Thematic areas and complexity of integrated community case management (iCCM) design, implementation, and evaluation: protocol for a scoping review

Abstract

Background Integrated community case management (iCCM) is a community-based child health strategy designed to reduce deaths due to pneumonia, malaria, and diarrhea in low-income countries. Due to the integrated nature of the intervention and the diversity of its stakeholders and activities, iCCM is complex and comprises many systems elements. However, the extent to which studies examine these different elements is unknown. The purpose of this scoping review is to summarize the key areas of emphasis of the iCCM literature and assess the extent to which this takes into account systems complexity. Methods This study will be guided by Arksey and O’Malley’s scoping review methodology. We will systematically screen MEDLINE, Web of Science, and the specialized platform Community Case Management (CCM) Central Library for published literature in English related to the design, implementation, and evaluation of iCCM. Two investigators will independently screen the full list of titles and abstracts for eligibility, followed by a full-text review of selected titles divided between investigators. Emergent themes will be categorized according to a thematic tool iteratively developed to guide the charting and analysis process. To compare the extent to which the literature assesses systems factors, we will compare our results with the iCCM Interagency Framework. We will use the Intervention Complexity Tool for Systematic Reviews (iCAT_SR) to assess how literature measures complexity. Results will be presented in narrative fashion, supplemented by interactive graphical interfaces. Discussion The results of this scoping review will identify the priorities and deficiencies of the analysis and evaluation of iCCM programs and may illustrate the need for systems approaches. Bottom-up emergent iCCM themes can help researchers, policymakers, and implementers target and better emphasize true priorities of iCCM. Understanding how complexity is considered and examined in iCCM may result in greater attention to this critical dimension of iCCM program assessment, resulting in the design and development of more robust and sustainable iCCM programs.

Building power-ful health systems: the impacts of electrification on health outcomes in LMICs

“…The majority of RMNCH deaths remain preventable or treatable (WHO, 2022) -the results echo this sentiment. Integrated health services are highly effective in reaching women and children in rural communities (Karim et al, 2020;Diaz et al, 2014). The results highlight that RMNCH services are the first to improve with electrification, reflecting its role in facilitating integrated service packages.…”

The building blocks of community health systems: a systems framework for the design, implementation and evaluation of iCCM programs and community-based interventions

“…We assessed publications against prescribed inclusion criteria in two stages. 19 In the first stage, we screened titles and abstracts; remaining articles were read in their entirety in the second stage. The search and subsequent application of inclusion criteria were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method for scoping reviews.…”

“…This was supplemented by a document review of selected country iCCM policy and publicly available program documents. The methods and criteria for this scoping review can be found elsewhere 19. As the domain charting process was part of the methodological approach to the development of the framework, results of the literature search are presented in this section.…”

“…We assessed publications against prescribed inclusion criteria in two stages 19. In the first stage, we screened titles and abstracts; remaining articles were read in their entirety in the second stage.…”