Integrated Community Case Management (ICCM) Delivered by Village Health Teams in Bushenyi District in Uganda

Healthy Child Uganda

Status: Completed

Conditions: Maternal and Child Health

Treatments: Other: ICCM delivered by VHT; Other: No intervention; Other: ICCM delivered by VHT with Cell Phone

Study type: Interventional

Funder types: Other

Identifiers

NCT02046018

HCU_AHSI

Details and patient eligibility

About

In Sub-Saharan Africa (SSA), many children die from diarrhoea, acute respiratory illness (ARI) and malaria, despite well- recognized, inexpensive and highly effective treatments, since health access and human resources are limited. Healthy Child Uganda (HCU) is a Ugandan-Canadian partnership that since 2003, has developed, implemented and evaluated a Village Health Volunteer (VHV) program in 175 rural villages. Volunteers, selected by peers, provide health education and refer sick children. Volunteer retention (94%) and significant decreases in child deaths are remarkable. Now, HCU wonders whether VHV scope can extend to provide treatment for sick children using Oral Rehydration Salts (ORS)/Zinc, antibiotics, and antimalarials. Use of lay providers in this capacity, called integrated community case management (iCCM), has been proposed as a potential inexpensive solution to SSA's human health resource crisis.

PRIMARY QUESTION: In rural southwest Uganda, can iCCM provided by lay volunteers, improve the proportion of children with diarrhoea receiving ORS/Zn, ARI receiving antibiotics, and fever/malaria receiving antimalarials? Secondary study questions consider VHV capacity to prescribe appropriate drug, dose, duration; iCCM acceptance by family, and VHV; VHV retention/motivation; program cost. Selected VHV will be iCCM trained then receive treatments for distribution. Qualitative and quantitative methods including household surveys, and focus groups will consider pre/post intervention differences and differences in control and intervention populations. A research short course and micro research grants (~ $3000 to multidisciplinary groups pursuing relevant questions) will promote health system evaluation capacity. Lessons learned are critical as SSA countries move forward in planning for increased iCCM programming.

Enrollment: 5,000 patients

Sex: All

Ages: Under 59 months old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Children under five (< or =59 months)

Exclusion criteria

• Children over five years (> 59 Months)

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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5,000 participants in 3 patient groups

ICCM delivered by VHT

Active Comparator group

Description:

Health Outcomes in Communities where VHT's were trained in ICCM and given drugs.

Treatment:

Other: ICCM delivered by VHT

ICCM delivered by VHT with cell phone

Active Comparator group

Description:

Health Outcomes in communities with VHT's who were trained in ICCM and given cell phones

Treatment:

Other: ICCM delivered by VHT with Cell Phone

Other: ICCM delivered by VHT

Health outcomes in communities with no ICCM

Active Comparator group

Description:

Health outcomes in communities with VHT's who were not trained in ICCM

Treatment:

Other: No intervention