{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:59:44Z","timestamp":1790661584008,"version":"4.1.0"},"reference-count":30,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,2]]},"abstract":"<jats:p>We conducted a cluster randomized trial of the effects of the integrated community case management of childhood illness (iCCM) strategy on careseeking for and coverage of correct treatment of suspected pneumonia, diarrhea, and malaria, and mortality among children aged 2\u201359 months in 31 districts of the Oromia region of Ethiopia. We conducted baseline and endline coverage and mortality surveys approximately 2 years apart, and assessed program strength after about 1 year of implementation. Results showed strong iCCM implementation, with iCCM-trained workers providing generally good quality of care. However, few sick children were taken to iCCM providers (average 16 per month). Difference in differences analyses revealed that careseeking for childhood illness was low and similar in both study arms at baseline and endline, and increased only marginally in intervention (22.9\u201325.7%) and comparison (23.3\u201329.3%) areas over the study period (<jats:italic>P<\/jats:italic> = 0.77). Mortality declined at similar rates in both study arms. Ethiopia's iCCM program did not generate levels of demand and utilization sufficient to achieve significant increases in intervention coverage and a resulting acceleration in reductions in child mortality. This evaluation has allowed Ethiopia to strengthen its strategic approaches to increasing population demand and use of iCCM services.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0586","type":"journal-article","created":{"date-parts":[[2016,1,20]],"date-time":"2016-01-20T04:38:13Z","timestamp":1453264693000},"page":"596-604","source":"Crossref","is-referenced-by-count":63,"title":["Effects of the integrated Community Case Management of Childhood Illness Strategy on Child Mortality in Ethiopia: A Cluster Randomized Trial"],"prefix":"10.4269","volume":"94","author":[{"given":"Agbessi","family":"Amouzou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Hazel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan P.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengistu","family":"Tafesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yared","family":"Mekonnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence H.","family":"Moulton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Bryce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Black","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Lancet","first-page":"466","article-title":"Countdown to 2015 and beyond: fulfilling the health agenda for women and children","volume":"385","author":"Requejo","year":"2015"},{"key":"ref2","series-title":"Levels and Trends in Child Mortality: 2014 Report","author":"UN Inter-agency Group for Child Mortality Estimation","year":"2014"},{"key":"ref3","series-title":"Lancet","first-page":"430","article-title":"Global, regional, and national causes of child mortality in 2000\u201313, with projections to inform post-2015 priorities: an updated systematic analysis","volume":"385","author":"Liu","year":"2015"},{"key":"ref4","series-title":"Lancet","first-page":"427","article-title":"Maternal and child undernutrition and overweight in low-income and middle-income countries","volume":"382","author":"Black","year":"2013"},{"key":"ref5","series-title":"Lancet","first-page":"347","article-title":"Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?","volume":"384","author":"Bhutta","year":"2014"},{"key":"ref6","series-title":"Lancet","first-page":"65","article-title":"How many child deaths can we prevent this year?","volume":"362","author":"Jones","year":"2003"},{"key":"ref7","series-title":"Lancet","first-page":"159","article-title":"Reducing child mortality: can public health deliver?","volume":"362","author":"Bryce","year":"2003"},{"key":"ref8","series-title":"Lancet","first-page":"189","article-title":"Every newborn: progress, priorities, and potential beyond survival","volume":"384","author":"Lawn","year":"2014"},{"key":"ref9","series-title":"Integrated Community Case Management (iCCM)","author":"World Health Organization, United Nation Children's Fund","year":"2012"},{"key":"ref10","series-title":"Lancet","first-page":"1331","article-title":"Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition","volume":"380","author":"Chopra","year":"2012"},{"key":"ref11","series-title":"Trop Med Int Health","first-page":"1234","article-title":"Can lay community health workers be trained to use diagnostics to distinguish and treat malaria and pneumonia in children? 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the perspectives and experiences of caregivers","author":"Shaw","year":"2015"},{"issue":"Suppl 3","key":"ref26","series-title":"Ethiop Med J","first-page":"15","article-title":"National scale-up of integrated community case management in rural Ethiopia: implementation and early lessons learned","volume":"52","author":"Legesse","year":"2014"},{"key":"ref27","series-title":"Clin Trials","first-page":"297","article-title":"Covariate-based constrained randomization of group-randomized trials","volume":"1","author":"Moulton","year":"2004"},{"key":"ref28","series-title":"Stata: Release 13","author":"StataCorp","year":"2013"},{"issue":"Suppl 3","key":"ref29","series-title":"Ethiop Med J","first-page":"47","article-title":"Utilization of integrated community case management services in three regions in Ethiopia after two years of implementation","volume":"52","author":"Tadesse","year":"2014"},{"key":"ref30","series-title":"Policy and Practice: Federal Ministry of 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