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  • INTEGRATED COMMUNITY CASE

    MANAGEMENT OF CHILDHOOD ILLNESS: Documentation of Best Practices and Bottlenecks to Program Implementation in Senegal

    January 2012

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  • This program and report was made possible by the generous support of the American people through the United States Agency for International Development (USAID), under the terms of the Leader with Associates Cooperative Agreement GHS-A-00-08-00002-000. The contents are the responsibility of the Maternal and Child Health Integrated Program (MCHIP) and do not necessarily reflect the views of USAID or the United States Government.

    The Maternal and Child Health Integrated Program (MCHIP) is the USAID Bureau for Global Health flagship maternal and child health (MNCH) program. MCHIP supports programming in maternal, newborn and child health, immunization, family planning, malaria and HIV/AIDS, and strongly encourages opportunities for integration. Cross-cutting technical areas include water, sanitation, hygiene, urban health and health systems strengthening. Visit www.mchip.net to learn more.

  • INTEGRATED COMMUNITY CASE

    MANAGEMENT OF CHILDHOOD ILLNESS: Documentation of Best Practices and Bottlenecks to Program Implementation in Senegal

    Revised and Submitted 2 September 2011 to: United States Agency for International Development

  • Integrated Community Case Integrated Community Case Integrated Community Case Integrated Community Case Management of Childhood Illness:Management of Childhood Illness:Management of Childhood Illness:Management of Childhood Illness: Documentation of Best Practices and Bottlenecks to Program Implementation in SenegalDocumentation of Best Practices and Bottlenecks to Program Implementation in SenegalDocumentation of Best Practices and Bottlenecks to Program Implementation in SenegalDocumentation of Best Practices and Bottlenecks to Program Implementation in Senegal iiii

    Table of Contents

    ACKNOWLEDGMENTSACKNOWLEDGMENTSACKNOWLEDGMENTSACKNOWLEDGMENTS ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................ IIIIIIIIIIII

    ACRONYMSACRONYMSACRONYMSACRONYMS ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................VVVV

    EXECUTIVE SUMMARYEXECUTIVE SUMMARYEXECUTIVE SUMMARYEXECUTIVE SUMMARY.................................................................................................................................................................................................................................................................................................................................................................................................................................................................... VIIVIIVIIVII

    INTRODUCTIONINTRODUCTIONINTRODUCTIONINTRODUCTION................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ 1111

    1. CONTEXT1. CONTEXT1. CONTEXT1. CONTEXT .................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... 3333

    1.1 The Senegalese Health System................................................................................................................3

    1.2 Community Participation ..........................................................................................................................4

    1.3 Indicators ...................................................................................................................................................5

    1.4 Integrated Management of Childhood Illness .........................................................................................5

    2. GOAL AND OBJECTIV2. GOAL AND OBJECTIV2. GOAL AND OBJECTIV2. GOAL AND OBJECTIVES OF THE DOCUMENTATES OF THE DOCUMENTATES OF THE DOCUMENTATES OF THE DOCUMENTATIONIONIONION .................................................................................................................................................................................................................................................................................... 7777

    2.1 Goal 7

    2.2 Specific Objectives ....................................................................................................................................7

    3. MET3. MET3. MET3. METHODOLOGYHODOLOGYHODOLOGYHODOLOGY ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ 8888

    3.1 Document and Secondary Data Review ..................................................................................................8

    3.2 Semi-Structured Interviews ......................................................................................................................9

    3.3 Focus Group Discussions .........................................................................................................................9

    3.4 Direct Observation ....................................................................................................................................9

    3.5 Site Selection.............................................................................................................................................9

    3.6 Scope and Limitations of the Documentation ...................................................................................... 10

    3.7 Analytical Framework ............................................................................................................................. 10

    4. HISTORICAL OVERVI4. HISTORICAL OVERVI4. HISTORICAL OVERVI4. HISTORICAL OVERVIEWEWEWEW ........................................................................................................................................................................................................................................................................................................................................................................................................................................ 11111111

    4.1 Phase I: Introduction of Community Case Management in Senegal (19672001) ....................... 11

    4.2 Phase II: Advocating for the Introduction of Antibiotics for Pneumonia and Updating Malaria and Diarrhea Treatment (20022004) ........................................................................................ 12

    4.3 Phase III: Expansion and Integration of iCCM (2006-2010) ............................................................... 13

    4.4 Building Partnerships for iCCM ............................................................................................................. 14

    5. FINDINGS5. FINDINGS5. FINDINGS5. FINDINGS ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ 16161616

    5.1 Coordination and Policy Setting ............................................................................................................ 16

    5.2 Financing ................................................................................................................................................ 19

    5.3 Human Resources ....................................