Table 1.
Global CCM operations research agenda with contributions from this supplement*
| Topic | Question | Supplement contribution |
|---|---|---|
| Front-line health workers | 1. What is the effect on the performance of CHW when management of one or more disease is added to the existing responsibility? | Chinbuah and others,15 Kayemba and others19 |
| 2. Are CHWs able to assess, classify, and treat various illnesses under integrated CCM? | Mukanga and others16 | |
| 3. What are the best ways to improve and sustain performance of CHWs? | ||
| 4. What are the cost and performance of different training methods for (illiterate/literate) CHWs? | ||
| 5. What are the best methods for evaluating the quality of service provided by CHW? | Cardemil and others28 | |
| 6. What is the optimal number of CHWs to give near universal coverage to a given geographic area? | Guenther and others13 | |
| 7. What are the best ways of supervising CHWs? | ||
| 8. Which factors increase recruitment and reduce attrition? | Strachan and others26 | |
| 9. Which methods of remuneration/incentivization are effective and sustainable? | ||
| Implementation | 10. What are the cost and cost-effectiveness of CCM? | Sadruddin and others29 |
| 11. What are appropriate methods for cost recovery and financing? | ||
| 12. How can effective coverage be achieved by CCM (equity, community effectiveness, etc.)? | Guenther and others,13 Kalyango and others18 | |
| 13. How can the private sector become involved in delivering integrated CCM? | Awor and others23 | |
| 14. How acceptable are CHWs to the health system, and how can CCM requirements for drugs, supplies, supervision, etc. be met? | Callaghan-Koru and others,21 Chandani and others27 | |
| 15. What are health system effects of CCM on referral and caseload and mix? | Nsona and others,20 Lainez and others,30 Seidenberg and others25 | |
| 16. What is the effect of CCM on antibiotic resistance? | ||
| 17. What is the impact of CCM on drug use and therapeutic outcomes in the community? | Kalyango and others,18 Mukanga and others16 | |
| Management of illness | 18. How can available tools (RDTs, clinical signs, timers, drugs, pulse oximeters, etc.) be combined into clinical algorithms? | |
| 19. What is the algorithm performance in different epidemiologic scenarios? | ||
| 20. What is the appropriate duration of antibiotic treatment of WHO-defined non-severe pneumonia in African settings? | ||
| 21. Can CHWs treat WHO-defined severe pneumonia in the community? | Sadruddin and others29 | |
| 22. How can age-dose regimens for different drugs be harmonized, and what are the effects on treatment of different packaging techniques? | ||
| 23. What is the impact of pre-referral drugs on clinical outcomes of children with severe disease? | ||
| 24. What is the most appropriate antibiotic for treatment of pneumonia? | ||
| 25. What is the most appropriate formulation of antibiotics? | ||
| Families and caregivers | 26. Do family members recognize the disease and promptly seek care? | Seidenberg and others,25 Nanyongo and others,24 Awor and others23 |
| 27. What are the elements that facilitate family members to use CCM services? | Rutebemberwa and others17 | |
| 28. Do family members follow treatment recommendations properly? | ||
| 29. How does prescription of multiple medicines for multiple diseases (e.g., malaria and pneumonia) impact adherence? | ||
| Impact | 30. What is the impact of integrated CCM on health and survival of children? | Chinbuah and others,15 Mukanga and others16 |
| 31. Does CCM lead to increased penetration in terms of reaching the poor? (effective coverage) | Guenther and others,13 George and others22 |
*
CCM = community case management; CHW = community health worker; RDT = rapid diagnostic test; WHO = World Health Organization.