinc, antibiotics, and antimalarials. Use of lay providers in this capacity, called integrated community case management (iCCM), has been proposed as a potential inexpensive solution to SSA's human health resource crisis. PRIMARY QUESTION: In rural southwest Uganda, can iCCM provided by lay volunteers, improve the proportion of children with diarrhoea receiving ORS/Zn, ARI receiving antibiotics, and fever/malaria receiving antimalarials? Secondary study questions consider VHV capacity to prescribe appropriate drug, dose, duration; iCCM acceptance by family, and VHV; VHV retention/motivation; program cost. Selected VHV will be iCCM trained then receive treatments for distribution. Qualitative and quantitative methods including household surveys, and focus groups will consider pre/post intervention differences and differences in control and intervention populations. A research short course and micro research grants (\~ $3000 to multidisciplinary groups pursuing relevant questions) will promote health system evaluation capacity. Lessons learned are critical as SSA countries move forward in planning for increased iCCM programming.

Conditions

• Maternal and Child Health

Interventions

Type	Name	Description
OTHER	ICCM delivered by VHT	VHT's deliver ICCM to children under five in their communities
OTHER	ICCM delivered by VHT with Cell Phone	ICCM delivered to children under 5 by VHT trained in ICCM and given cell phones
OTHER	No intervention	VHT's selected by no ICCM training given and no drugs or cell phones.

Timeline

• Start date: 2009-10-01
• Primary completion: 2012-11-01
• Completion: 2013-05-01
• First posted: 2014-01-27
• Last updated: 2014-07-11