Lessons and considerations from the Integrated Community Case Management ‘Plus’ (ICCM+) Pilot

This case study is part of a compendium of country-level case studies produced by the Delivery System for Scale project that explore promising, context-specific approaches to scale the management of wasting treatment for children under five. In Somalia, Save the Children, in partnership with DesignHealth and the Somaliland Ministry of Health and Development piloted the integrated community case management “plus” (ICCM+) approach – representing the first-known operational implementation of ICCM+ model in the Horn of Africa region and in Somalia, in particular. The pilot provided for community-level treatment of acute malnutrition via female health workers (FHWs), with the expectation that the approach would increase screening and earlier admissions, leading to both improved nutrition outcomes and coverage in hard-to- reach areas. Learning from the pilot is timely, in light of new recommendations in the World Health Organization’s (WHO) guidelines on the prevention and management of wasting and nutritional oedema in infants and children under 5 years. This case study, therefore, outlines the ICCM+ pilot in Somalia, highlights key lessons learned, and details those considerations that should be kept in mind when considering adopting the approach moving forward.