Thematic areas and complexity of integrated community case management (iCCM) design, implementation, and evaluation: protocol for a scoping review

Aliya Karim,Daniel Cobos Muñoz,Daniel Mäusezahl,Don De Savigny

doi:10.1186/s13643-020-01454-y

Aliya Karim, Daniel Cobos Muñoz + Show 2 more

Open Access

https://doi.org/10.1186/s13643-020-01454-y

Copy DOI

Abstract

BackgroundIntegrated community case management (iCCM) is a community-based child health strategy designed to reduce deaths due to pneumonia, malaria, and diarrhea in low-income countries. Due to the integrated nature of the intervention and the diversity of its stakeholders and activities, iCCM is complex and comprises many systems elements. However, the extent to which studies examine these different elements is unknown. The purpose of this scoping review is to summarize the key areas of emphasis of the iCCM literature and assess the extent to which this takes into account systems complexity.MethodsThis study will be guided by Arksey and O’Malley’s scoping review methodology. We will systematically screen MEDLINE, Web of Science, and the specialized platform Community Case Management (CCM) Central Library for published literature in English related to the design, implementation, and evaluation of iCCM. Two investigators will independently screen the full list of titles and abstracts for eligibility, followed by a full-text review of selected titles divided between investigators. Emergent themes will be categorized according to a thematic tool iteratively developed to guide the charting and analysis process. To compare the extent to which the literature assesses systems factors, we will compare our results with the iCCM Interagency Framework. We will use the Intervention Complexity Tool for Systematic Reviews (iCAT_SR) to assess how literature measures complexity. Results will be presented in narrative fashion, supplemented by interactive graphical interfaces.DiscussionThe results of this scoping review will identify the priorities and deficiencies of the analysis and evaluation of iCCM programs and may illustrate the need for systems approaches. Bottom-up emergent iCCM themes can help researchers, policymakers, and implementers target and better emphasize true priorities of iCCM. Understanding how complexity is considered and examined in iCCM may result in greater attention to this critical dimension of iCCM program assessment, resulting in the design and development of more robust and sustainable iCCM programs.

Highlights

Integrated community case management is a community-based child health strategy designed to reduce deaths due to pneumonia, malaria, and diarrhea in low-income countries
Integrated community case management is a strategy that aims to address this through community-based diagnosis and care of common childhood illnesses in hard-to-reach areas of low- and middle-income countries (LMICs)
The intervention is implemented by local community health workers (CHWs) within assigned catchment areas, who are trained and equipped to diagnose and treat a range of conditions responsible for high child mortality rates, pneumonia, malaria, and diarrhea [3,4,5]. Integrated community case management (iCCM) was globally endorsed in 2004 in a joint statement produced by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO)

Summary

Introduction

Integrated community case management (iCCM) is a community-based child health strategy designed to reduce deaths due to pneumonia, malaria, and diarrhea in low-income countries. ICCM was globally endorsed in 2004 in a joint statement produced by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) Since it has been adopted by many countries, including most of sub-Saharan Africa, as a common child health policy [6,7,8,9]. ICCM is generally considered a relatively complex intervention, comprising many interactions among multiple processes and actors across a range of administrative levels and systems building blocks These elements are wide in scope and can include anything from the procurement and distribution of supplies, country policy environments, supervision strategies, and design inputs, to caregiver and CHW interactions, and geographic contexts, among others [10,11,12]. While these global benchmarks have been tested for feasibility in collection, these have not to our knowledge been tested for comprehensiveness to evaluate the design, implementation, and monitoring of iCCM [14]

Objectives

Methods

Conclusion