title: Community acceptability and adoption of integrated community case management in Uganda.
abstract: Integrated community case management (iCCM) is a recommended strategy to curb child mortality. Drawing on diffusion of innovations (DOIs), the acceptability and adoption of iCCM were qualitatively explored. Data from focus group discussions and interviews with community members, community health workers (CHWs), and supervisors conducted in seven communities were analyzed using content analysis. Perceived relative advantage and compatibility of the program with sociocultural beliefs and healthcare expectations of the communities positively affected acceptability and adoption of iCCM. The degree of stringency, quality, and cost of access to healthcare were crucial to adoption. Failure of the health system to secure regular drug supplies, monetary support, and safe referrals globally hindered adoption. Individual CHW characteristics like undesired behavior, demotivation, and lack of reciprocated trust deterred adoption in some areas. Optimal functioning of iCCM programs will require community sensitization and targeted health systems strengthening to enhance observable program benefits like reduced child mortality.
authors.forename: Agnes
authors.initials: A
authors.lastname: Nanyonjo
authors.forename: Maureen
authors.initials: M
authors.lastname: Nakirunda
authors.forename: Frederick
authors.initials: F
authors.lastname: Makumbi
authors.forename: Göran
authors.initials: G
authors.lastname: Tomson
authors.forename: Karin
authors.initials: K
authors.lastname: Källander
authors.lastname: The inSCALE Study Group
mesh_terms: D000293:Adolescent; D000328:Adult; D019090:Case Management / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D003150:Community Health Workers; D003469:Culture; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005069:Evaluation Studies as Topic; D005260:Female; D017144:Focus Groups; D006268:Health Facilities; D006297:Health Services Accessibility; D006801:Humans; D008288:Malaria / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014454:Uganda; D055815:Young Adult