Document Detail


Narrowing the treatment gap with equitable access: mid-term outcomes of a community case management program in Cameroon.
MedLine Citation:
PMID:  23144228     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Coverage of case management interventions remains low and inadequate to achieve millennium development goal (MDG) target reductions in child mortality. Children living in the poorest households are particularly disadvantaged. Community case management (CCM) uses trained and supervised community health workers to improve access to, quality of and demand for effective case management. Evidence that CCM programs can achieve equitable improvements in coverage is limited. This cross-sectional study uses a quasi-experimental design with intervention and comparison areas. Outcomes of a CCM program for malaria and diarrhoea operating in two districts of Cameroon were measured after 1 year of implementation. A household census (N = 16 954) provided measurement of treatment-seeking behaviour for recent episodes of fever and diarrhoea. Results were compared between areas using chi-square tests. Intervention-area children with fever or diarrhoea were nearly nine times more likely to receive treatment with artemisinin combination therapy or oral rehydration salts, respectively, vs neighbouring comparison-area children. High levels of effective treatment were equitable across socioeconomic status in intervention areas, whereas disparities were observed in neighbouring comparison areas. CCM can achieve rapid and equitable improvements in coverage of case management for malaria and diarrhoea, and is a promising strategy for achieving MDG 4. Improved access to treatment, quality of care and caregiver demand were achieved in two districts of Cameroon. CCM must be scaled up to demonstrate outcomes and impact at scale.
Authors:
Megan Littrell; Laure Vartan Moukam; Roger Libite; Jean Christian Youmba; Gunther Baugh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-11
Journal Detail:
Title:  Health policy and planning     Volume:  -     ISSN:  1460-2237     ISO Abbreviation:  Health Policy Plan     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610614     Medline TA:  Health Policy Plan     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Malaria and Child Survival, Population Services International, PO Box 14355-00800, Whitefields Place, School Lane, Westlands, Nairobi, Kenya, Department of Research, Cameroon Association for Social Marketing (ACMS), Yaoundé, Cameroon, National Institute for Statistics (INS), PO Box 134, Centre Ville, face de l'immueble rose, Yaoundé Cameroon, and Department of Maternal and Child Health, Cameroon Association for Social Marketing (ACMS), PO Box 14025, Face Dragage Mballa II, Yaoundé Cameroon.
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