Malawi integrated community case management

  • Implemented in all 28 districts of the country
  • Currently 9,776 Health Surveillance Assistants (HSAs), of which 3,746 have been trained in iCCM
    • 3,330 (88.9%) are running functional village clinics for the treatment of malaria
    • 1 HSA per 1,000 people
  • Scale-up plan to reduce the radius from 8 km to 5 km from a health facility
    • Will require 1,600 additional HSAs 
  • Rectal artesunate recommended as the pre-referral intervention for severe malaria at the community level
    • Funding requested for 3 years of refresher training to implement changes


  • Attrition of staff

  • Health Surveillance Assistants (HSAs) not residing in their catchment areas

  • Training, supervision and mentorship for HSAs 

  • Difficulty capturing data from integrated community case management through HSAs