The Federal Ministry of Health
Nigeria
TheNational
IntegratedCommunityCaseManagement
(iCCM)ImplementationFramework
A 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 iCCMTask Force.
September, 2015
The iCCM ImplementationNational Framework
4
Table of Contents
The iCCM ImplementationNational Framework
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
The iCCM ImplementationNational Framework
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
The iCCM ImplementationNational Framework
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
1
robust policies, strategies, guidelines and interventions to address child health in Nigeria .
2
According 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
3
services 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 iCCM ImplementationNational Framework
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
4
iCCM DecisionTree 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.
The iCCM ImplementationNational Framework
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, ProfessionalAssociations and Individuals. It
will support and participate at every level of implementation of iCCM for example the selection and
monitoring of CORPs.
The iCCM ImplementationNational Framework
THE NATIONAL iCCM IMPLEMENTATION FRAMEWORK
10 The iCCM ImplementationNational Framework
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THE NIGERIA iCCM IMPLEMENTATION FRAMEWORK
3
STATE LEVEL -CTC [SMOH, DEVELOPMENT PARTNERS/NGO]
Adopt/Adapt Adopt/Adapt N
Coordination 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
7
the 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
3
contributing to the reduction of morbidity and mortality of under-fives .
The iCCM ImplementationNational Framework
THE NIGERIA iCCM IMPLEMENTATION LOGIC MODEL
3,7
THENATIONALiCCMIMPLEMENTATIONLOGICMODEL
3,7
iCCMBCCmaterialsavailableforstate
adaptationanduse;Sustainable
incentivesmodel
Allhardtoreachcommunitiessensitized
andmobilized;Communitystructuresfor
mobilizationandsensitizationsetin
place.
FunctionaliCCMTaskforce;VisibleiCCM
CommoditySecurity;PoolofHRforiCCM
exists;NationwideImplementationof
iCCM;AvailabilityoffundingforiCCM;
TheiCCMimplementationstrategiesledby
theLGAHealthDept.established;
Functional2wayReferralforiCCM;
InstitutionalizationofiCCMstrategies
withinfunctionalWDCs;Functional
logisticsmanagementsystemexists;
AvailablepoolofMastertrainersfor
iCCM;StandardizedTraininganddata
collectionmaterialsforiCCMinstituted;
EffectiveandEfficientMonitoringand
Evaluationmechanismestablished
AvailabilityoffunctionaliCCMReferral
Facilities;CommoditysecurityforiCCM
exists;FunctionalSupportiveSupervision
andMonitoringforiCCM.
PolicyandStandardsinstitutedfor
iCCM;EffectiveCoordinationand
PartnershipforiCCM;Available
technicalSupportforState
implementation;Resourcesecurityfor
iCCM;ChildRightsActsdomesticated.
ExistenceofLGADept.ofHealthled
iCCMimplementation;FunctionalWDC
foriCCMimplementation.
THEIMMEDIATEOUTCOMES
THEULTIMATEOUTCOME
Reductionofthenumberofdeathsamongchildrenunderfivethroughimprovedaccesstotreatmentforcommonchildhood
illnesswithinthechildren'shomesandcommunitiesinlinewiththeSustainableDevelopmentGoals.
DEMANDACCESSQUALITYADVOCACY&POLICY
Stateawarenessofthebenefitsofthe
implementationofiCCMcreated;State
accountabilityandownershipon
implementationofiCCMconfirmed;
Nationalsustainableincentivemodel
adaptedtostate.
FunctionalStateiCCMTaskforce/Child
SurvivalWorkingGroupestablishedinthe
state;Adequateandevendistributionof
adequatelytrainediCCMworkforce
availablewithinthestate;Established
iCCMCommoditiesSecurity;Established
privatesectorinvolvement;Statebuy-in.
AvailablePoolofStatebasedtrainersfor
iCCM;StatecommitmenttoiCCM
implementation;Standardized
implementationinlinewithNational
guidelines;EffectiveandEfficient
MonitoringandEvaluationmechanism
established.
StateiCCMPolicyandStandardsexist;
ExistenceofStatebasediCCM
commoditiessecurity;Availabilityof
FundingforiCCM;Coordinated
implementationofiCCM;Effective
PrivateSectorengagementiniCCM
established;CRAdomesticatedatstate
level;StateChampionsforiCCM.
ExistenceofGendersensitive
CommunitystructuresforiCCM
implementation;
AvailableHumanResourceforiCCM;
AvailabilityofiCCMCommodities;
EffectivedocumentationforiCCMexists;
AppropriatemanagementofU5
childhoodillnessaccordingtonational
standardsandprotocols;SickU5
Childrenwithdangersigns,severe
malnutritionandsicknewbornare
referredtoHealthfacilities
EstablishedpoolofhighlymotivatedCORPs
providingstandardiCCMservices;
measurableimprovedaccesstoiCCM
throughtheCORPSforunder-fivesintheir
communities
Improvedgendersensitivecareseeking
behaviorforfamiliesandhousehold;
Culture-basedgoodpracticesforiCCM
adopted;
FEDERAL STATE COMMUNITYLGA
DEMAND
Communitiesmobilizedand
empoweredtodemandand
useofiCCMStrategy
QUALITY
Improvedadherenceto
NationalStandards.
Increasedavailabilityand
utilizationofQualityHealth
Services.
ADVOCACY&POLICY
Conduciveenvironment
foriCCMimplementation
exists.
THEINTERMEDIATEOUTCOMES
ACCESS
TheiCCMImplementationNationalFramework12
THEEXPECTEDOUTPUTS
Sensitizationandsocialmobilizationon
iCCM,ActiveCommunityParticipation
throughfunctionalWDC;Program
feedbacktothe
Community;Documentationofgood
practices;
CapacityBuildingofTrainers,CHEWs/CORP
&SupervisorsoniCCM;AvailabilityofiCCM
Medicines&Commodities;Functional
iCCMTaskforce;iCCMReferralFacilities
identifiedandequippedwithadequate
HWs,Medicines&Equipments
Training/SensitizationofWDConiCCM
progmgt;AvailabilityofFunctionaliCCM
ReferralFacilities,SelectionofHard-To-
ReachCommunities/WardforiCCM
Trainingimplementationmaterialsfor
iCCM;RegularMeetingofTaskforce;
FinancialTransparency&Accountability;
EstablishmentofSustainableincentives
model;DocumentationofGlobalGood
Practices;MasterTrainersforiCCM
trained.
SelectionandequippingiCCMReferral
Facilities;Selection&sensitizingWDCfor
iCCM;EffectiveSupplyChainSystemfor
iCCMDrugs,diagnostics&consumables;
ReportingforiCCMonHMIS
NationalGuidelineforiCCM;iCCM
ImplementationFramework;iCCM
Advocacy&CommunicationPlan;iCCM
M&EPlan;CostediCCMOperational
Plan;AdvocacyKit,iCCMTaskforce;
StateRollOut;iCCMonAnnualBudget
line;GuidelineonPPP
RolesofCHEWs/CORPs&Community;
Procurementofdrugs&consumables;
SelectionofPPP;
FEDERAL STATE COMMUNITYLGA
TheiCCMImplementationNationalFramework
ADVOCACY&POLICY
DIRECTION
QUALITYACCESS
AdvocateforFunctionalNationaliCCM
Taskforce;PrivateSectorParticipation;
SensitizationonmHealthforiCCM.
DEMAND
CommunityMobilizationonbenefitsof
iCCMService;Promotionon
IdentificationofCHEWs/CORPsforiCCM;
ActiveCommunityParticipation
&Ownership;PromotionofCareSeeking
Behavior;PromotionofCulture-based
goodpracticesforiCCM;Jingleson
reductionofSocio-culturalbarriers.
13
MeetingsforSelectionofCORPs;
SensitizationonbenefitsofiCCMService;
SensitizationoniCCMasagapfor
geographical&financialbarriers;Active
ParticipationofCommunityforownership
andsustainability
AvailabilityofTrainedCHEWs/CORPson
iCCM;FunctioningCommunityBased
InformationSystemforiCCM;Availability
ofiCCMKit;TrainedSupervisorsfor
iCCM;CHEWs/CORPsfollowuponU5on
iCCMmgt.
PrintingofiCCMCBIStools;Training
ManualsforCORPs;ISSTools;
EstablishmentofStructureforiCCM
commoditiesFlow
FunctionalStateiCCMTWG;Private
SectorParticipation;Sensitizationon
HealthforiCCM;SelectionofHardto
ReachCommunity;Coordinationof
Partnership;DisseminationofGood
Practices;FeedbackoniCCMactivity;
Inclusionofsocialdiscriminated&
socialexcludediniCCM;
AdoptionofiCCMService;iCCMTWG;
SelectionofiCCMReferralFacilities,
AdoptionofmHealthforiCCM;Trainingof
CHEWs/CORPsoniCCM;Maleinvolvement
foriCCM;ChildSurvivalWorkingGroup;
iCCMCommoditiessecurity;Healthfor
iCCM;TOTforPrivateSectorworking
group;
TrainedCHEWs/CORPs;Quarterly
SupportiveSupervision;Supportive
SupervisionforPPP;Documentationof
ActualReleasedFundsforimplementation;
Implementingincentives
model;AvailabilityofStandardOperating
ProceduresandNational
ImplementationDocumentsoniCCM;
MappingofICCMpartners.
AdoptionofNationalGuidelines,Plans
&ImplementationFramework;CS
WorkingGrp;SelectionofPPP;iCCMon
AnnualBudgetline;Procurementof
drugs&consumables;iCCM
commoditiesprocurementintegrated
intoexistingGovt.structures;useof
Mobile/eHealthforiCCM;Selectionof
CHEWs/CORPs,Community&SMOH;
14
Guideline,Framework&Operational
PlansDevelopment;Advocacyvisits;
TrainingManualsdevelopment;
StrategicPlanning;TechnicalMeeting,
Statesrollout;
THEKEYACTIVITIES
Jobaids,wallcharts,healthplatform,
HumanResources,Materials,Funds;
Logistics;SOPs;JobAids;Tools;
THEKEYINPUTS
TheiCCMImplementationNationalFramework
*Allactivitiesandinputshavenotbeenspeltout,however,asummaryofthekeyareasareshownbasedonthespecificityofthethematicareaas
demandcreation,access,quality,advocacyandpolicybasedactivities.
ADVOCACY&POLICY
ADVOCACY&POLICY
Advocacykits;Powerpoint
presentation;documentaries
(audio/visual);Jobaids,wallcharts,
healthplatform,HumanResources,
Materials,Funds;Logistics;SOPs;Job
Aids;Tools;
QUALITY
QUALITY
Trainings;TrainingofTrainers;
Supportivesupervisionvisits;Meeting;
Assessments;Sensitization;
Documentation;Mapping;Assessment;
Supplychainsystem;Reporting;Follow
up;
ACCESS
Jobaids;wallcharts;trainingmaterials,
flipcharts;funds;logistics;Jobaids,wall
charts,healthplatform,HumanResources,
Materials,Funds;Logistics;SOPs;JobAids;
Tools;
ACCESS
Staffing;recruitment;Trainings;Trainingof
Trainers;Supportivesupervisionvisits;
Meetings;Assessments;Sensitization;
Communitydialogue;TownHallmeeting
DEMAND
Advocacykits;Powerpointpresentation;
documentaries(audio/visual);jingles,
posters;banners;dramascript;flyers;
billboards;leaflets;townannouncers;
funds;Jobaids,wallcharts,health
platform,HumanResources,Materials,
Funds;Logistics
DEMAND
AdvocacyandSensitizationmeetings;
SocialMobilization;Training;Community
dialogue;Conferences;Radio/TV
Magazineshows;Drama/theatre,
roadshows/rallies,marketstorm
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
QualityAssurance 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 iCCM ImplementationNational Framework
THE NATIONAL iCCM PERFORMANCE MEASUREMENT MATRIX
3,6
TheiCCMImplementationNationalFramework
16
EXPECTEDRESULTS6
INDICATORS7,9
BASELINE
DATA
(2014)
TARGET
TIME
(2020)
DATA
SOURCE
DATA
COLLECTION
FREQRESPONSIBLE
PERSON
1.POLICYANDCOORDINATION
ANationalGuidelineforimplementation
ofiCCMinNigeria
AvailabilityofaNationalGuidelinefor
implementationofiCCMinNigeria
Available
(2014)
FMOH
AniCCMTWG/SCWGledbytheMOH
(Federal,State&LGA)andincludingkey
stakeholdersexistsandmeetsregularlyto
coordinateiCCMactivities
AvailabilityofaniCCMTWG/SCWGled
bytheMOH(Federal,State&LGA)and
includingkeystakeholdersexistsand
meetsregularlytocoordinateiCCM
activities.
Availableat
National
Available
atNational
Stateand
LGA
FMOH
State,LGA
Reportsof
Monthly/Quarte
rlyMeetings.
MonthlyFMOH,SMOH,LGA
ANationalImplementationFrameworkfor
iCCMforuniformityofimplementation
AvailabilityofaNationalImplementation
FrameworkforiCCM,tobeadoptedbyall
states
Available
(2015)
FMOH,National
TaskforceoniCCM
iCCMPartnersMapping
AvailabilityofUp-to-dateMapping/Listof
iCCMPartners,activitiesandlocations
NoneAvailableFMOH
State,LGA
Updatedlistof
partners
YearlyFMOH,STATE,LGA
AStandardImplementationMaterialsand
TemplatesforiCCM[TrainingManuals;
JobAids;SupervisoryChecklists;M&E
Tools&IECMaterials]
AvailabilityofaStandardImplementation
MaterialsandTemplatesforiCCM
[TrainingManuals;JobAids;Supervisory
Checklists;M&ETools&IECMaterials]to
beadoptedbyallstates
AvailableAvailableFMOH
State,LGA
Documents,job
aids,tools
availableas
hardandsoft
electroniccopy
FMOH,National
TaskforceoniCCM
2.COSTINGANDFINANCING
AcostedoperationalplanforiCCM[oras
partofabroaderhealthoperationalplan]
attheFederal,StateandLGA,updated
annually
Availabilityofacostedoperationalplan
foriCCM[oraspartofabroaderhealth
operationalplan]attheFederal,Stateand
LGA,updatedannually
4States
(Abia,Niger,
Adamawa&
KebbiStates)
36+1Federal
State
Op.Plans
availableashard
&softelectronic
copies
YearlyFMOH,STATE
ActualiCCMFundsreleasedfromthe
costedoperationalplansatfederaland
statelevels
PercentageofactualiCCMBudgeted
Fundreleasedforimplementationatthe
federalandstatelevel
None36+1Federal,
State
FMOH&SMOH
Budget
YearlyFMOH,STATE
THENIGERIAiCCMPERFORMANCEMEASUREMENTMATRIX
3,6
17TheiCCMImplementationNationalFramework
EXPECTEDRESULTSINDICATORSBASELINE
DATA
(2014)
TARGET
TIME
(2020)
DATA
SOURCE
DATA
COLLECTION
FREQRESPONSIBLE
PERSON
3.HUMANRESOURCEFORiCCM
TrainingofProgramManagersasMaster
TrainersforiCCM
NumberofiCCMTOTsCoursesconducted
atNationallevel
2Officers12FMOHTraining
Reports.
AnnuallyFMOH,SMOH
CapacityBuildingforiCCM-Master
Trainersatthestate
NumberofiCCMTOTsCoursesconducted
atstatelevel.
036+1
States
SMOHTrainingReportsAnnuallyFMOH,SMOH
CapacitybuildingofCHEWsandCORPsto
provideiCCMServices
ProportionofJCHEWsandCORPstrained
iniCCMwhoareprovidingiCCMServices
0TBDLGATrainingreportsAnnuallyFMOH,SMOH
TrainedCHEWsandCORPsproviding
iCCM
ProportionofTrainedJCHEWsandCORPs
providingiCCMServicesinthecommunity
0TBDLGATrainingreportsAnnuallySMOH,LGA
4.SUPPLYCHAINMANAGEMENT
Ensuringnostockoutofrecommended
medicineanddiagnosticsatthe
communitylevel
ProportionofCHEWsandCORPswhohad
nostockoutofrecommendedmedicine
anddiagnosticsduringthedayof
assessmentvisitorlastdayofreporting
period
Nodata
available
<5%LGASupervision
reports
QuarterlySMOH,LGA
Ensuringnostockoutofrecommended
medicineanddiagnosticsattheLink
Facilities
ProportionofLinkFacilitiesthathadno
stockoutofrecommendedmedicineand
diagnosticsduringthedayofassessment
visitorlastdayofreportingperiod
Nodata
available
<5%LGASupervision
reports
QuarterlySMOH,LGA
5.SERVICEDELIVERYANDREFERRAL
Ensuringadherencetotreatmentplan
accordingtoiCCMprotocol
Percentageofsickchildrenwhoreceived
appropriatetreatmentaccordingto
specificprotocol
NoData>80%Health
Facility
Survey
HealthFacility
SurveyResults
AnnuallyFMOH,SMOH,
PHC
iCCMcasemanagementrate
NumberofiCCMconditionsmanagedby
CHEWsandCORPsper1,000children
underfiveintargetareasinagiventime
period(quarterly/annually)(reportedby
condition)
NoData>80%Health
Facility
Survey
HealthFacility
SurveyResults
AnnuallyFMOH,SMOH,
PHC
18TheiCCMImplementationNationalFramework
EXPECTEDRESULTSINDICATORSBASELINE
DATA
(2014)
TARGET
TIME
(2020)
DATA
SOURCE
DATA
COLLECTION
FREQRESPONSIBLE
PERSON
SuccessfulFollowuprate
Proportionofcasesfollowedupafter
receivingtreatmentfromCHEWsand
CORPsaccordingtonationalprotocol
Nodata>80%Health
Facility
Survey
HealthFacility
SurveyResults
AnnuallyFMOH,SMOH,
PHC
StrengtheningReferralsystemforiCCM
implementation
ProportionofCHEWs/CORPsthatensure
atleast80%ofidentifiedcaseswith
dangersignsarereferredtothehealth
facilities.
Nodata>80%Health
Facility
Survey
HealthFacility
SurveyResults
AnnuallyFMOH,SMOH,
PHC
6.COMMUNICATIONFORBEHAIVOURANDSOCIALCHANGE
ExistenceofacomprehensiveIntegrated
Communication&DemandCreation
StrategyplanforiCCM
Existenceofacomprehensiveintegrated
Communication&DemandCreation
StrategyplanforiCCM
Available
(2015)
FMOH,SMOH,
Caregiverknowledgeofillnesssigns
Proportionofcaregiverswhoknowtwoor
moresignsofchildhoodillnessthat
requireimmediateassessmentand
treatment,ifappropriate
Nodata>60%FMOH
Health
Facility
Survey
HealthFacility
SurveyResults
AnnuallyFMOH,SMOH,
7.SUPERVISIONANDQUALITYASSURANCE
EnsuringEffectiveSupervisionand
MonitoringofCHEWsandCORPsoniCCM
services
ProportionofCHEWsandCORPswho
receivedatleastonesupervisorycontact
duringthepriorthreemonthswherea
sickchildvisitorscenariowasassessed
andcoachingprovided
Nodata>60%Supervision
Visits
ISSquarterly
reports
QuarterlyFMOH,SMOH,
CorrectCaseManagement[Knowledge]
ProportionofCHEWsandCORPswho
demonstratedcorrectknowledgeofcase
managementofsickchildcasescenarios
Nodata>60%FMOH
Health
Facility
Survey
HealthFacility
SurveyResults
AnnuallyFMOH,SMOH,
8.MONITORING&EVALUATIONANDHMIS
NationalMonitoringandEvaluationPlan
foriCCM
Availabilityofacomprehensive,
IntegratedM&EPlanforiCCM
Available
(2015)
FMOH
LGA&WARDMonitoringiCCMonHMISProportionofLGA/WardreportingiCCM
inexistingHMIS
None100%LGAHMISreportsSMOH,LGA
19
List of Contributors
Federal Ministry of Health
1. Dr. Wapada Balami, mni Director, FHD/FMOH
2. Dr. A. R. Adeniran H/Child Health, FMOH
3. Mr. Alex Omoru DD/MNCH FMOH
4. Tinu Taylor DD/CS FMOH
5. Pharm Tile Titus DD FDA/FMOH
6. Thompson K. C. FMOH
7. Franca Okafor FMOH
8. Dr. Hadiza S. Idris FMOH
9. Dr. Bose Ezekwe iCCM Desk Officer, FMOH
10. Dr. Femi James FMOH
11. Dr Seyi Omokore FMOH
12. Helen Akhigbe FMOH
13. Bayode A. H FMOH
14. Adama Abdul FMOH
15. Elue D. C. FMOH
NPHCDA and other FMOH Agencies
16. Dr Nnenna Ezeigwe National Coordinator NMEP
17. Dr. Val Obijekwu SMO NPHCDA
18. Dr Nnenna Ogbulafor NMEP
19. Dr. Sam Obasi NPHCDA
20. Dr Sola Oresanya
21. Dr Femi Ajumobi NMEP
22. Mrs Chinwe Ezeife NPHCDA
23. Dr Isa Kawu NMEP
24. Dr. Bakunawa G. Bello NPHCDA
25. Dr Akannu Ogechi NDACDA
Development Partners
26. Dr. Mbewe Andrew WHO
27. Dr. Nosa Orobaton USAID/TSHIP JSI
28. Dr. Amos Bassi USAID/TSHIP
29. Dr. Kennedy Ongwae UNICEF
30. Dr. Francis Ohanyido USAID/TSHIP
31. Prof. Otolorin Dipo JHPIEGO
32. Dr. Oyinbo Manuel Save the Children
33. Dr. Nkeiru Onuekwusi UNICEF
34. Dr. Joy Ufere WHO
35. Dr Lynda Ozor WHO
36. Dr. Olayinka Farouk USAID/TSHIP
37. Dr. Chinwoke Isiguzo SFH
38. Dr. Funke Fasawe CHAI
39. Dr. Kolawole Maxwell Malaria Consortium
40. Chinedu Egwuonwu ARFH
The iCCM ImplementationNational Framework
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 CountryAction 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/UNICEFjoint 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
The iCCM ImplementationNational Framework
TARGETED STATES HIGH IMPACT
shipshipPROJECTS
World Health
Organization
CLINTON
HEALTH ACCESS INITIATIVE
Save the Children
an alliance of johns Hopkins University
innovating to save lives
Jhpiego
Paediatric
Association of
Nigeria (PAN)
evidence for action
mother babies alive
Mamaye!
F HS
USAIDFROM THE AMERICAN PEOPLE
JSI Research & Training Institute, Inc.
JSI

Nigeria national iccm implementation framework