This publication describes lessons learned in five African cities using community case management of malaria (CCMm) to provide artemesinin-based combination therapy (ACT) for children less than five years of age. This approach is an established route of distribution of anti-malaria drugs in rural areas, but the feasibility and acceptability of the approach in urban areas has not been explored. The study used community medicine distributors (CMDs) and was conducted in Ghana (two cities), and in Burkina Faso, Ethiopia and Malawi. The investigators found that quality of services delivered by CMDs and adherence by caregivers are similar to those seen in rural CCMm settings. The proportion of cases seen by CMDs, however, tended to be lower than was generally seen in rural CCMm. Urban CCMm is feasible, but it struggles against other sources of established healthcare providers. Each country provides specific lessons learned in that environment.
Amuyunzu-Nyamongo, M. Community case management of malaria in urban settings. A feasibility study in five African sites. UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, (2011) 54 pp. ISBN 978 92 4 150269 6