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iCCM Country Snapshot: Zambia



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iCCM Introduction

2010


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Stage of Implementation

Scale-Up


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Coverage*

66 out of 105 districts



By policy, Community Health Workers (CHWs) must be certified by the district and it is only these certified CHWs that can be trained by partners in iCCM. Since the CHW has already been certified, they come to the iCCM training with previous experience in a variety of health issues. Depending on the district and partners, they may have a background and be tasked to support health issues including water and sanitation, maternal and child health, nutrition, HIV, vaccination, and antenatal care. While CHWs are frequently supervised by either an Environmental Health Technician or a MCH Nurse from the nearest health center, there is inconsistency throughout Zambia in supervisory structure. CHWs are provided a variety of incentives and many NGOs also provide a transportation or monthly stipend.

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iCCM Package

CHWs are able to treat and assess pneumonia, malaria, and diarrhea. They are also able to check for malnutrition, check for immunization, do growth monitoring and promotion (GMP), assess and administer the micro-nutrients (Vitamin A and Deworming). They are equipped to distribute Insecticide Treated Nets (ITNs) and perform health education promotion during community and Home visits.

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Other Community Cadres

The Community Health Worker (CHW) lives (usually) over five kilometers from a health facility. They are both male and female who are literate (able to read and write English), and they specialize in hard-to-reach and underserved areas. Other cadre include: CHAs, SMAGs, HIV supporters, Lay counsellor, TB supporters, Environmental agents, Growth monitoring promotors, Malaria agents and Neighborhood Health Committees etc.


Training & Incentives

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Status

Total of 5060 CHWs and 983 Health Centre supervisors in iCCM have been trained to date.


Challenges

  • •Inadequate or lack of incentives for CHWs motivation for retention
  • •Inadequate funds for iCCM scale up
  • •Inadequate iCCM drugs especially Zinc sulphate tablets
  • •Inadequate iCCM supervision/Mentorship
  • •Inadequate transport for iCCM supervision/Mentorship
  • •Inadequate iCCM training materials
  • •Few partners supporting C-IMCI ( 6weeks training) now incorporates iCCM

Opportunities

There is an opportunity for more partners to support capacity building to saturate to all the districts to have an impact.

Coordination

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Status

The Ministry of Health coordinates and spearheads iCCM implementation in Zambia and holds IMCI sub-committee meetings every after two months with partners.


Challenges

Not all partners attend meetings regularly.


Opportunities

Partners may avail the Ministry with action plans for better coordination.

Financing of iCCM

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Status

The Government of the Republic of Zambia allocates funds for iCCM and about 10 partners support iCCM implementation.


Challenges

The funding for iCCM from some partners is not well known and there remains inadequate funding for iCCM implementation overall.


Opportunities

There is a need for more partners to come on board to accelerate scale-up.

Supply Chain Management

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Status

The supply chain is managed by the Ministry of Health through the Child Health Unit.


Challenges

  • •Few partners support printing of training materials and those that print only do for their supported districts.
  • •One or two partners supporting procurement of ARI Timers and MUAC straps

Opportunities

There is an opportunity for procurement of iCCM supplementary drugs (Antibiotics, Zinc sulphate and ORS).

Supervision

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Status

Health centre supervisors are the immediate supervisors for the CHWs. Supervision is conducted on a monthly and quarterly basis.


Challenges

  • •No funds for printing supervision materials
  • •Inadequate transport
  • •Understaffed

Opportunities

More than two supervisors should be trained per facility for better supervision and mentorship to address these challenges.

Social Mobilization

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Status

Social mobilization is done during outreach and GMP in Zambia.


Challenges

The challenge is reaching every caregiver.


Opportunities

There is an opportunity to better engage the community to reach every caregiver.

M&E Indicators in HMIS/DHIS2; research agenda

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Status

M&E experts are still working on improving the community HMIS.


Challenges

It has been challenging to operationalize in a timely manner.


Opportunities

A study was done in two districts on mhealth and the results are yet to be disseminated, but this study could potentially inform the Zambia M&E agenda.

Resources and Tools on or from Zambia

Download (PDF, 104KB)

References

1. MCHIP. Review of Integrated Community Case Management Materials: Ten African Countries. Washington, DC: 2013.
2. MCHIP. Child Health Country Profile: Zambia. Washington, DC: 2012.


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