title: Setting global research priorities for integrated community case management (iCCM): Results from a CHNRI (Child Health and Nutrition Research Initiative) exercise.
abstract: OBJECTIVE
  To systematically identify global research gaps and resource priorities for integrated community case management (iCCM).
  
  
  METHODS
  An iCCM Child Health and Nutrition Research Initiative (CHNRI) Advisory Group, in collaboration with the Community Case Management Operational Research Group (CCM ORG) identified experts to participate in a CHNRI research priority setting exercise. These experts generated and systematically ranked research questions for iCCM. Research questions were ranked using a "Research Priority Score" (RPS) and the "Average Expert Agreement" (AEA) was calculated for every question. Our groups of experts were comprised of both individuals working in Ministries of Health or Non Governmental Organizations (NGOs) in low- and middle-income countries (LMICs) and individuals working in high-income countries (HICs) in academia or NGO headquarters. A Spearman's Rho was calculated to determine the correlation between the two groups' research questions' ranks.
  
  
  RESULTS
  The overall RPS ranged from 64.58 to 89.31, with a median score of 81.43. AEA scores ranged from 0.54 to 0.86. Research questions involving increasing the uptake of iCCM services, research questions concerning the motivation, retention, training and supervision of Community Health Workers (CHWs) and concerning adding additional responsibilities including counselling for infant and young child feeding (IYCF) and treatment of severe acute malnutrition (SAM) ranked highly. There was weak to moderate, statistically significant, correlation between scores by representatives of high-income countries and those working in-country or regionally (Spearman's ρ = 0.35034, P < 0.01).
  
  
  CONCLUSIONS
  Operational research to determine optimal training, supervision and modes of motivation and retention for the CHW is vital for improving iCCM, globally, as is research to motivate caregivers to take advantage of iCCM services. Experts working in-country or regionally in LMICs prioritized different research questions than those working in organization headquarters in HICs. Further exploration is needed to determine the nature of this divergence.
authors.affiliation: Centre for Global Child Health, the Hospital for Sick Children, Toronto, Canada.
authors.forename: Kerri
authors.initials: K
authors.lastname: Wazny
authors.affiliation: Save the Children, Fairfield, CT, USA.
authors.forename: Salim
authors.initials: S
authors.lastname: Sadruddin
authors.affiliation: Programme for Global Paediatric Research, the Hospital for Sick Children, Toronto, Canada.
authors.forename: Alvin
authors.initials: A
authors.lastname: Zipursky
authors.affiliation: Zambia Center for Applied Health Research and Development, Lusaka, Zambia ; Center for Global Health and Development, Boston University, Boston, MA, USA ; Department of International Health, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
authors.affiliation: Global Health Bureau, United States Agency for International Development, Washington DC, USA.
authors.forename: Troy
authors.initials: T
authors.lastname: Jacobs
authors.affiliation: Malaria Consortium, London, UK ; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden ; Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Karin
authors.initials: K
authors.lastname: Kallander
authors.affiliation: Global Malaria Programme, World Health Organization, Geneva, Switzerland.
authors.forename: Franco
authors.initials: F
authors.lastname: Pagnoni
authors.affiliation: Makerere University School of Public Health, Kampala, Uganda ; International Women's and Children's Health, Uppsala University, Sweden ; Global Health, Karolinska Institutet, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Peterson
authors.affiliation: Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland.
authors.forename: Shamim
authors.initials: S
authors.lastname: Qazi
authors.affiliation: John Snow, Inc., Washington DC, USA ; Maternal and Child Health Integrated Project (MCHIP), Washington, DC, USA.
authors.forename: Serge
authors.initials: S
authors.lastname: Raharison
authors.affiliation: John Snow, Inc., Washington DC, USA ; Maternal and Child Health Integrated Project (MCHIP), Washington, DC, USA.
authors.forename: Kerry
authors.initials: K
authors.lastname: Ross
authors.affiliation: Programme Division, United Nations Children's Fund, New York, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Young
authors.affiliation: Save the Children, Fairfield, CT, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Marsh