CDI Module 1: Overview of iCCM Strategy
through Community-Directed Intervention
©Jhpiego Corporation
The Johns Hopkins University
A Training Program on CommunityDirected Intervention (CDI) to Improve
Access to Essential Health Services
Welcome and Overview
 Our goal in health care is to ensure that all
communities—through their full participation—
have access to simple but scientifically sound
lifesaving preventive and treatment services
 We have organized a series of 18 training
modules for a five- or six-day workshop that can
be used to deliver technical content:
 On case management and prevention of common
health problems
 Through a community-directed delivery mechanism
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Background
These modules build on:
 Jhpiego field experience in delivering malaria
services, through community effort, including:
 Malaria in pregnancy services
 Illness case management
 The 16+ years of effort by the African Program for
Onchocerciasis Control and the Special Program for
Research and Training in Tropical Diseases of the
World Health Organization and its partners
This approach can be adapted for many locally
relevant health issues
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Some Acronyms We Will Use
 Interventions
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ACT: artemisinin-based combination therapy
ANC: antenatal care
CDI: community-directed intervention
CDT: community-directed treatment
DOT: direct observation of treatment
DOTS: directly observed treatment, short course (for TB)
HMM: home management of malaria
iCCM: integrated community case management
IPTp: intermittent preventive treatment in pregnancy
ITN: insecticide-treated net
LLIN: long-lasting insecticide-treated net
ORS: oral rehydration solution
ORT: oral rehydration therapy
RDT: rapid diagnostic test
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Some More Acronyms We Will Use
 Interveners
 CBO: community-based organization
 CDD: community-directed distributor
 CHA: community health agent
 CHW: community health worker
 CIMCI: community-integrated managers of childhood
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illness
CORP: community-oriented resource person
NGO: nongovernmental organization
PMV: patent medicine vendor
RMCG: role model caregiver
VHW: village health worker (volunteer)
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Workshop Objectives and Outcomes
This workshop is
action-oriented and is
based on work by CDI
implementation teams
Team work will result in two documents:
1. A strategy development document
2. An implementation planning document
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Workshop Outcomes: Strategy
Development Document
The strategy development document will:
 Review CDT scope, program plans and activities
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to date
Review national guidelines on iCCM/HMM
Set your program’s CDT/iCCM goals, targets,
objectives for each team
Outline key technical and management strategies
Determine measurement and monitoring
mechanisms
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Workshop Outcomes: Implementation
Planning Document
The implementation planning document will
develop an overall implementation plan as well as
specific components, including:
 A training guide and plan for health workers,
CBOs, NGOs, PMVs, traditional healers,
traditional birth attendants and village
development workers
 A commodity procurement, supply and
management plan
 A supervision checklist
 A monitoring and evaluation (M&E) plan
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Outline of Agenda: Day 1 Morning
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Welcome and introductions
Overview, objectives, agenda
Ground rules
Expectations of workshop on strategy for
implementing integrated community case
management through community-directed
treatment
 Overview of program context
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Outline of Agenda: Day 1 Morning (Part 2)
Organize learners to achieve workshop outcomes
by:
 Sharing and explaining templates for developing:
 A strategy
 An implementation plan
 Taking Stock
 Sharing work to date by teams
 Identifying gaps
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Outline of Agenda: Day 1 Afternoon
 Review national guidelines on:
 Community health volunteers and their roles
 iCCM and HMM as a basis for strategy
 Present modules 2–4 on CDI/CDT processes:
 What is CDI and how is it applied to malaria?
– Success stories
 Working with the health system
 Working with the community
 Training community volunteers
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Overview of the Larger Project/Program
Provide an overview of:
 National efforts and community interventions we will
focus on this week
 The week’s agenda
Introduce:
 Working teams (state, regional, district, etc.) and
facilitators who will assist them
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integrated Community Case Management
 iCCM provides high-impact interventions on a
large scale, at reasonable cost, and thus, has
measurable, attributable effects on:
 Treatment of common illnesses
 Reproductive health
 Safe motherhood
 Child health interventions such as immunization and
vitamin A
 Each project chooses an appropriate mix of such
interventions.
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Community-Directed Intervention
 CDI provides an ideal delivery mechanism for
iCCM services
 As we will discuss in Module 2, CDI involves the
community in organizing its own service delivery
 The health system enhances the capacity of the
community to help itself through training,
supportive supervision and commodity supplies
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Malaria High-Impact Interventions
Malaria provides a good example of interventions
the community can deliver:
 IPTp with sulfadoxine-pyrimethamine (SP)
 LLINs (distribution and promotion of use)
 Prompt diagnosis, appropriate treatment with:
 RDTs
 ACT medicines
And as we achieve impact and move toward
elimination, the community can undertake
surveillance
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Key Components of
Your Strategy Document
 Background: status of health issues (malaria,
pneumonia, etc.) in your geographic area
 Goals, targets, objectives
 Partnership: stakeholders and leadership
 Community taking responsibility through their
CDDs/CORPs
 iCCM facilitation teams from the health service
 Technical interventions to be delivered by the
community and its volunteers (e.g., ACTs,
LLINs, ORT, etc.)
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Strategy Addresses the
Management of Interventions
Supply chain
management
Supportive
management of
illnesses in the
community
Supportive
supervision and
quality
assurance
Advocacy,
community
involvement and
mobilization
Monitoring,
surveillance and
evaluation
Training
community
volunteers,
leaders,
organizations
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Implementation Plan
Activities,
Date
steps
planned
Goal 1: (e.g., M&E)
Responsible
person
Resources
Date of
completion
Goal 2: (e.g., Procurement)
Goal 3: (e.g., Training)
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COMMENTS AND QUESTIONS
Followed by the initial meeting of teams …
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