142nd APHA Annual Meeting and Exposition

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Changes in Coverage of Preventive and Promotive Interventions before and After Introducing Integrated Community Case Management (ICCM) in Ethiopia

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Efrem Teferi, MD , JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
Hibret Alemu, PhD , Harvard University School of Public Health, Boston, MA
Tesfaye Bulto, MD, MPH , JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
Dedefo Teno, MPH , JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
Ismael Bashir Ali, BSC, MPH , JSI Research & Training Institute, Inc., Addis Ababa, Ethiopia
Background: The effect of integrated community case management (ICCM) of common childhood illness on vital preventive health services is not known. The Federal Ministry of Health (FMOH) has given high priority to community based health service delivery systems through the Health Extension Program.

Objectives: Measure coverage of maternal and child health preventive and promotive interventions before and after scaling up ICCM.

Methods: We conducted cross-sectional, population-based, household coverage surveys in 2,560 households across four IFHP target regions (Amhara, Oromia, SNNP and Tigray) in 2011 when ICCM was initially implemented in 6% of health posts, and again in 2013 when ICCM was expanded to 90% of health posts.

Results: Coverage increased in 10 of 15 indicators, mainly for maternal, immunization and nutrition services– pregnant women with>4 antenatal care visits 16.6 to 41.3%, antenatal iron and foliate 39.1 to71.7%, infants 0-11 months, infants 0-5 months exclusively breastfed 57.7 to 79.2%, children 12-23 months fully vaccinated 77 to 86.4%,children 6-23 months starting complementary feeding at 6 months 60.8 to75.4%, and women 15-49 years currently using any family planning method 44 to53.9%.Three other indicators remained high and unchanged (bed net ownership 80.9 to 81.6%, children sleeping under bed nets 72.9 to 71.4 %) and latrine use 71.6 to 70%). Two indicators decreased (mothers of children 0-11 months received tetanus toxoid 77.4 to 69.7%, and HH with >2 bed nets 64-55.1%).

Conclusion: Scale-up of ICCM was consistent with increased coverage of most preventative and promotive interventions, which may contribute to the life-saving effect of ICCM.

Learning Areas:

Provision of health care to the public

Learning Objectives:
Compare coverage of maternal and child health preventive and promotive interventions before and after scale up of ICCM.

Keyword(s): Community-Based Health, Case Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a medical doctor and have served as the technical director for child health and nutrition on this USAID funded project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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