Grant to help community care in Africa

Malaria Consortium has received a $10m grant from the Bill & Melinda Gates Foundation to demonstrate how government-led integrated community case management (iCCM) programmes can be expanded so that more children with diarrhoea and other common diseases receive appropriate treatment.

Commenting on the news, Dr James Tibenderana, Malaria Consortium's director of case management, said: "We estimate that each year diarrhoea causes about 30,000 and 36,000 deaths, in Mozambique and Uganda respectively, where this project will be implemented, in children aged under five years old. This grant will give us the opportunity to prevent some of these deaths, which is a responsibility we take very seriously."

Developing a better understanding of community-based agents' (CBA) motivation and attrition, and finding workable solutions to their retention and performance are essential if iCCM implementation is to be successful on a national scale.

Health systems in resource-poor countries are investing in CBAs to deliver lifesaving treatment to children. They have the job of increasing timely and appropriate treatment in the community using high quality medicines. However, while there are many advantages to using CBAs, their effectiveness is hampered by limited community involvement, shortages of medicines, shortfalls in training materials and a lack of refresher training and supervision. The data collected by CBAs is also underutilised. These factors contribute to CBAs' low activity levels and lack of motivation.

As the lead agency, Malaria Consortium will build on established operations and relationships with the ministries of health and key national and international partners. It will manage a partnership combining expertise in research, communications and information technology, including the London School of Hygiene & Tropical Medicine, University College London Centre for International Health and Development, Straight Talk Foundation, N'Weti and Software Factory.

The five-year project will complement the work started recently by Malaria Consortium through a Canadian International Development Agency (CIDA) funded project in four countries, including Uganda and Mozambique. While the CIDA project will measure the impact of interventions, this new programme will add implementation research and activities to promote uptake of iCCM to 50 per cent coverage in both countries.