Nigeria national iccm implementation framework

The Federal Ministry of Health Nigeria

The National Integrated Community Case Management

(iCCM) Implementation FrameworkA roadmap to iCCM implementation in Nigeria

...healthy children, happy family

Integrated Community Case Management

2

Foreword

In recognition of the absence of a frame work for the implementation of Integrated Community

Case Management (iCCM), the Federal Ministry of Health and stakeholders in the maternal,

newborn and child health community developed the framework on iCCM in Nigeria.

This framework builds on the existing platform of the National guideline on iCCM implementation

in Nigeria following its adoption in 2012. The intervention targets the three major childhood

diseases namely Malaria, Diarrhoea and Pneumonia which contribute 58% of under five mortality.

In addition, the iCCM implementation framework is anchored on the Child Health Policy, the

Decision Tree and other ancillary documents and presents an overarching frame for the iCCM

national scale up. It aims to achieve a “ONE NATIONAL iCCM MODEL” with clear programme

boundaries such as policy, coordination, case management, commodity security logistics,

advocacy, resource mobilization, monitoring, evaluation and quality assurance as well as the role

of the private sector in expanding access to iCCM.

Finally, I reiterate that iCCM framework will create the enabling environment for the provision of

uniform, qualitative and sustainable child health care services and recommend that all players in

the iCCM millue will use this framework to guide their activities.

L.N Awute, mni

Permanent Secretary

Federal Ministry of Health.

September 2015

The National iCCM Implementation Framework

3

Acknowledgements

The Federal Ministry of Health in collaboration with MNCH stakeholders developed the national

framework on Integrated Community Case Management (iCCM) in line with emerging issues in

child health.

The Ministry would like to extend its sincere thanks and gratitude to individuals, iCCM taskforce

members and organizations who contributed considerable time in the development of the

framework. I commend the support of our development partners notably WHO and USAID/TSHIP

JSI for the time and resources committed to the development of the framework. Gratitude to all

other partners for their technical inputs

I also wish to acknowledge the technical contributions and understanding of the Consultant

'tomowo Faduyile who facilitated the process of developing the document.

Special appreciation goes to the staff of the Child Health Division of Family Health Department,

under the guidance of Dr A. R Adeniran for providing excellent leadership and unflinching

commitment throughout the entire process that made the development of the frame work a reality.

Dr Wapada I. Balami, mni

Director, Department of Family Health / Chairman iCCM Task Force.

September, 2015

The iCCM Implementation National Framework

4

Table of Contents


ACKNOWLEDGEMENTS 03

TABLE OF CONTENTS 04

FOREWORD 02

ACRONYMS 05

LIST OF CONTRIBUTORS 19

REFERENCES 20

BACKGROUND 07

THE NATIONAL iCCM IMPLEMENTATION LOGIC MODEL 11

THE NATIONAL iCCM IMPLEMENTATION FRAMEWORK 09

THE NATIONAL iCCM PERFORMANCE MEASUREMENT MATRIX 15

THE NATIONAL iCCM IMPLEMENTATION FRAMEWORK

5

Acronyms


BCC

CBO

CRA

CMAM

CHAI

CHEWs

CORPS

CSO

CSWG

CTC

DFATD

EU

FMoH

HC

Hws

HMIS

HR

iCCM

IEC

IMCI

IMNCH

JCHEW

JSI

Behavioral Change Communication

Community-Based Organizations

Child Right Act

Community Management of Acute Malnutrition

Clinton Health Access Initiative

Community Health Extension Workers

Community Oriented Resource Persons

Civil Society Organizations

Child Survival Working Group

Core Technical Committee

Department of Foreign Affairs, Trade and Development

European Union

Federal Ministry of Health

Health Centre

Health Workers

Health Management Information System

Human Resource

Integrated Community Case Management

Information, Education Communication

Integrated Management of Childhood Illness

Integrated Supportive Supervision

Integrated Maternal, Newborn and Child Health

Junior Community Health Extension Workers

John Snow Research and Training Institute Inc.

ARFH Association of Reproductive and Family Health

ISS

6

Acronyms


LGA

M&E

MDGs

NDHS

MOH

NHSDP

NPHCDA

PHCs

PPMVs

PPP

RAcE

SMoH

SOP

TSHIP

TOT

TV

TWG

U5

U5MR

UNICEF

USAID

WDC

WHO

Local Government Area/Authority

Monitoring and Evaluation

Millennium Development Goals

Nigeria Demographic and Health Survey

Ministry of Health

National Health Strategic Development Plan

National Primary Health Care Development Agency

Primary Health Care/Centres

Propriety Patent Medicine Vendors

Public Private Partnership

Rapid Access Expansi

State Ministry of Health

Standard Operating Procedure

Targeted States High Impact Projects

Training of Trainers

Television

Technical Working Group

Under 5 years

Under- five Mortality Rate

United Nations Children’s Fund

United States Agency for International Development

Ward Development Committee

World Health Organization

7

In the efforts to reduce child mortality rate, the Nigeria government developed the National Child

Policy, Integrated Maternal, Newborn and Child Health (IMNCH) strategy and other child survival

interventions such as Integrated Management of Childhood Illness (IMCI), Community

Management of Acute Malnutrition(CMAM) and community case management of Malaria(CCM)

which are all incorporated into the NSHDP.

In the past two decades, the need to accelerate reduction in this vulnerable group became critical

though gradual impact have been made. However, there is still a huge gap in the coverage of

appropriate cost-effective curative interventions for common childhood illness, in spite of available

1robust policies, strategies, guidelines and interventions to address child health in Nigeria .

2According to NDHS 2013, majority of under-five death about 68% occurs at home . The

Integrated Community Case Management (iCCM) of childhood illness is one strategy that

provides community-based curative interventions while working to strengthen the health system.

Since the delivery of health services is either weak or non-existent in rural, hard-to-reach areas of

Nigeria, iCCM takes curative care to homes and communities where access to facility-based

3services is low .

The Integrated Community Case Management (iCCM) Strategy presents a platform for

acceleration of the management of childhood diarrhea, malaria, pneumonia at the community and

referral of sick newborn, children with any danger signs or severe malnutrition to the health facility

4,thus contributing to the significant reduction of mortality attributed to these conditions .


THE NATIONAL INTEGRATED COMMUNITY CASE MANAGEMENT

(iCCM) IMPLEMENTATION FRAMEWORK IN NIGERIA

Background

8

Since the introduction of iCCM in Nigeria in 2013, four states are currently implementing the

strategy in Abia and Niger states under the WHO-RAcE/DFATD project and Adamawa and Kebbi

states (UNICEF/EU). Nigeria is at the stage of scaling up iCCM nationally and therefore requires

an implementation framework that will serve as a 'one national model' with clear programme

boundaries.

The framework will serve as a charter from where federal, states, local governments and

organizations can frame their plan of actions for iCCM. This is not a stand-alone document; it is a

framework that shows in a simply logical flow how iCCM is to be implemented at all levels in

Nigeria. The detailed guideline and state specific process is in the National iCCM Guideline and

4iCCM Decision Tree for State Level, Nigeria , respectively.

The objective of the National iCCM implementation framework is to have “ONE NATIONAL iCCM

IMPLEMENTATION MODEL” which can be adopted at various levels of implementation.


Objective

9

The National iCCM Implementation Framework describes the activities expected to be carried out

at the different levels of government, with clear programme boundaries, roles and responsibilities

of individuals, organizations and other players. This framework also shows the pattern of

information flow for iCCM in the country.

The Federal level consists of the Federal Ministry of Health and its agencies, partners and Non-

Governmental Organizations (NGO). The role at this level focuses on policy direction,

coordination, guideline and standard settings, monitoring and evaluation.

The State level consists of the State Ministry of Health, its agencies, partners and NGO. It

assumes a similar overarching role while adopting and adapting the national policies for the state.

In addition, the State level ensures effective implementation of iCCM.

The Local Government Level consists of the LGA Health Department, partners, Community

Based Organizations (CBO). It plays a coordination role and also provides oversight of iCCM

implementation at the PHC and Community level.

The CHEWs/JCHEWs/CORPs are the key human resource for iCCM. They are trained to assess,

classify and treat the sick under five children when necessary or else referral to the PHC for further

care. They are to be equipped with uninterrupted medicines and supplies and regularly

supervised.

The Private Sector consists of several NGOs, CSOs, Professional Associations and Individuals. It

will support and participate at every level of implementation of iCCM for example the selection and

monitoring of CORPs.


THE NATIONAL iCCM IMPLEMENTATION FRAMEWORK

10 The iCCM Implementation National Framework

F

E

E

D

B

A

C

K

S

PRIVATE

SECTOR

ENGAGEMENTS

THE NIGERIA iCCM IMPLEMENTATION FRAMEWORK3

STATE LEVEL -CTC [SMOH, DEVELOPMENT PARTNERS/NGO]

Adopt/Adapt Adopt/Adapt NCoordination of Partners; Capacity Building; Resource

ational Guideline, Develop Plans; Advocacy & Sensitization;

Mobilization; Supervision Plan; Referral Facilities Strengthened; Monitoring & Evaluation; Supply Chain System Mgt.

LGA LEVEL [LG HEALTH DEPT, PARTNERS/NGO]

Capacity Building; Supportive Supervision; Strengthened iCCM Referral Facilities; Operational Plan; Effective Community

Entrance; Strengthened WDC; Supply Chain System Mgt; Monitoring & Evaluation.

PRIMARY HEALTH CARE CENTER

Communities; Monitoring; Commodity Security; Community Based Info System; Data Collation

iCCM Referral; Provision of Case Management, oversees & supervises CORPs in targeted

CHEWS / JCHEWS / CORPs

COMMUNITY LEVEL

Promote Health Seeking behavior; Assess, Classify & Treat U5 in line

with Guideline; Refer when appropriate; Documentation; Community & Social Mobilization

HOUSEHOLD [CAREGIVERS OF UNDER 5 CHILDREN]

Practice Good Care seeking behavior; Adherence to treatment;

Identify danger signs to seek further care

FEDERAL LEVEL - FMOH iCCM TASKFORCE [FMOH, DEVELOPMENT PARTNERS/NGO]

Coordination; Policy Direction; Guideline and standard setting; Implementation Plan;

Partnership; Advocacy; Resource Mobilization; Capacity Building;

Commodity Security; Operational Research and State Support/Roll Out, Monitoring & Evaluation;

Technical Assistance; Supportive Supervision.

WDC, COMMUNITY GATEKEEPERS

Selection of CORPs; Participate in Planning; Implementation; Monitoring and Resource Mobilization;

Community & Social Mobilization; Commodity Security and Community Security.

11

The National iCCM Implementation Logic Model is a frame that helps to structure 7the main elements of a project, highlighting the logical linkages between them . It

consists of the inputs, activities, outputs and the outcomes of the iCCM programme

that culminates into the overall goal and objectives of the programme.

The iCCM Implementation Logic model focuses on the key thematic areas namely

Demand Creation, Access, Quality, Advocacy and Policy Environment with

emphasis on the different level of implementation namely Federal, States, LGAs

and Community.

The expected outputs and outcomes at these levels are harnessed to have a

uniform national approach to planning and implementation of iCCM thus 3contributing to the reduction of morbidity and mortality of under-fives .


THE NIGERIA iCCM IMPLEMENTATION LOGIC MODEL 3,7

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ple

men

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mat

eria

ls f

or

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egu

lar

Mee

tin

g o

f Ta

skfo

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anci

al T

ran

spar

ency

&A

cco

un

tab

ility

;

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blis

hm

ent

o

f Su

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le in

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s

mo

del

;

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cum

enta

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lob

al G

oo

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Pra

ctic

es; M

aste

r Tr

ain

ers

for

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trai

ned

.

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ctio

n a

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eq

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g

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ral

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s; S

elec

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n &

sen

siti

zin

g

WD

C f

or

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M; E

ffec

tive

Su

pp

ly C

hai

n S

yste

m f

or

iCC

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rugs

, dia

gno

stic

s &

co

nsu

mab

les;

Rep

ort

ing

for

iCC

M o

n H

MIS

Nat

ion

al G

uid

elin

e fo

r iC

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; iC

CM

Imp

lem

enta

tio

n F

ram

ewo

rk; i

CC

M

Ad

voca

cy &

Co

mm

un

icat

ion

Pla

n; i

CC

M

M&

E P

lan

; Co

sted

iCC

M O

per

atio

nal

Pla

n; A

dvo

cacy

K

it, i

CC

M T

askf

orc

e;

Stat

e R

oll

Ou

t; iC

CM

on

An

nu

al B

ud

get

line;

Gu

idel

ine

on

PP

P

Ro

les

of

CH

EWs/

CO

RP

s &

Co

mm

un

ity;

Pro

cure

men

t o

f d

rugs

& c

on

sum

able

s;

Sele

ctio

n o

f PP

P;

FEDERAL

STATE

COMMUNITY

LGA

Th

e

iC

CM

Im

ple

men

tati

on

N

ati

on

al

Fra

mew

ork

AD

VO

CA

CY

& P

OLI

CY

DIR

ECTI

ON

QU

ALI

TY A

CC

ESS

Ad

voca

te f

or

Fun

ctio

nal

Nat

ion

al iC

CM

Ta

skfo

rce;

Pri

vate

Sec

tor

Part

icip

atio

n;

Sen

siti

zati

on

on

mH

ealt

h f

or

iCC

M.

DEM

AN

D

Co

mm

un

ity

Mo

bili

zati

on

on

ben

efit

s o

f

iCC

M S

ervi

ce; P

rom

oti

on

on

Id

enti

fica

tio

n o

f C

HEW

s/C

OR

Ps

for

iCC

M;

Act

ive

Co

mm

un

ity

Part

icip

atio

n

&O

wn

ersh

ip;P

rom

oti

on

of

Car

e Se

ekin

g B

ehav

ior;

Pro

mo

tio

n o

f C

ult

ure

- b

ased

go

od

pra

ctic

es f

or

iCC

M;

Jin

gles

on

re

du

ctio

n o

f So

cio

-cu

ltu

ral b

arri

ers.

13

Mee

tin

gs f

or

Sele

ctio

n o

f C

OR

Ps;

Sen

siti

zati

on

on

ben

efit

s o

f iC

CM

Ser

vice

;

Sen

siti

zati

on

on

iCC

M a

s a

gap

fo

r

geo

grap

hic

al &

fin

anci

al b

arri

ers;

Act

ive

Part

icip

atio

n o

f C

om

mu

nit

y fo

r o

wn

ersh

ip

and

sust

ain

abili

ty

Ava

ilab

ility

of

Trai

ned

CH

EWs/

CO

RP

s o

n

iCC

M; F

un

ctio

nin

g C

om

mu

nit

y B

ased

Info

rmat

ion

Sys

tem

fo

r iC

CM

;

Ava

ilab

ility

of

iCC

M K

it; T

rain

ed S

up

ervi

sors

fo

r

iCC

M; C

HEW

s/C

OR

Ps

follo

w u

p o

n U

5 o

n

iCC

M m

gt.

Pri

nti

ng

of

iCC

M C

BIS

to

ols

; Tra

inin

g

Man

ual

s fo

r C

OR

Ps;

ISS

Too

ls;

Esta

blis

hm

ent

of

Stru

ctu

re f

or

iCC

M

com

mo

dit

ies

Flo

w

Fun

ctio

nal

Sta

te iC

CM

TW

G; P

riva

te

Sect

or

Part

icip

atio

n; S

ensi

tiza

tio

n o

n

Hea

lth

fo

r iC

CM

; Sel

ecti

on

of

Har

d t

o

Rea

ch C

om

mu

nit

y; C

oo

rdin

atio

n o

f Pa

rtn

ersh

ip; D

isse

min

atio

n o

f G

oo

d

Pra

ctic

es; F

eed

bac

k o

n iC

CM

act

ivit

y;

Incl

usi

on

of

soci

al d

iscr

imin

ated

&

so

cia

l e

xclu

de

d i

n

iCC

M;

Ad

op

tio

n o

f iC

CM

Ser

vice

; iC

CM

TW

G;

Sele

ctio

n o

f

iCC

M R

efer

ral F

acili

ties

,

Ad

op

tio

n o

f mH

ealt

h f

or

iCC

M; T

rain

ing

of

CH

EWs/

CO

RP

s o

n iC

CM

; Mal

e in

volv

emen

t

for

iCC

M; C

hild

Su

rviv

al W

ork

ing

Gro

up

;

iCC

M C

om

mo

dit

ies

secu

rity

; Hea

lth

fo

r

iCC

M; T

OT

for

Pri

vate

Sec

tor

wo

rkin

g

gro

up

;

Trai

ned

CH

EWs/

CO

RP

s;

Qu

arte

rly

Sup

po

rtiv

e Su

per

visi

on

; Su

pp

ort

ive

Sup

ervi

sio

n f

or

PP

P; D

ocu

men

tati

on

of

Act

ual

R

elea

sed

Fu

nd

s fo

r im

ple

men

tati

on

;

Imp

lem

enti

ng

ince

nti

ves

mo

del

;Ava

ilab

ility

of

Stan

dar

d O

per

atin

g

Pro

ced

ure

s an

d N

atio

nal

Imp

lem

enta

tio

n D

ocu

men

ts o

n iC

CM

;

Map

pin

g o

f IC

CM

par

tner

s.

Ad

op

tio

n o

f N

atio

nal

Gu

idel

ines

, Pla

ns

&

Imp

lem

enta

tio

n F

ram

ewo

rk; C

S W

ork

ing

Grp

; Sel

ecti

on

of

PP

P; i

CC

M o

n

An

nu

al B

ud

get

line;

Pro

cure

men

t o

f d

rugs

& c

on

sum

able

s; iC

CM

co

mm

od

itie

s p

rocu

rem

ent

inte

grat

ed

into

exi

stin

g G

ovt

. str

uct

ure

s; u

se o

f M

ob

ile /

eHea

lth

fo

r iC

CM

; Sel

ecti

on

of

CH

EWs/

CO

RP

s,

Co

mm

un

ity

& S

MO

H;

14

Gu

idel

ine,

Fra

mew

ork

& O

per

atio

nal

Pla

ns

Dev

elo

pm

ent;

Ad

voca

cy v

isit

s;

Trai

nin

g M

anu

als

dev

elo

pm

ent;

Stra

tegi

c P

lan

nin

g; T

ech

nic

al M

eeti

ng,

Stat

es r

oll

ou

t;

THE

KEY

AC

TIV

ITIE

S

Job

aid

s, w

all c

har

ts,

hea

lth

pla

tfo

rm,

Hu

man

Res

ou

rces

, Mat

eria

ls, F

un

ds;

Lo

gist

ics;

SO

Ps; J

ob

Aid

s; T

oo

ls;

THE

KEY

INP

UTS

Th

e

iC

CM

Im

ple

men

tati

on

N

ati

on

al

Fra

mew

ork

*All a

cti

vit

ies a

nd

in

pu

ts h

ave n

ot

be

en

sp

elt

ou

t, h

ow

ever,

a s

um

mary

of

the k

ey a

reas a

re s

ho

wn

ba

se

d o

n t

he

sp

ec

ific

ity

of

the

th

em

ati

c a

rea

as

d

em

an

d c

reati

on

, access, q

uality

, ad

vo

cacy a

nd

po

licy b

ased

acti

vit

ies.

AD

VO

CA

CY

& P

OLI

CY

AD

VO

CA

CY

& P

OLI

CY

Ad

voca

cy k

its;

Po

wer

po

int

pre

sen

tati

on

; d

ocu

men

tari

es

(au

dio

/vis

ual

); J

ob

aid

s, w

all c

har

ts,

hea

lth

pla

tfo

rm,

Hu

man

Res

ou

rces

, M

ater

ials

, Fu

nd

s; L

ogi

stic

s; S

OPs

; Jo

b

Aid

s; T

oo

ls;

QU

ALI

TY

QU

ALI

TY

Trai

nin

gs; T

rain

ing

of

Trai

ner

s;

Sup

po

rtiv

e su

per

visi

on

vis

its;

Mee

tin

g;

Ass

essm

ents

; Sen

siti

zati

on

;

Do

cum

enta

tio

n; M

app

ing;

Ass

essm

ent;

Sup

ply

ch

ain

sys

tem

; Rep

ort

ing;

Fo

llow

up

;

AC

CES

S

Job

aid

s; w

all c

har

ts; t

rain

ing

mat

eria

ls,

flip

char

ts; f

un

ds;

logi

stic

s; Jo

b a

ids,

wal

l ch

arts

, hea

lth

pla

tfo

rm, H

um

an R

eso

urc

es,

Mat

eria

ls, F

un

ds;

Lo

gist

ics;

SO

Ps; J

ob

Aid

s;

Too

ls;

AC

CES

S

Staf

fin

g; r

ecru

itm

ent;

Tra

inin

gs; T

rain

ing

of

Trai

ner

s; S

up

po

rtiv

e su

per

visi

on

vis

its;

Mee

tin

gs; A

sses

smen

ts; S

ensi

tiza

tio

n;

Co

mm

un

ity

dia

logu

e; T

ow

n H

all m

eeti

ng

DEM

AN

D

Ad

voca

cy k

its;

Po

wer

po

int

pre

sen

tati

on

; d

ocu

men

tari

es (

aud

io/v

isu

al)

; jin

gles

, p

ost

ers;

ban

ner

s;

dra

ma

scri

pt;

fly

ers;

b

illb

oar

ds;

leaf

lets

; to

wn

an

no

un

cers

; fu

nd

s; J

ob

aid

s, w

all c

har

ts, h

ealt

h

pla

tfo

rm,

Hu

man

Res

ou

rces

, Mat

eria

ls,

Fun

ds;

Lo

gist

ics

DEM

AN

D

Ad

voca

cy a

nd

Sen

siti

zati

on

mee

tin

gs;

Soci

al M

ob

iliza

tio

n; T

rain

ing

; Co

mm

un

ity

dia

logu

e; C

on

fere

nce

s; R

adio

/TV

M

agaz

ine

sho

ws;

Dra

ma/

thea

tre,

ro

ad s

ho

ws/

ralli

es, m

arke

t st

orm

15

The National iCCM Performance Measurement Matrix reveals the key expected results from the

iCCM implementation framework and logic model. These results are linked to the key indicators

needed to measure them.

The iCCM Performance measurement matrix focuses on the country approved Monitoring and

Evaluation Indicator as captured in the National Guideline for iCCM.

This is in line with the Global Good Practices in eight key thematic areas namely Policy and

Coordination; Costing and Financing; Human Resource for iCCM; Supply Chain Management;

Service Delivery and Referral; Communication for Behaviors and Social Change; Supervision and

Quality Assurance and lastly Monitoring & Evaluation and HMIS.

The Performance Measurement Matrix shows the indicators to be tracked, when to track them, the

set targets and the responsible persons/organizations for its data generation. This shows a quick

win progress of iCCM implementation at the different levels of care.


THE NATIONAL iCCM PERFORMANCE MEASUREMENT MATRIX 3,6

Th

e

iC

CM

Im

ple

men

tati

on

N

ati

on

al

Fra

mew

ork

1

6

EXP

ECTE

D R

ESU

LTS

6 IN

DIC

ATO

RS

7,9

BA

SELI

NE

DA

TA

(20

14

)

TAR

GET

TI

ME

(20

20

)

DA

TA

SOU

RC

E D

ATA

C

OLL

ECTI

ON

FR

EQ

RES

PO

NSI

BLE

P

ERSO

N

1.

PO

LIC

Y A

ND

CO

OR

DIN

ATI

ON

A N

atio

nal

Gu

idel

ine

for

imp

lem

enta

tio

n

of

iCC

M in

Nig

eria

Ava

ilab

ility

of

a N

atio

nal

Gu

idel

ine

for

imp

lem

enta

tio

n o

f iC

CM

in N

iger

ia

A

vaila

ble

(20

14

)

FM

OH

An

iCC

M T

WG

/SC

WG

led

by

the

MO

H

(Fed

eral

, Sta

te &

LG

A)

and

incl

ud

ing

key

stak

eho

lder

s ex

ists

an

d m

eets

reg

ula

rly

to

coo

rdin

ate

iCC

M a

ctiv

itie

s

Ava

ilab

ility

of

an iC

CM

TW

G /

SC W

G le

d

by

the

MO

H (

Fed

eral

, Sta

te &

LG

A)

and

incl

ud

ing

key

stak

eho

lder

s ex

ists

an

d

mee

ts r

egu

larl

y to

co

ord

inat

e iC

CM

acti

viti

es.

Ava

ilab

le a

t

Nat

ion

al

Ava

ilab

le

at N

atio

nal

Stat

e an

d

LGA

FMO

H

Stat

e, L

GA

Rep

ort

s o

f

Mo

nth

ly/Q

uar

te

rly

Mee

tin

gs.

Mo

nth

ly

FMO

H, S

MO

H, L

GA

A N

atio

nal

Imp

lem

enta

tio

n F

ram

ewo

rk f

or

iCC

M f

or

un

ifo

rmit

y o

f im

ple

men

tati

on

A

vaila

bili

ty o

f a

Nat

ion

al Im

ple

men

tati

on

Fram

ewo

rk f

or

iCC

M, t

o b

e ad

op

ted

by

all

stat

es

A

vaila

ble

(20

15

)

FM

OH

, Nat

ion

al

Task

forc

e o

n iC

CM

iCC

M P

artn

ers

Map

pin

g

Ava

ilab

ility

of

Up

-to

-dat

e M

app

ing

/Lis

t o

f

iCC

M P

artn

ers,

act

ivit

ies

and

lo

cati

on

s

No

ne

A

vaila

ble

FM

OH

Stat

e, L

GA

Up

dat

ed li

st o

f

par

tner

s

Year

ly

FMO

H, S

TATE

, LG

A

A S

tan

dar

d Im

ple

men

tati

on

Mat

eria

ls a

nd

Tem

pla

tes

for

iCC

M [

Trai

nin

g M

anu

als;

Job

Aid

s; S

up

ervi

sory

Ch

eckl

ists

; M&

E

Too

ls &

IEC

Mat

eria

ls]

Ava

ilab

ility

of

a St

and

ard

Imp

lem

enta

tio

n

Mat

eria

ls a

nd

Tem

pla

tes

for

iCC

M

[Tra

inin

g M

anu

als;

Jo

b A

ids;

Su

per

viso

ry

Ch

eckl

ists

; M&

E To

ols

& IE

C M

ater

ials

] to

be

ado

pte

d b

y al

l sta

tes

Ava

ilab

le

Ava

ilab

le

FMO

H

Stat

e, L

GA

Do

cum

ents

, jo

b

aid

s, t

oo

ls

avai

lab

le a

s

har

d a

nd

so

ft

elec

tro

nic

co

py

FM

OH

, Nat

ion

al

Task

forc

e o

n iC

CM

2.

CO

STIN

G A

ND

FIN

AN

CIN

G

A c

ost

ed o

per

atio

nal

pla

n f

or

iCC

M [

or

as

par

t o

f a

bro

ader

hea

lth

op

erat

ion

al p

lan

]

at t

he

Fed

eral

, Sta

te a

nd

LG

A, u

pd

ated

ann

ual

ly

Ava

ilab

ility

of

a co

sted

op

erat

ion

al p

lan

for

iCC

M [

or

as

par

t o

f a

bro

ader

hea

lth

op

erat

ion

al p

lan

] at

th

e Fe

der

al, S

tate

an

d

LGA

, up

dat

ed a

nn

ual

ly

4 S

tate

s

(Ab

ia, N

iger

,

Ad

amaw

a &

Keb

bi S

tate

s)

36

+1

Fed

eral

Stat

e

Op

. Pla

ns

avai

lab

le a

s h

ard

& s

oft

ele

ctro

nic

cop

ies

Year

ly

FMO

H, S

TATE

Act

ual

iCC

M F

un

ds

rele

ased

fro

m t

he

cost

ed o

per

atio

nal

pla

ns

at f

eder

al a

nd

stat

e le

vels

Per

cen

tage

of

actu

al iC

CM

Bu

dge

ted

Fun

d r

elea

sed

fo

r im

ple

men

tati

on

at

the

fed

eral

an

d s

tate

leve

l

No

ne

3

6+1

Fe

der

al,

Stat

e

FMO

H &

SM

OH

Bu

dge

t

Year

ly

FMO

H, S

TATE

TH

E N

IGE

RIA

iC

CM

PE

RF

OR

MA

NC

E M

EA

SU

RE

ME

NT

MA

TR

IX

3,6

17

Th

e

iC

CM

Im

ple

men

tati

on

N

ati

on

al

Fra

mew

ork

EXP

ECTE

D R

ESU

LTS

IN

DIC

ATO

RS

B

ASE

LIN

E D

ATA

(2

01

4)

TAR

GET

TI

ME

(20

20

)

DA

TA

SOU

RC

E D

ATA

C

OLL

ECTI

ON

FR

EQ

RES

PO

NSI

BLE

P

ERSO

N

3.

HU

MA

N R

ESO

UR

CE

FOR

iCC

M

Trai

nin

g o

f P

rogr

am M

anag

ers

as M

aste

r

Trai

ner

s fo

r iC

CM

Nu

mb

er o

f iC

CM

TO

Ts C

ou

rses

co

nd

uct

ed

at N

atio

nal

leve

l

2 O

ffic

ers

12

FM

OH

Tr

ain

ing

Rep

ort

s.

An

nu

ally

FM

OH

, SM

OH

Cap

acit

y B

uild

ing

for

iCC

M -

Mas

ter

Trai

ner

s at

th

e st

ate

Nu

mb

er o

f iC

CM

TO

Ts C

ou

rses

co

nd

uct

ed

at s

tate

leve

l.

0

36

+1

Stat

es

SMO

H

Trai

nin

g R

epo

rts

An

nu

ally

FM

OH

, SM

OH

Cap

acit

y b

uild

ing

of

CH

EWs

and

CO

RP

s to

pro

vid

e iC

CM

Ser

vice

s

Pro

po

rtio

n o

f JC

HEW

s an

d C

OR

Ps

trai

ned

in iC

CM

wh

o a

re p

rovi

din

g iC

CM

Ser

vice

s

0

TBD

LG

A

Trai

nin

g re

po

rts

An

nu

ally

FM

OH

, SM

OH

Trai

ned

CH

EWs

and

CO

RP

s p

rovi

din

g

iCC

M

Pro

po

rtio

n o

f Tr

ain

ed J

CH

EWs

and

CO

RP

s

pro

vid

ing

iCC

M S

ervi

ces

in t

he

com

mu

nit

y

0

TBD

LG

A

Trai

nin

g re

po

rts

An

nu

ally

SM

OH

, LG

A

4.

SUP

PLY

CH

AIN

MA

NA

GEM

ENT

Ensu

rin

g n

o s

tock

ou

t o

f re

com

men

ded

med

icin

e an

d d

iagn

ost

ics

at t

he

com

mu

nit

y le

vel

Pro

po

rtio

n o

f C

HEW

s an

d C

OR

Ps

wh

o h

ad

no

sto

ck o

ut

of

reco

mm

end

ed m

edic

ine

and

dia

gno

stic

s d

uri

ng

the

day

of

asse

ssm

ent

visi

t o

r la

st d

ay o

f re

po

rtin

g

per

iod

No

dat

a

avai

lab

le

<5%

LG

A

Sup

ervi

sio

n

rep

ort

s

Qu

arte

rly

SMO

H, L

GA

Ensu

rin

g n

o s

tock

ou

t o

f re

com

men

ded

med

icin

e an

d d

iagn

ost

ics

at t

he

Lin

k

Faci

litie

s

Pro

po

rtio

n o

f Li

nk

Faci

litie

s th

at

had

no

sto

ck o

ut

of

reco

mm

end

ed m

edic

ine

and

dia

gno

stic

s d

uri

ng

the

day

of

asse

ssm

ent

visi

t o

r la

st d

ay o

f re

po

rtin

g p

erio

d

No

dat

a

avai

lab

le

<5%

LG

A

Sup

ervi

sio

n

rep

ort

s

Qu

arte

rly

SMO

H, L

GA

5.

SER

VIC

E D

ELIV

ERY

AN

D R

EFER

RA

L

Ensu

rin

g ad

her

ence

to

tre

atm

ent

pla

n

acco

rdin

g to

iCC

M p

roto

col

Perc

enta

ge o

f si

ck c

hild

ren

wh

o r

ecei

ved

app

rop

riat

e tr

eatm

ent

acco

rdin

g to

spec

ific

pro

toco

l

No

Dat

a

>80

%

Hea

lth

Faci

lity

Surv

ey

Hea

lth

Fac

ility

Surv

ey R

esu

lts

An

nu

ally

FM

OH

, SM

OH

,

PH

C

iCC

M c

ase

man

agem

ent

rate

Nu

mb

er o

f iC

CM

co

nd

itio

ns

man

aged

by

CH

EWs

and

CO

RP

s p

er 1

,00

0 c

hild

ren

un

der

fiv

e in

tar

get

area

s in

a g

iven

tim

e

per

iod

(q

uar

terl

y/an

nu

ally

) (r

epo

rted

by

con

dit

ion

)

No

Dat

a

>80

%

Hea

lth

Faci

lity

Surv

ey

Hea

lth

Fac

ility

Surv

ey R

esu

lts

An

nu

ally

FM

OH

, SM

OH

,

PH

C

18

Th

e

iC

CM

Im

ple

men

tati

on

N

ati

on

al

Fra

mew

ork

EXP

ECTE

D R

ESU

LTS

IN

DIC

ATO

RS

B

ASE

LIN

E D

ATA

(2

01

4)

TAR

GET

TI

ME

(20

20

)

DA

TA

SOU

RC

E D

ATA

C

OLL

ECTI

ON

FR

EQ

RES

PO

NSI

BLE

P

ERSO

N

Succ

essf

ul F

ollo

w u

p r

ate

Pro

po

rtio

n o

f ca

ses

follo

wed

up

aft

er

rece

ivin

g tr

eatm

ent

fro

m C

HEW

s an

d

CO

RPs

acc

ord

ing

to n

atio

nal

pro

toco

l

No

dat

a >8

0%

H

ealt

h

Faci

lity

Surv

ey

Hea

lth

Fac

ility

Surv

ey R

esu

lts

An

nu

ally

FM

OH

, SM

OH

,

PH

C

Stre

ngt

hen

ing

Ref

erra

l sy

stem

fo

r iC

CM

im

ple

men

tati

on

Pro

po

rtio

n o

f C

HEW

s/C

OR

Ps t

hat

en

sure

at

leas

t 8

0%

of

iden

tifi

ed c

ases

wit

h

dan

ger

sign

s ar

e re

ferr

ed t

o t

he

hea

lth

fa

cilit

ies.

No

dat

a >8

0%

H

ealt

h

Faci

lity

Surv

ey

Hea

lth

Fac

ility

Surv

ey R

esu

lts

An

nu

ally

FM

OH

, SM

OH

,

PH

C

6.

CO

MM

UN

ICA

TIO

N F

OR

BEH

AIV

OU

R A

ND

SO

CIA

L C

HA

NG

E

Exis

ten

ce o

f a

com

pre

hen

sive

Inte

grat

ed

Co

mm

un

icat

ion

& D

eman

d C

reat

ion

St

rate

gy p

lan

fo

r iC

CM

Exis

ten

ce o

f a

com

pre

hen

sive

inte

grat

ed

Co

mm

un

icat

ion

& D

eman

d C

reat

ion

St

rate

gy p

lan

fo

r iC

CM

A

vaila

ble

(20

15

)

FM

OH

, SM

OH

,

Car

egiv

er k

no

wle

dge

of

illn

ess

sign

s

Pro

po

rtio

n o

f ca

regi

vers

wh

o k

no

w t

wo

or

mo

re s

ign

s o

f ch

ildh

oo

d il

lnes

s th

at

req

uir

e im

med

iate

ass

essm

ent

and

tr

eatm

ent,

if a

pp

rop

riat

e

No

dat

a >6

0%

FM

OH

Hea

lth

Faci

lity

Surv

ey

Hea

lth

Fac

ility

Surv

ey R

esu

lts

An

nu

ally

FM

OH

, SM

OH

,

7.

SUP

ERV

ISIO

N A

ND

QU

ALI

TY A

SSU

RA

NC

E

Ensu

rin

g Ef

fect

ive

Sup

ervi

sio

n a

nd

M

on

ito

rin

g o

f C

HEW

s an

d C

OR

Ps o

n iC

CM

se

rvic

es

Pro

po

rtio

n o

f C

HEW

s an

d C

OR

Ps w

ho

re

ceiv

ed a

t le

ast

on

e su

per

viso

ry c

on

tact

d

uri

ng

the

pri

or

thre

e m

on

ths

wh

ere

a si

ck c

hild

vis

it o

r sc

enar

io w

as a

sses

sed

an

d c

oac

hin

g p

rovi

ded

No

dat

a >6

0%

Su

per

visi

on

Vis

its

ISS

qu

arte

rly

rep

ort

s

Qu

arte

rly

FMO

H, S

MO

H,

Co

rrec

t C

ase

Man

agem

ent

[Kn

ow

led

ge]

Pro

po

rtio

n o

f C

HEW

s an

d C

OR

Ps w

ho

d

emo

nst

rate

d c

orr

ect

kno

wle

dge

of

case

m

anag

emen

t o

f si

ck c

hild

cas

e sc

enar

ios

No

dat

a >6

0%

FM

OH

Hea

lth

Faci

lity

Surv

ey

Hea

lth

Fac

ility

Surv

ey R

esu

lts

An

nu

ally

FM

OH

, SM

OH

,

8.

MO

NIT

OR

ING

& E

VA

LUA

TIO

N A

ND

HM

IS

Nat

ion

al M

on

ito

rin

g an

d E

valu

atio

n P

lan

fo

r iC

CM

A

vaila

bili

ty o

f a

com

pre

hen

sive

, In

tegr

ated

M&

E P

lan

fo

r iC

CM

Ava

ilab

le

(20

15

)

FM

OH

LGA

& W

AR

D M

on

ito

rin

g iC

CM

on

HM

IS

Pro

po

rtio

n o

f LG

A/W

ard

rep

ort

ing

iCC

M

in e

xist

ing

HM

IS

No

ne

10

0%

LG

A

HM

IS r

epo

rts

SM

OH

, LG

A

19

List of Contributors

Federal Ministry of Health1. Dr. Wapada Balami, mni Director, FHD/FMOH2. Dr. A. R. Adeniran H/Child Health, FMOH3. Mr. Alex Omoru DD/MNCH FMOH4. Tinu Taylor DD/CS FMOH5. Pharm Tile Titus DD FDA/FMOH6. Thompson K. C. FMOH7. Franca Okafor FMOH8. Dr. Hadiza S. Idris FMOH9. Dr. Bose Ezekwe iCCM Desk Officer, FMOH10. Dr. Femi James FMOH11. Dr Seyi Omokore FMOH12. Helen Akhigbe FMOH13. Bayode A. H FMOH14. Adama Abdul FMOH15. Elue D. C. FMOH

NPHCDA and other FMOH Agencies16. Dr Nnenna Ezeigwe National Coordinator NMEP17. Dr. Val Obijekwu SMO NPHCDA18. Dr Nnenna Ogbulafor NMEP19. Dr. Sam Obasi NPHCDA20. Dr Sola Oresanya21. Dr Femi Ajumobi NMEP22. Mrs Chinwe Ezeife NPHCDA23. Dr Isa Kawu NMEP24. Dr. Bakunawa G. Bello NPHCDA25. Dr Akannu Ogechi NDACDA

Development Partners26. Dr. Mbewe Andrew WHO27. Dr. Nosa Orobaton USAID/TSHIP JSI28. Dr. Amos Bassi USAID/TSHIP29. Dr. Kennedy Ongwae UNICEF30. Dr. Francis Ohanyido USAID/TSHIP31. Prof. Otolorin Dipo JHPIEGO32. Dr. Oyinbo Manuel Save the Children33. Dr. Nkeiru Onuekwusi UNICEF34. Dr. Joy Ufere WHO35. Dr Lynda Ozor WHO36. Dr. Olayinka Farouk USAID/TSHIP37. Dr. Chinwoke Isiguzo SFH38. Dr. Funke Fasawe CHAI39. Dr. Kolawole Maxwell Malaria Consortium40. Chinedu Egwuonwu ARFH


41. Dr Abidemi Okechukwu USAID

42. Kachi Amajor IPATH

43. Ronke Atamewaleu Marie Stopes

44. Dr Lazarus Eze ARFH

45. Paulette Ibeka CHAI

46. Dorathy Payi CHAI

47. Tiwadayo Braimoh CHAI

48. Dr. Bamidele Abegunde USAID /TSHIP

49. Anthony Edozieuno Christian Aid

50. Daniel Salihu UNICEF

51. Josephine Okide UNICEF

52. Yetunde Oke USAID/MAPS

53. Ogechi Onuoha SFH/ESMPIN

54. Ogedegbe Ewomazino ARFH

55. Chukwumalu Kingsley Save the Children

56. Jennifer Anyanti Dr SFH

57. Ufuoma P. Obi Mariestopes Nigeria

58. Onosi Ifesemen USAID/DELIVER

59. Nomtai Kaduno USAID /TSHIP

60. Charity Ibekwe NURHI

61. Obinna Odika UNICEF

62. Priscilia Ikparen

63. Nanlop Ogbureke Christian Aid, UK

64. Omowunmi Omoniwa CHAI

65. Elizabeth Igharo USAID/DELIVER

‘tomowo Faduyile George Consultant/TSHIP JSI (2015)

[The National iCCM Implementation Framework development]

20

References

1. Demographic and Health Survey (2013),

2. Integrated Maternal, Newborn and Child Health Strategy (2012), Nigeria

3. National Guideline for the implementation of iCCM of common childhood illness in Nigeria (2013)

4. National Malaria Strategic Plan (2014 – 2020), Nigeria

5. iCCM Country Action Plan –Nigeria (2014). CCM Central. Retrieved on 6-12-2015 from http://ccmcentral.com/wp-content/uploads/2014/03/Country-Action-Plan-

Nigeria.pdf

6. CCM Global Indicators Chart. Retrieved on 6-12-2015 from http://ccmcentral.com/wp-content/uploads/2014/03/CCM Global indicators Chart. pdf

7. DFID, (2002). Department for International Development of the United Kingdom, Tools for Development: a handbook for those involved in development activity

(2002): Retrieved on 6-19-2015 from www.dfid.gov.uk/pubs/files/toolsfordevelopment.pdf

8. WHO/UNICEF joint Statement on iCCM (2012) UNICEF. Retrieved on 8-23-2015 from http://www.unicef.org/health/files/iCCM_Joint_Statement_2012.pdf

9. Integrated Community Case Management (iCCM) Decision Tree for State Level, Nigeria. (2014).

Nigeria


TARGETED STATES HIGH IMPACT

shipship PROJECTS

World Health Organization

CLINTONHEALTH ACCESS INITIATIVE Save the Children

an alliance of johns Hopkins University

innovating to save lives

JhpiegoPaediatricAssociation ofNigeria (PAN)

evidence for actionmother babies alive

Mamaye!

F HS

USAIDFROM THE AMERICAN PEOPLE

JSI Research & Training Institute, Inc.

JSI

Nigeria national iccm implementation framework

Healthcare

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