1 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

2 Outline Background What is i-CCM? Key achievements Challenges Next steps

3 IHP and DRC Overview The 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

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

5 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.

6 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

7 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 Kivu Bukavu 65105,300 21,060 Uvira 1539,900 7,980 Katanga Kamina 45115,825 23,165 Kolwezi 4234,830 6,966 Kasaï Oriental Mwene Ditu 6265,455 13,091 Tshumbe 5177,800 15,560 Kole 811,150 2,230 Kasaï OccidentalLuiza 3890,835 18,167 TOTAL , ,219

8 Results

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10 Results: Collaborative Approach

11 Incentives and motivation for CHWs Supervision Post-training follow-up Bicycles to facilitate household visits Recognition from the community

12 Justine’s story Justine during a home visit with a father and his son

13 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.

14 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.

15 DRC-IHP: Plans de communication, positionnement et de marquage Thank you for your attention and participation.