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iNSCALE
Overall the iNSCALE project aims to increase coverage of integrated community case management (iCCM) in two countries (Uganda and Mozambique) with community based agents (CBAs) tha...ver maisOverall the iNSCALE project aims to increase coverage of integrated community case management (iCCM) in two countries (Uganda and Mozambique) with community based agents (CBAs) that perform optimally (i.e. performance) and who remain functional over longer periods of time (i.e. retention). The main challenges that currently limit coverage of iCCM in terms of its geographical distribution and quality will be identified and documented. Already, experiences indicate that CBA supervision and motivation are critical constraints that limit coverage of community-based delivery of health care. Our experience suggests that proper collection, flow and use of data between CBAs and the health system is another major challenge that hinders optimal implementation. Solutions to three main constraint areas i.e. i) supervision, ii) motivation and, iii) information flow and use will be identified and evaluated. Solutions will be formulated based on current knowledge and experiences from implementation of relevant community-based initiatives in both countries and elsewhere. These solutions will be categorized as innovations in i) supervision, ii) motivation and, iii) monitoring and evaluation. Important innovations that have potential to address the project’s aims but lack sufficient evidence of impact will be formally evaluated through a randomized controlled trail (RCT). The formulation of the innovations will be grounded in theoretical evidence of mechanisms that promote health worker performance and retention through job satisfaction and motivation. The health system and social context in which the innovations are inter-linked and operational will be appreciated using a conceptual framework which will be iteratively improved from experiences from this work and, results from the formative research and evaluations.ver menos