Table 8.

Studies of the effectiveness of Community–Integrated Management of Childhood Illnesses (C–IMCI) and Integrated Community Case Management (iCCM)

Intervention	Type of outcome	Population size of study area	Specific outcome	Effect compared to control	Statistical significance	Reference number*
Randomized controlled trials:
CHWs trained as part of the family and community activities associated with IMCI, as well as health system strengthening	Mortality; change in nutritional status	The catchment areas of 10 health facilities (175 000 persons)	All–cause mortality 0 to <5 y; prevalence of exclusive breast feeding 0 to <6 mo	Decreased by 13.4%; Increased by 10.1%	0.01; 0.05	[S182]
Non–randomized controlled trials:
Linkage of CHWs with local health facilities and provision of training to CHWs	Coverage; change in nutritional status	Children 0 to <2 y in a population of 160 000	Percentage of children 12–23 mo fully immunized; percentage of children receiving at least five meals per day	Increased by 21%; increased by 32%	0.05; 0.05	[S183]
Awareness seminars conducted during the first year for leaders of all villages followed 1 y later by similar seminars for extension workers and teachers	Coverage; change in nutritional status	Women of child–bearing age and their children in villages with a total population of 18 000	Percentage of children with full immunization coverage; percentage of children with severe undernutrition	Increased by 50%; decreased by 27%	0.001; 0.05	[S184]
CHWs trained in iCCM	Mortality	Children <5 y in villages with a total population of 14 000	Under–5 mortality	Decreased by 38%	0.003	[S185]
On–site monthly supervision on C–IMCI by trained supervisors of Health Extension Workers (HEWs)	Quality of care	500 HEWs assessed	Quality of case management over two years (percentage of cases that were correctly classified, treated, and followed–up within two days of initiating treatment)	Increased by 200%	0.04	[S186]
C–IMCI with 2 HEWs working at a community health post	Quality of care	87 HEWS	Correct prescription of anti–malarial medications in comparison to HEWs working in a vertical malaria control program	Increased by 10%	0.05	[S187]
Drug sellers trained in iCCM protocols	Quality of care	Sick children who made 7667 visits to 44 trained drug sellers	Correct treatment of common illnesses	Increased by 27%	0.001	[S188]
Peer support groups among CHWs trained in iCCM	Coverage	1575 children in 6 districts	Number of sick children treated for ARI, malaria, and diarrhea (compared to CHWs trained in iCCM without peer support groups)	Increased by 167%	0.001	[S189]
CHWs trained in iCCM	Coverage	306 190 children 6 mo to <5 y	Number of sick children treated for ARI, malaria, diarrhea	Increased by 23%	0.05	[S190]
CHWs trained in iCCM	Coverage	38 009 children <5 y	Percentage of children sleeping under ITNS	Increased by 33%	0.01	[S191]

ARI – acute respiratory infection, HEW – health extension workers, ITN – insecticide–treated bed nets, mo – month(s), y – year(s)

*See Appendix S2 in Online Supplementary Document(Online Supplementary Document).