title: Integrated community case management: quality of care and adherence to medication in Beneshangul-Gumuz Region, Ethiopia.
abstract: BACKGROUND
  The International Rescue Committee (IRC) supports implementation of integrated Community Case Management (iCCM) in all 20 woredas (districts) of Benishangul Gumuz Region (BSG) in Ethiopia.
  
  
  OBJECTIVE
  To identify the gaps in the provision of quality iCCM services provided by Health Extension Workers (HEWs) and to assess caregivers' adherence to prescribed medicines for children under five years of age.
  
  
  METHODS
  We conducted a cross-sectional descriptive study with both quantitative and qualitative study methods. We interviewed 233 HEWs and 384 caregivers, reviewed HEW records of 1,082 cases, and organized eight focus groups.
  
  
  RESULTS
  Most cases (98%) seen by HEWs were children 2-59 months old, and 85% of the HEWs did not see any sick young infant. The HEWs' knowledge on assessments and classification and need for referral of cases was above 80%. However; some reported challenges, especially in carrying out assessment correctly and not checking for danger signs. Over 90% of caretakers reported compliance with HEWs' prescription.
  
  
  CONCLUSIONS
  Partners have successfully deployed trained HEWs who can deliver iCCM according to protocol; however, additional support is needed to assure a supply of medicines and to mobilize demand for services, especially for young infants.
authors.forename: Robinah
authors.initials: R
authors.lastname: Najjemba
authors.forename: Lilian
authors.initials: L
authors.lastname: Kiapi
authors.forename: Shiferaw Dechasa
authors.initials: SD
authors.lastname: Demissie
authors.forename: Tadesse
authors.initials: T
authors.lastname: Gossaye
authors.forename: Mezgebu
authors.initials: M
authors.lastname: Engida
authors.forename: Ruwan
authors.initials: R
authors.lastname: Ratnayake
authors.forename: Tedbabe
authors.initials: T
authors.lastname: Degefie
authors.forename: Hailemariam
authors.initials: H
authors.lastname: Legesse
authors.forename: Ataklti Fisseha
authors.initials: AF
authors.lastname: Lemma
authors.forename: Hiwot
authors.initials: H
authors.lastname: Getachew
authors.forename: Muluken
authors.initials: M
authors.lastname: Gebrie
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use; D017028:Caregivers; D019090:Case Management / Q000592:standards*; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D003153:Community Health Services / Q000592:standards*; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated; D003967:Diarrhea / Q000188:drug therapy; D005002:Ethiopia; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000188:drug therapy; D008297:Male; D011014:Pneumonia / Q000188:drug therapy; D011787:Quality of Health Care; D015532:Rehydration Solutions / Q000627:therapeutic use; D016903:Drug Monitoring
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials; D015532:Rehydration Solutions