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LETTER TO EDITOR
Year : 2018  |  Volume : 9  |  Issue : 2  |  Page : 108-109

Reducing the deaths of under-five children through integrated community case management strategy in Nigeria


1 Department of Community Medicine, Member of the Medical Education Unit and Medical Research Unit, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Date of Web Publication27-Nov-2018

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjmsr.mjmsr_3_18

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How to cite this article:
Shrivastava SR, Shrivastava PS. Reducing the deaths of under-five children through integrated community case management strategy in Nigeria. Muller J Med Sci Res 2018;9:108-9

How to cite this URL:
Shrivastava SR, Shrivastava PS. Reducing the deaths of under-five children through integrated community case management strategy in Nigeria. Muller J Med Sci Res [serial online] 2018 [cited 2018 Dec 14];9:108-9. Available from: http://www.mjmsr.net/text.asp?2018/9/2/108/246167



Dear Editor,

The global estimates suggest that more than 5.5 million children in the under-five year age group died in the year 2016, of which in excess of 50% result because of the conditions which are either preventable or treatable through simple and affordable measures.[1] Pneumonia, diarrhea, and malaria have been identified as the leading causes of death among children after the neonatal period till the age of 5 years, and that the children in the sub-Saharan African region have a very high risk of dying when compared to developed nations.[1],[2],[3]

Acknowledging the need, the integrated community case management (iCCM) strategy was launched in 2012 by the World Health Organization, which is a cost-effective approach and essentially involves the community health workers to diagnose and treat these three diseases among under-five children in remote settings.[4] To streamline the implementation of the strategy, and to reduce the incidence of child mortality and to generate evidence to guide target nations about the treatment practices for the diseases, the Rapid Access Expansion Programme (RAcE), came into existence in 2013.[4]

In this program, community health workers were recruited and then trained to diagnose and treat children.[4],[5] As of now, close to 8500 health workers have been trained to deliver iCCM services.[4] These workers were further supervised by extension workers at the primary health center level.[4] In fact, currently, RAcE program is functional in five different malaria-endemic nations with the support of different nongovernmental agencies.[5] These agencies have supported the national health ministry to bring about a policy change, assistance in the formulation of guidelines for the scale-up activities at different levels, strengthening of the data reporting system and improving the procurement and distribution of the required resources.[4],[5]

The obtained results from the implementation of the program have been remarkable, with more than 7 million children being diagnosed and treated with any of the 3 deadly diseases in the 5 nations.[4] The obtained outcome is the result of the constant partnership between the community and the existing health system.[4] It is really encouraging that in one of the remote villages of the Nigerian state, no child death has been reported in the past 3 years.[5] This is a significant improvement as before the launch of this initiative, in the year 2013, more than 125 deaths were reported per 1000 live births.[5]

However, the real credit for the obtained success goes into the recruitment of educated workers, who were living within the local communities, and to the uninterrupted supply of quality-assured medicines, and sustained community support and involvement.[4],[5] Under the program, specific emphasis has been given toward supervision, monitoring and evaluation, motivation of outreach staff, and the use of innovative approaches.[4],[5]

To conclude, since the launch of iCCM strategy, significant gains have been made toward reducing the deaths of under-five children. It is high time that this strategy should be expanded further to other nations as well and the resulting benefit can be enhanced subsequently.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Children: Reducing Mortality – Fact Sheet No. 178; 2017. Available from: http://www.who.int/mediacentre/factsheets/fs178/en/. [Last accessed on 2018 Feb 11].  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Standardizing the assessment and management protocol of critically ill under-five children: World Health Organization. Ann Trop Med Public Health 2016;9:215-6.  Back to cited text no. 2
  [Full text]  
3.
Shrivastava SR, Shrivastava PS, Ramasamy J. Addressing the public health concern of childhood pneumonia: Global perspective. J Med Soc 2017;31:63-4.  Back to cited text no. 3
  [Full text]  
4.
World Health Organization. Rapid Access Expansion Programme (RAcE); 2017. Available from: http://www.who.int/malaria/areas/rapid_access_expansion_2015/overview/en/. [Last accessed on 2018 Feb 11].  Back to cited text no. 4
    
5.
World Health Organization. Remote Nigeria Communities Welcome Child Health Programme; 2018. Available from: http://www.who.int/malaria/areas/rapid_access_expansion_2015/features/community-health-care-nigeria/en/. [Last accessed on 2018 Feb 13].  Back to cited text no. 5
    




 

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