Position: Institutionalization of integrated Community Case Management (iCCM) Assessment Consultant
Department: PMI Impact Malaria
Based: Washington, DC or Remote
Who we are
With nearly 50 years of experience, working in over 60 countries, Population Services International (PSI) is the world’s leading non-profit social marketing organization. PSI is reimagining healthcare by putting the consumer at the center and, wherever possible, bringing care to the front door. We are working to fix market failures, shape future health markets, and shift policy and funding to better support consumer powered healthcare.
There are over 8,000 “PSI’ers” around the world. It’s a diverse group of professionals with an unusually wide range of backgrounds and experience – from the medical industry to the music business – all with unique skills that we bring to the job.
The U.S. President’s Malaria Initiative (PMI) Impact Malaria project is PMI’s flagship global service delivery project, supporting countries in their efforts to fight malaria and save lives by strengthening diagnosis, treatment, and drug-based prevention for those most at risk—particularly young children and pregnant women. PMI Impact Malaria is a USAID contract hosted and led by PSI as the prime contractor.
PMI Impact Malaria is helping national malaria control programs tackle malaria service delivery challenges by working to:
The PMI Impact Malaria (IM) team provides global technical leadership along with implementation support and technical assistance in health facility and community settings in up to 27 countries around the world.
We are a focused, multi-disciplined, and multi-cultured team, based out of Washington DC, working through PSI country offices as well as through our partners Jhpiego, MCDI, and UCSF.
Institutionalization of integrated Community Case Management (iCCM)
Globally, 5.2 million children under the age of 5 died in 2019, 2.4 million of them were newborns. Nearly half of these under five deaths occurred in sub-Saharan Africa. Overall, 53 countries are not on track to achieve the Sustainable Development Goals (SDG) child survival target of less than 25 deaths per 1000 live births by 2030.1 Pneumonia, diarrhea and malaria remain the main causes of child mortality, with approximately 802,000, 424,000 and 274,000 deaths, respectively, among children under five in 2018.2,3 Moreover, due to the weakness of the health and surveillance systems in the countries where most of these deaths occurred, it is highly likely that these numbers are under-reported.
Reaching the child health related SDG targets require strong primary health care systems, including the institutionalization of community health. Integrated programming approaches with effective coverage have been shown to have a high impact on the delivery of key interventions at community level and have improved outcomes for key causes of child morbidity and death.4 Studies and evaluations have proven that properly trained, supervised, and supported community health workers (CHWs) can effectively deliver a range of preventive, promotive, and curative health services. The World Health Organization (WHO) CHW Guidelines have consolidated evidence on optimizing CHW programmes through the identification of policy options on the selection, education, management, remuneration, system support and community embeddedness of CHWs5.
The WHO and UNICEF recommend integrated Community Case Management (iCCM) of childhood illness as a community-level component of a comprehensive strategy for integrated management of childhood and newborn illness (IMCI).6,7 By targeting hard-to-reach, vulnerable populations and supporting extension of the formal health system to the community level, iCCM increases access to life saving interventions for malaria, pneumonia and diarrhea as well as promoting the rational use of medications and the promotion of nutrition, timely care seeking, and evacuation of severe cases to higher levels of care. However, key findings from a WHO-led 2016 strategic review of IMCI showed lack of prioritization of the community component in favour of capacity building of facility-based health workers.8
Nevertheless, considerable progress has been made. To date, more than 30 countries have implemented iCCM – mostly at the subnational level – with the support of global development partners9. A small number of countries, though, have been successful in developing national iCCM programs covering most or all of the targeted areas in their countries. While in recent years funding allocations for iCCM have greatly improved, financial sustainability is challenged by reliance on external support from donors and development partners. In addition, inadequate planning, budgeting, and resource mobilization for the entire iCCM package as well as insufficient community engagement, has meant that many countries that initially were able to start implementation of the iCCM component of the IMCI strategy have struggled to maintain an acceptable level of quality of care and coverage, and large portions of the population remain underserved. The availability of essential commodities also remains a major challenge in many of the countries as well as the proper inclusion of iCCM in the overall community and public health systems and IMCI strategies.
In July 2019, with the aim to institutionalize iCCM in the context of primary health care and comprehensive child health programming, UNICEF and the WHO co-hosted a technical consultation targeting countries in sub-Saharan Africa with high child mortality burden. The meeting aimed to break down silos between national malaria control programs and maternal and child health programs to address challenges to iCCM scale-up. Participants identified means for resolving four common challenges to iCCM scale-up and put forth 10 recommendations to advance the institutionalization of iCCM10.
PMI Impact Malaria is seeking a consultant to leverage the findings from the 2019 technical consultation and assess best practices, lessons learned, and key challenges from selected countries that have developed sustainable, national-scale iCCM programs.
Scope of Activities
The consultant will work with IM, PMI, the Child Health Task Force (CHTF), and partners on two distinct activities:
Activity 1: Design and conduct an in-depth assessment with the objective of identifying best practices, lessons learned, and key challenges from three countries that have developed sustainable, national-scale iCCM programs. The consultant will propose the three countries covered in the assessment. The final list of three countries will be finalized in consultation with PMI, IM, and the CHTF.
Activity 2: Design and conduct a landscaping of CHW compensation and incentive schemes across multiple countries. The list of countries covered in the landscaping will be developed in consultation with IM, PMI, and the CHTF.
IM will facilitate linkages with all external stakeholders such as PMI, the CHTF, and other key partners. It is expected that both activities will be conducted remotely and will not require consultant travel to the countries included in the methodologies.
Activity 1: Assessment of three sustainable, national-scale iCCM programs
As part of their work on the assessment of three iCCM programs, the consultant will:
Activity 2: Landscaping of CHW compensation and incentive schemes in multiple countries
As part of their work on the landscaping of CHW compensation and incentive schemes, the consultant will:
The consultant will hand over all final tools (eg. questionnaires, reference libraries, etc.) and datasets to IM, as necessary.
This assignment will start as soon as possible and require between three to four months of full- time level of effort from completion of the subcontract until submission of the final deliverables.
What would get us excited?
Applicants will be reviewed on a rolling basis and are encouraged to apply early.
PSI is an Equal Opportunity Employer and encourages applications from qualified individuals regardless of actual or perceived race, religion, colour, sex, age, national origin, disability, sexual orientation, marital status, personal appearance, matriculation, political affiliation, family status or responsibilities, gender identity or expression, pregnancy, childbirth, related medical conditions or breastfeeding, genetic information, amnesty, veteran, special disabled veteran or uniform service member status or employment status.
1 United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), ‘Levels & Trends in Child Mortality: Report 2020, Estimates developed by the United Nations Inter-agency Group for Child Mortality Estimation’, United Nations Children’s Fund, New York, 2020.
2 UNICEF analysis based on WHO and Maternal and Child Epidemiology Estimation Group interim estimates produced in September 2019, applying cause fractions for the year 2017 to United Nations Inter-Agency Group for Child Mortality Estimation estimates for the year 2018
3 WHO 2020. World Malaria Report. 2020
4 Black R et al. Reproductive Maternal, Newborn and Child Health: Key messages from Disease Control Priorities 3rd Edition. Lancet 2016.
5 WHO. WHO guideline on health policy and system support to optimize community health worker programmes. Geneva,
Switzerland: WHO, 2018. https://www.who.int/hrh/resources/health-policy-system-support-hw-programmes/en/ 6 WHO.UNICEF. 2015 Caring for newborns and children in the community. Package of resources. https://www.who.int/maternal_child_adolescent/documents/community-care-newborns-children/en/
7 Young M, Wolfheim C, Marsh D, and Hammamy D. World Health Organization/United Nations Children's Fund Joint Statement on Integrated Community Case Management: An Equity-Focused Strategy to Improve Access to Essential Treatment Services for Children. Am. J. Trop. Med. Hyg. 2012; 87(5 Suppl): 6–10. doi: 10.4269/ajtmh.2012.12-0221.
8 Costello AM and Dalglish SL on behalf of the Strategic Review Study Team. “Towards a Grand Convergence for child survival and health: A strategic review of options for the future building on lessons learnt from IMNCI.” Geneva: WHO, 2016.
9 Source: GF ICCM report, Oct 2018.
10 Institutionalizing integrated community case management (iCCM) to end preventable child deaths: a technical consultation and country action planning, 22-26 July 2019, Addis Ababa. Geneva: World Health Organization and the United Nations Children’s Fund (UNICEF), 2020. Licence: CC BY-NC-SA 3.0 IGO.