Community Dialogues for ICCM

Source: Malaria Consortium

Year of Publication:

2012

Integrated community case management (ICCM) – an approach where community-based health workers are trained to identify, treat and refer children under-five with pneumonia, diarrhea and malaria – is increasingly being used across sub-Saharan Africa to supplement the gaps in basic healthcare provision. ICCM programs have been endorsed by major international organizations and donors, and many African Ministries of Health as a key strategy for reducing child mortality. This learning paper describes Malaria Consortium’s approach to and experience of engaging local communities in integrated community case management (ICCM) in three African countries.

This learning paper looks at some key barriers to the early treatment of sick children and the interventions developed to address them, with a focus on the Community Dialogue (CD) approach. Preliminary findings drawn from the early stages of implementation show that CD has been a very effective way of identifying and filling information gaps, as well as encouraging community analysis and planning.

Dialogues are chaired by community leaders and co-facilitated by CHWs. Ten simple steps are outlined to organize and lead fruitful community dialogue sessions, comprising three core phases:

Exploring the topic: questioning assumptions, filling knowledge gaps, clarifying misconceptions.
Identifying issues: reflecting on personal experiences of childhood diseases’ management and prevention.
Action planning: agreeing on a few achievable individual or collective actions to ensure prompt, high-quality medical care for young children as well as appropriate ways to prevent these diseases.

Initial feedback indicates that the CD approach is highly appreciated by community-based facilitators, community members, and health center staff. Because it is grassroots-based, reaching out to communities, it allows ‘ordinary people’ to interact and reflect on health information within their villages and not at health facilities, where such interactions usually happen. Not all community members have access to radio or a phone to participate in radio phone-in programs. Others, because of low literacy, can misinterpret posters. Participants are encouraged at CD sessions to express their views, ask questions and tell their own stories and do so freely because the session is facilitated by peers rather than professional health staff.