Nigeria community case management

Community Health Systems:

  • The framework for community health system is still being developed and needs to be expanded. It is an effective system but with low reach (Global Fund Concept Note)
  • Community Based Organizations (CBOs) provide community based prevention, sensitization & mobilization, demand creation, care and support, refer and follow up on cases

  • Coordinated by the Lead NGOs at the zonal level, who are attached to private and secondary health facilities

  • Role Model Mothers used for increased access to commodities, increased active referrals and escorting clients to PHCs and secondary facilities.

Community Case Management

  • NMEP policy supports the use of pre-referral rectal artesunate at a community or peripheral health facility level.



  • Funding (often not costed and included in appropriations)

  • Interventions often not adjusted to fit peculiarities of communities (diverse cultural, social and religious set ups)

  • Cultural and operational barriers such as a lack of referral linkages to the formal health system, limited availability of rectal artesunate, and poor supervision and reporting have prevented implementation


  • The National Malaria Elimination Programme (NMEP) intends to expand access to malaria case management through iCCM (implemented in Nigeria since 2014)
  • This will be led by the Child Health Division
  • Delay in starting and the challenge of commodities


  • The Canadian International Development Agency supports implementation of iCCM in two states (Abia and Niger State) as part of the WHO Rapid Access Expansion (RACE) Programme
  • The Global Fund supports the rollout of the malaria component in the remaining 21 Local Government Areas (LGAs) in Niger State
  • WHO funds the additional non-malaria commodities
  • ICF-International provides semi-annual data quality assessments to the project
  • USAID-Nigeria, through maternal, neonatal and child health funding, is implementing national-level advocacy support to the Federal Ministry of Health, and landscaping the different models of community-level case management to determine a sustainable model for Nigeria
  • PMI will implement iCCM in PMI supported states.