Proactive community case management and child survival: protocol for a cluster randomised controlled trial.

Area of Science:

• Global Health
• Public Health Interventions
• Child Survival

Background:

• Community health workers (CHWs) are crucial for improving healthcare access and reducing child mortality.
• National programs using CHW-led integrated community case management (iCCM) have shown limited impact on child mortality.
• Innovative strategies are needed to maximize CHW effectiveness for achieving Sustainable Development Goals (SDGs).

Purpose of the Study:

• To evaluate the impact of proactive, door-to-door case detection by CHWs on under-five mortality in rural Mali.
• To compare the efficacy of proactive CHW home visits against the conventional approach of clinic-based iCCM services.
• To contribute evidence for optimizing CHW-led interventions to reduce child mortality and achieve SDGs.

Main Methods:

• An unblinded, cluster randomized controlled trial in rural Mali.
• Intervention arm: CHWs conduct daily proactive home visits for case-finding, counseling, care, referral, and follow-up.
• Control arm: CHWs provide iCCM services exclusively at fixed community health sites.
• Primary endpoint: Under-five mortality rate per 1000 person-years at risk.

Main Results:

• This is a pre-results abstract; no findings are available yet.
• The trial is ongoing, and results are pending.
• Data collection for the primary endpoint (under-five mortality) is underway.

Conclusions:

• The study will provide crucial data on the effectiveness of proactive CHW home visits for reducing child mortality.
• Findings will inform strategies for enhancing CHW programs to better achieve child survival goals.
• The trial's results are expected to guide policy and practice in global child health initiatives.