Iccm Me Plan

MINISTRY OF HEALTH
INTEGRATED COMMUNITY
CASE MANAGEMENT (iCCM),
2013 – 2018
MONITORING AND EVALUATION PLAN
AUGUST 2013 EDITION

Foreword
The Government of Kenya is committed to the achievement of national, regional and international
targets, including the Millennium Development Goals (MDGs), to improve maternal, newborn
and child health and development indicators. Globally, most deaths in children are caused by
preventable and easily treated diseases, namely pneumonia (18%), diarrhea (11%), malaria (7%)
and newborn related conditions (pre-term birth complications – 14% and, intrapartum related
complications - 9%).
It is estimated that in 2011, a total of 188,928 children under-five died in Kenya, and out of these,
21% deaths were caused by diarrhoea, 11% by malaria and (16%) by pneumonia. Neonatal
deaths account for approximately 60% of the infant mortality in Kenya, as per the 2008/09
Kenya Demographic Health Survey (KDHS). Appropriate management of diarrhea, malaria, and
pneumonia is one of the most cost effective interventions towards the reduction of the global
burden of disease. There exist evidence-based high-impact interventions that can ensure a
visible impact on reduction of childhood mortality.
The Integrated Community Case Management (iCCM) implementation plan presents a platform
for acceleration of the control and management of childhood diarrhoea, malaria, pneumonia,
neonatal mortality and malnutrition at the community level, thus contributing to the attainment
of the MDG 4 by reducing significantly mortality attributed to the five conditions. The iCCM
implementation plan addresses key areas including policy, coordination, case management,
commodity logistics, advocacy, communication and social mobilization and monitoring and
evaluation (M&E).
The iCCM M&E plan seeks to guide the tracking of the overall rollout of the national iCCM
strategy. The plan will establish a well-coordinated, harmonized monitoring, evaluation and
operational research system for iCCM that provides timely and accurate strategic information
to guide the planning of iCCM implementation. The plan will feed into the existing Community
Heath Strategy (CHS) M&E framework.
All stakeholders are urged to utilize this M&E plan to facilitate monitoring of the implementation
process and the evaluation of effectiveness of iCCM towards improving access and quality of
services at community level, where these services are most needed.
It is our sincere hope that implementation of this five-year plan, alongside other areas covered
in the Community Health Strategy, will go a long way in reducing child morbidity and mortality
in Kenya.
Dr. S. K. Sharif, MBS, MBChB, MMed, DLSHTM, MSc. Dr. Francis Kimani,
Director of Public Health Director of Medical Services
and Sanitation
3
Acknowledgments
The Ministry Of Health (MOH) wishes to thank all those organizations and individuals
who contributed to the development and completion of the integrated Community Case
Management (iCCM) national framework and plan of action and a Monitoring and evaluation
(M&E) plan that guides the tracking of its implementation.
We wish to pay special tribute to the Department of Family Health; Head DCAH, Dr. Stewart
Kabaka; and Dr. Deborah Okumu for their exemplary leadership during the process. The Ministry
also makes note of the special contributions made by Dr. David Soti, Head Division of Malaria
Control; Dr. David Mwitari, Head Division of Community Health Services; and Dr. Bernard
Muia, Deputy Head Division of Health Promotion. We specifically acknowledge the critical
contributions of Dr Santau Migiro, formerly Head of DCAH and her Deputy, Dr Khadija Ahmed,
for their exceptional support during policy advocacy for iCCM strategy.
We wish to laud the collaboration involving Division of Community Health Services (DCHS),
Department of Health Promotion (DHP), Department of Pharmacy (DOP), Division of Malaria
Control (MOPHS), Division of Vaccines & Immunization (DVI), Division of Nutrition (DON) and
Kenya Medical Supply Agency (KEMSA).
Special thanks go to UNICEF, WHO and USAID MCHIP for their financial and technical support.
We extend our gratitude to the Lead Consultants, Dr. Vincent Orinda (UNICEF) and Dr. Laban
Tsuma (USAID MCHIP) and Dr Tanya Guenther (USAID MCHIP) who provided technical facilitation
during development of this document. We also acknowledge technical support from Dr. Savitha
Subramanian (USAID MCHIP), Dr. Dan Otieno (USAID MCHIP), Dr. Mark Kabue (JHPIEGO) and Dr.
Peter Okoth (UNICEF Kenya Country Office).
We thank the following partners who offered invaluable inputs during the process: Micro
Nutrient Initiative, PATH, PSI, Save the Children UK, Kenya Red Cross Society, KEMRI, PATH, JSI/
SC4CCM, AMREF, APHIAPLUS Zone 1, JHPIEGO and World Vision Kenya.
We specifically thank the strong secretariat consisting of Lydia Karimurio (DCAH), Dr Deborah
Okumu (DCAH), Ruth Ngechu (DCHS), Eunice Ndungu (UNICEF), Dr Elizabeth Ogaja (MOMS),
Gichohi Mwangi (KEMSA), Charles Matanda (DCAH), Julius Kimitei (DOMC), Isabella Ndwiga
(DHP), James Njiru (DON), Dr Dan Otieno and Dr Mark Kabue (Jhpiego).
Dr Annah Wamae, OGW

Head, Department of Family Health,
Ministry of Health
4
Table of Contents
ABBREVIATIONS 7
1. INTRODUCTION 11
1.1 Background of the M&E Plan 11
1.2 Goals and Objectives of the iCCM M&E Plan 11
2. NATIONAL ICCM FRAMEWORK AND PLAN FOR ACTION 13
3. INDICATORS 14
4. DATA COLLECTION METHODS 17
4.1 Routine data collection: 17
4.2 Periodic/survey data collection: 18
4.3 Complementary Methods: 19
5. IMPLEMENTATION OF M&E FOR iCCM 20
5.1 Coordination of iCCM M&E Plan 20
5.2 Monitoring of the iCCM program 20
5.3 Data flow 22
5.4 Data quality assurance 23
5.5 Evaluation plan 23
5.6 Implementation Capacity 25
5.7 Operations/Implementation research and special studies 26
5.8 Dissemination and Use 27
5.9 Detailed M&E Action Plan and Resources 28
5.10 Review of the M&E plan 28
5
ANNEX 1: NATIONAL iCCM INDICATORS 29
ANNEX 2: CHW PERFORMANCE MATRIX 39
ANNEX 3A: CHEW MONTHLY SUMMARY WITH ICCM INDICATORS 41
ANNEXT 3B: SUPPORT SUPERVISION CHECKLIST FOR SUB COUNTY

LEVEL SUPERVISION TO LEVEL 1 (COMMUNITY) 42
ANNEX 4: CHEW SUPERVISION CHECKLIST 49
ANNEX 5: CHW REFERRAL FORM 52
ANNEX 6: SICK CHILD RECORDING FORM 53
ANNEX 7A: CHW TREATMENT & TRACKING REGISTER 54
ANNEX 7B: CHEW iCCM Monthly Summary form 55
ANNEX 8: CHW INVENTORY CARD 56
ANNEX 9: CHEW REQUISITION, ISSUE AND RECEIPT VOUCHER 57
ANNEX 10: STOCK CONTROL CARD 58
ANNEX 11: CHEW RE-SUPPLY REGISTER 59
ANNEX 12: COMMUNITY NEWBORN CHECKLIST 60
ANNEX 13: LIST OF CONTRIBUTORS 61
REFERENCES 63
6
ABBREVIATIONS
ACT Artemisinin-based combination therapy
AL Artemether-lumefantrine
AMREF Africa Medical and Research Foundation
APHIAPLUS Aids, Population and Health Integrated Assistance Plus
CCM Community case management
CDF Constituency Development Fund
CHEW Community Health Extension Worker
CHIS Community Health Information System
CHW Community Health Worker
CU Community Unit
DCAH Division of Child and Adolesent Health
DCHS Division of Community Health Services
DHIS District Health Information System
DHMT District Health Management Team
DHP Division of Health Promotion
DOMC Division of Malaria Control
DON Division of Nutrition
FGD Focus Group Discussion
GoK Government of Kenya
HMIS Health Management Information System
HRIO Health Records Information Officer
HSSF Health Sector Services Fund
iCCM Integrated Community Case Management
IMCI Integrated Management of Childhood Illness
IMR Infant Mortality Rate
ITN Insecticide treated nets
IYCN Infant and Young Child Nutrition
JSI John Snow Inc.
KAP Knowledge Attitudes and Practices
KEMRI Kenya Medical Research Institute
KEMSA Kenya Medical Supply Agency
KHDS Kenya Health Demographic Survey
7
KRCS Kenya Red Cross Society
KSPA Kenya Service Provision Assessment
LLITN Long Lasting Insecticide Treated Net
LMIS Logistics Management Information System
LQAS Lot Quality Assuarance Sampling
MCHIP Maternal and Child Health Integrated Program
M&E Monitoring and Evaluation
MDG Millennium Development Goal
MICS Multiple Indicator Cluster Survey
MIS Malaria Indicator Survey
MOH Ministry of Health
MOMS Ministry of Medical Services
MOPHS Ministry of Public Health and Sanitation
MUAC Mid Upper Arm Circumference
NHIF National Hospital Insurance Fund
NHSSP National Health Sector Strategic Plan
ORS Oral Rehydration Salt
ORT Oral Rehydration Therapy
PHC Primary Health Care
RDT Rapid diagnostic tests
RDQA Rapid Data Quality Assesment
RUTF Ready-to-use therapeutic food
SCUK Save the Children United Kingdom
TWG Technical Working Group
UNICEF United Nations Children’s Fund
USAID Unites States Agency for International Development
WHO World Health Organisation
8
List of Tables
Table 1: List of Implementation Strength Indicators 15
Table 2: Selected Routine Indicators 15
Table 3: List of Periodic Indicators 16
Table 4: List of National Milestone Indicators 16
Table 5: Overview of Tools Used For Routine Data Collection 17
Table 6: Overview of Periodic Data Sources 18
Table 7: Overview of Complementary Data Sources 19
Table 8: Overview of Implementation Strength Indicators, Targets and

Required Data Elements 21
Table 9: Overview of Data Flow, Roles and Responsibilities and Forms

by System Level 22
Table 10: Outcome Indicators for iCCM and Targets 24
Table 11: Evaluation Questions and Data Collection Methods 25
Table 12: Priority Implementation Research Questions for iCCM in Kenya 27
9
10
S E C T ION
1 INTRODUCTION
1.1 Background of the M&E Plan

The Division of Child and Adolescent Health services, in partnership with a wide range of
stakeholders, developed the M&E Plan to coordinate stakeholders towards one agreed country-
level monitoring and evaluation system for integrated Community Case Management (iCCM)
for the period 2013 - 2018.
The process of developing the iCCM M&E plan was participatory through wide consultations
with a wide range of stakeholders at community, district, provincial and national levels – which
were the existing structures at the time this plan was developed. The process involved holding
a series of workshop and consensus meetings to ensure that iCCM is grounded in the existing
health delivery structures, bearing in mind the devolution of the governance and health systems
to the county level that was to start in 2013.
The iCCM M&E plan seeks to establish a well-coordinated, harmonized monitoring, evaluation
and operational research system for iCCM that provides timely and accurate strategic information
to guide the planning of the iCCM implementation in Kenya. The plan will feed into the
existing CHS M&E framework. Furthermore, the plan will help in tracking the implementation
of programmatic objectives through provision of regular data to assist in evidence-based
planning. Key intended users of this document include the DCAH and Division of Community
Health Services (DCHS) in the Ministry of Health programme managers and others involved in
planning and implementing iCCM, and development partners.
1.2 Goals and Objectives of the iCCM M&E Plan

The goal of the national iCCM M&E plan is to monitor the overall rollout of the national iCCM
strategy. This strategy was developed to contribute to the reduction of morbidity and mortality
among children under-5 by providing quality community case management for malaria,
pneumonia, diarrhea and malnutrition, identification and referring of sick newborns. The plan
will guide the measurement of achievement, implementation as well as preserving institutional
memory.
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Specific Objectives of the M&E Plan:
1. To monitor the implementation and adaption of the specific components of the
national iCCM.
2. To monitor the rollout and scaling up of iCCM across Kenya
3. To monitor the quality of implementation of the different components of iCCM
4. To monitor the extent to which the national iCCM program is achieving targets that have
been set in the overall iCCM implementation
5. To periodically measure the coverage of the iCCM across the different stages of scaling up
6. To evaluate the impact of the iCCM in improving coverage of prompt and appropriate
treatment among children under five for the childhood illness as defined by iCCM
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S E C T ION
2
NATIONAL ICCM
FRAMEWORK AND
PLAN FOR ACTION
Kenya adopted a Community Health Strategy (CHS) (MOH, 2007) as the overarching approach to
health promotion in communities in line with the primary health care principles. The strategy is a
flagship project aimed towards the attainment of Vision 2030 and the Millennium Development
Goals (MDGs). It was initiated in 2006 based on the second National Health Sector Strategic Plan
(NHSSP II), which aimed at reversing the decline in the health status of Kenyans through shifting
the emphasis from a disease-centered approach to the promotion of individual and community
health.
iCCM is a proven evidence-based strategy that trains, equips and supports various cadres of
community health providers to deliver high-impact treatment interventions in the community.
It is an important component of Integrated Management of Childhood Illness (IMCI), which
was developed by WHO in the 1990s. It builds upon progress made and lessons learnt in
the implementation of community IMCI and aims to augment health facility based case
management.
The vision of the iCCM operational strategy is a Kenya where communities have zero tolerance for
preventable deaths of children. A national framework and plan of action for the implementation
of iCCM in Kenya has been developed to present a platform for acceleration of the control and
management of childhood diarrhoea, malaria, pneumonia, neonatal mortality and malnutrition
at the community level, thus contributing to the attainment of the MDG 4. It is anchored on
the Ministry of Health (MOH) Community Health Strategy and Child Survival and Development
Strategy as well as the Policy Guidelines on Control and Management of Diarrhoeal Diseases in
Children below five years.
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S E C T ION
3 INDICATORS
The iCCM M&E plan has 29 indicators. The full performance matrix for these indicators is presented
in Annex 1. There are eight components, as per the global iCCM benchmark framework under
which iCCM will be assessed. The components are: (i) policy and coordination, (ii) costing and
financing, (iii) human resources, (iv) supply chain management, (v) service delivery and referral,
(vi) communication and social mobilization, (vii) supervision and quality assurance, and (viii)
M&E and Health Management Information System. A sub-set of the iCCM indicators have been
included in the CHS M&E framework to ensure integration with the overall CHS strategy. These
are outlined in Annex 2 (CHW perfomance matrix).
The iCCM indicators can be divided into several categories to measure the different aspects of
the national iCCM program. These include:
i. Indicators of implementation strength. Implementation strength indicators are routine
indicators that measure the critical program processes and outputs. They also help interpret
results’ indicators (e.g., utilization or coverage) by showing the “strength” of the program
that is received as in a “dose-response relationship. The Catalytic Initiative (CI) has outlined
generic indicators for five core elements in three supply side domains (human resources,
commodities and quality of care) based on the minimum requirements for service delivery (a
trained health worker is available and accessible to the population, equipped with required
supplies, and regularly supervised and supported). These were reviewed and adapted for
the Kenyan context, and additional indicators included capturing service delivery.
Table 1, in the next page lists the implementation strength indicators for the supply side domains
and additional indicators which have been adapted for Kenya.
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Table 1: List of Implementation Strength Indicators
Domain iCCM Indicator

Human Resources • Proportion of CHW/CHEWs targeted for iCCM who are trained in iCCM
• Proportion of CHWs trained in iCCM who are providing iCCM services
Commodities • Proportion of link facilities that had no stock out of recommended medicine and
diagnostics during the day of assessment visit or last day of reporting period
• Proportion of CU who had no stock out of recommended medicine and diagnostics
during the day of assessment visit or last day of reporting period
Quality of Care • Proportion of iCCM trained CHWs/CHEWs who received at least one administrative
supervisory contact in the prior three months during which registers and/or reports were
reviewed
• Proportion of iCCM trained CHWs/CHEWs who received at least one supervisory
contact during the prior three months where a sick child visit or scenario was assessed
and coaching was provided
Service Delivery and • Number of iCCM conditions managed by CHWs per 1,000 children under five in target
Referral areas in a given time period (quarterly/annually) (reported by condition)
• Proportion of newborns who received a home visit from a CHW within 48 hours
of delivery
ii. Indicators that can be potentially collected routinely, but through systems other than
the Community Health Information System (CHIS): CHIS is part of the district health
information system (DHIS). Since it may be difficult to add a longer list to the existing CHIS,
other methods could include rapid, small scale CHW surveys using Lot Quality Assurance
Sampling (LQAS) approaches.
Table 2: Selected Routine Indicators
Component iCCM Indicator
Service Delivery and Proportion of children with fever who are tested with RDTs at community level (where RDTs
Referral are part of the package)
Proportion of CHWs whose registers show completeness and consistency between
classification and treatment
Supervision and Proportion of CHWs who correctly classify malnourished children using MUAC
Quality Assurance Proportion of CHWs who correctly count respiratory rate
M&E and HMIS Proportion of counties/sub-counties reporting iCCM data on time and completely
iii. Indicators that can be collected periodically through surveys or special studies. These
indicators can be used to periodically assess specific components of implementation and
complement the routinely collected indicators listed above. Table 3 lists some of thyese
indicators. They can be incorporated into existing periodic surveys such as DHS, Multi
Indicator Cluster Survey (MICS), or can be captured through special survey/studies that
are developed for evaluating the implementation of iCCM. Some indicators on quality of
care (e.g. correct case management observed) require resource intensive special studies
involving direct observation of CHWs with clinical re-examination.
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Table 3: List of Periodic Indicators
Component iCCM indicator

Service Delivery and • Percentage of sick children who received timely and appropriate treatment according to
Referral iCCM guidelines
• Proportion of sick children under five in iCCM target areas taken to iCCM-trained CHWs as
first source of care
• Number and proportion of cases followed up after receiving treatment from CHW
according to iCCM guidelines
• Proportion of sick children recommended for referral who are received at the referral
facility
Communication and • Proportion of caregivers in target areas who know the presence and role of their CHW.
Social Mobilization • Proportion of caregivers who know two or more signs of childhood illness that require
immediate assessment and treatment, if appropriate
Supervision and • Proportion of CHWs who demonstrate correct knowledge of management of sick child
Quality Assurance case scenarios
• Proportion of CHWs who demonstrate correct case management of a sick child under
direct observation with clinical re-examination
• Proportion of caregivers whose children received treatment from a CHW who were
provided proper counseling
iv. Indicators that represent national level milestones: These indicators are qualitative and
can be used to periodically assess progress towards an enabling environment for iCCM.
(Refer to Table 4 below)
Table 4: List of National Milestone Indicators
Component iCCM indicator

Policy and • iCCM is incorporated into national MNCH policy/guideline(s) to allow CHWs to give:
coordination • low osmolarity ORS and zinc supplements for diarrhoea
• antibiotics for pneumonia
• ACTs (and RDTs, where appropriate) for fever/malaria in malaria-endemic counties
• An iCCM stakeholder coordination group, working group or task force, led by the MOH and
including key stakeholders, exists and meets regularly to coordinate iCCM activities.
• List of iCCM partners, activities and locations available and up to date
Costing and • A costed operational plan for iCCM exists (or is part of a broader health operational plan) and is
Financing updated annually.
• Percentage of the total annual iCCM budget which comes from Kenyan government funding sources
M&E and HMIS • Existence of a comprehensive, integrated monitoring and evaluation (M&E) plan for iCCM
• One or more indicators of community-based treatment for diarrhoea, pneumonia and/or malaria are
included in the national HMIS system
The main data collection methods required to capture the iCCM indicators include:
a) routine sources (such as HMIS, project reports, government databases, supervision reports, etc);
b) periodic surveys such as household surveys, health facility assessments and CHW surveys; and
c) other complementary methods (special studies, document reviews, key informant interviews, etc).
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S E C T ION
4
DATA COLLECTION
METHODS
The three categories of data collection processes are described in this section:
4.1 Routine Data Collection

The routine indicators for iCCM can be collected through the CHW treatment and tracking
register, CHW household register (MOH 513), CHEW supervision checklist and CHEW stock
records. They are summarized by the monthly CHEW report (MOH 515), which is entered into
the national CHIS/DHIS system. Other important sources of routine information include the
DHMT supervision checklist and government databases on training. The information collected
by these key tools is summarized in Table 5.
Table 5: Overview of Tools Used For Routine Data Collection
Tool Information that can be collected

CHW iCCM Treatment and Tracking • Captures information on sick child cases seen, treated and referred and
Register on follow-up and outcomes. Also records amount of each commodity
distributed. Data are summarized in the CHW report, which is then
aggregated by the CHEW in the iCCM CHEW monthly report.
CHIS Household Register • Records data on household demographics that can be used to calculate
(MOH 513) the denominator for the routinely collected service delivery iCCM
indicators. It is filled out by CHWs every six months and reported to
CHEWs.
CHW Log Book • Collects information on daily CHW activities conducted as part of
(MOH 514) household visits. The Log Book is to be updated daily and submitted
monthly by CHWs to CHEWs for summary.
CHEW Monthly Report • Summarizes data for the community unit in terms of service delivery
(MOH 515) (cases treated, referred, etc) and supervision and the main input into the
CHIS/DHIS
CHEW Supervision Checklist • Collects data on supervision of CHWs covering the full CHS package,
including availability of medicines and supplies, record keeping,
knowledge. Data related to indicators can be summarized on the CHEW
monthly report and thus available through the CHIS/DHIS
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Tool Information that can be collected
CHEW Commodity Registers • Collects data on receipt and consumption of CHS commodities, including
those for iCCM.
CHEW Summary for CHW Treatment • Summarises data collected by CHWs on treatment of children and
and Tracking Register consumption of CHS commodities, including those for iCCM.
DHMT Support Supervision Tool • Collects information on community units through interviews with CHEW.
This is collected quarterly.
SCHMT Training Inventory • Collects data on the training provided to CHEWs; It needs to be updated
to reflect iCCM human resource training status
Resource Database on Community • Collects data on the training provided to CHWs; needs to be updated to
Health Program (to Assess CHW reflect iCCM human resource training status
Training)
Other Logistics, Supply Chain Tools: • These are logistic and supply tools which allow the CHW and CHEW to
CHW Inventory control card; CHEW keep track of the medicinal and diagnostic products they are using on sick
Stock control card; CHEW requisition, children.
Issue and Order Voucher; CHEW re-
Supply register
4.2 Periodic/Survey Data Collection

Several indicators for iCCM can be collected through periodic surveys. The main types of surveys
and the information that can be gathered are highlighted in Table 6. These surveys are critical
to help understand program coverage and provide an important source of information to help
triangulate data collected through routine sources.
Table 6: Overview of Periodic Data Sources
Periodic Surveys/Tools for Information that can be collected

Special Studies
National Household Surveys Collect information on treatment coverage, caregiver knowledge of CHWs,
(KDHS, Malaria Indicator Survey caregiver knowledge on danger signs related to iCCM, caregiver care-seeking
(MIS), MICS behaviours. As these surveys are large scale and resource intensive, they are only
implemented every 3-5 years.
LQAS Survey Can collect same information as national household surveys, but with less
precision. It can be implemented in smaller geographic areas and with less
resources and thus more frequently. It is possible to sample CHWs and capture
information on activity levels, knowledge, availability of supplies, supervision
coverage and aspects of quality of care.
Health Facility Surveys Capture information on service delivery, availability of supplies and equipment,
supervision coverage, knowledge and skills. Special studies to assess quality of
care
CHW Surveys Capture information on service delivery, availability of supplies and equipment,
supervision coverage, knowledge and skills.
Census Data Collect information on key denominators for children under 5
Qualitative Tools (Focus Group Can be used to assess care-seeking behaviours of caregivers, other special studies
Discussions) related to the research questions identified
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4.3 Complementary Methods:
Several indicators, especially the qualitative national milestone indicators, require complimentary
sources such as document reviews and key information interviews, as outlined in Table 7.
Table 7. Overview of Complementary Data Sources
Periodic Surveys/Tools for Information to be Collected

Special Studies
Document Review Information on policies, plans, HMIS; etc
Key Informant Interviews Information on policies, plans and the extent of their implementation; important
source of triangulation for document review
Focus Group Discussions Information to assess extent of implementation at the different levels; important
source of triangulation for document review
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S E C T ION
5
IMPLEMENTATION OF
M&E FOR iCCM
5.1 Coordination of iCCM M&E Plan

Monitoring of the iCCM program at the national level will be embedded within the overarching
CHS and coordinated by the M&E Unit of DCAH iCCM secretariat with support from an M&E
sub-group of the National iCCM TWG and CHS. This M&E sub group will be part of the divisions/
Unit’s M&E working group. The M&E sub-group will comprise representatives from relevant
departments of the Ministry of Health and implementing partners such as UNICEF and non-
governmental agencies (NGOs). The M&E subgroup will meet at least quarterly to help ensure
that partner M&E plans and activities are shared early for inclusion into the MOH national M&E
framework. This coordination mechanism will ensure that partner M&E resources contribute to
the overall national iCCM M&E plan and avoid duplication of efforts.
At the county level, coordination of iCCM M&E will be led by County Director of Health with
support from implementing partners active in the county.
5.2 Monitoring of the iCCM Implementation

The M&E Plan identifies several indicators for routine monitoring, with a focus on sub-set
monitoring program implementation strength. Table 8 outlines these implementation strength
indicators, the data sources, targets and required data elements. The majority of these indicators
will be collected through the District Health Information System (DHIS) system as part of the
overall CHS monitoring system, which captures monthly data from each community unit. Data
for the existing CHS monitoring systems are generated through the CHEW monthly report,
which summarizes data for all CHWs in the community unit.
The existing CHEW monthly report includes some required elements for iCCM, but several
additional elements will need to be added to incorporate the minimal set of iCCM routine
monitoring indicators. The required data elements represent the core required to measure
implementation strength of the iCCM implementation. (see Annex 3a for the CHEW report
with the required data elements added). Other elements should also be added based on CHW
reports and CHEW supervision records. Program-focused, supportive supervision is critical for
program monitoring and will be conducted regularly by all levels using standard supervision
checklists. In addition, the supervision checklists will generate data on several indicators that
20
can be aggregated upwards and included within the CHIS/DHIS system. The sub county health
management team shall be expected to conduct joint support supervision at least once per
quarter to primary level health facilities. The CHEWs shall conduct monthly competency based
skill reinforcing supportive supervision for all CHWs. Support will be provided to the CHWs to
assess, classify and manage common childhood illnesses. The supervision will also assess CHWs
counseling skills to ensure treatment adherence. An integrated supervision checklist for CHEWs
to supervise CHWs is found in Annex 3b.
Table 8. Overview of Implementation Strength Indicators, Targets and Required Data Elements
Indicator Definition Data source & Target Data elements required

Frequency by 2018 in CHEW report DHIS
CHWs trained Proportion of CHW/CHEWs targeted for Annual: work 80% No. of CHWs/CHEWs (by
in CCM iCCM who are trained in iCCM plans & training level)
records No. of CHWs in CU trained
in iCCM
CHWs deployed Proportion of CHWs trained in iCCM Quarterly: DHIS 80% of No. of CHWs trained in
for CCM and who are providing iCCM services (CHEW reports) trained CCM who report providing
working (managing malaria, diarrhoea, CHWs iCCM services this month
pneumonia, malnutrition and newborn
cases according to protocol)
Availability of Proportion of link facilities that had no Quarterly: DHMT 80%
CCM Supplies stock out of recommended medicine supervision report;
and diagnostics during the day of
assessment visit or last day of reporting
period
Proportion of CUs who had no Quarterly: DHIS 80% Whether community unit
stock out of recommended medicine (CHEW reports) experienced stock-outs of
and diagnostics during the day of any key product for the
assessment visit or last day of reporting reporting month
period
CHWs Proportion of CHWs/CHEWs who Quarterly: DHIS 80% No. of CHWs trained in
supervised received at least one administrative (CHEW reports) CCM who were supervised
supervisory contact in the prior 3 using standard checklist
months during where a sick child or this month
scenario was assessed*
Service delivery Number of CCM conditions managed Quarterly: DHIS 80% No. of cases of malaria
per 1,000 children under five in target (CHEW reports) treated in U5 children
areas in a given time period (reported No. of cases of diarrhoea
by condition: treatment of malaria/ treated in U5 children
diarrhoea; referral for malnutrition/ No. of cases of moderate/
pneumonia/newborn) severe malnutrition in U5
children referred*
No. of cases of suspected
pneumonia in U5 children
referred
No. of sick newborns
referred
No. of U5 children in
community unit*
Number and percent of newborns who Quarterly: DHIS 80% No. of newborns visited at
received a home visit from a CHW (CHEW reports) home within the first 48
within 48 hours of delivery hours
* Data elements already included in the existing CHEW report/DHIS
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5.3 Data Flow
Data for iCCM will flow according to the existing system, starting with the CHWs reporting to the
CHEWs, who report to the link facilities and then to the sub-county level (see Table 9). Community
level data are entered into the online DHIS at sub-county level. In some cases, data are entered
at the health facility level or even at the community unit level if computers and internets services
are available. Once entered into the DHIS, the data are available for use at any level and can be
analyzed by individual community unit, by sub-county, by county and nationally. Details on the
data flow for commodities are provided in the supply chain management section of the iCCM
implementation guidelines.
Table 9. Overview of Data Flow, Roles and Responsibilities and Forms by System Level
Level/cadre Main data collection & reporting responsibilities Data collection & reporting forms
Community – CHW Track services provided and commodities received Existing: CHW logbook; Household
and consumed registers; CHW report
Prepare monthly report and submit to CHEW New: CHW Treatment and Tracking
Register; stock records, Newborn
Checklist (refer Annex 12)
Community unit - Supervise CHWs according to schedule and Existing: CHEW report (+ iCCM
CHEW document using standard checklist elements)
Review and compile CHW data, stock records and New: Supervision checklist for CHWs;
supervision records and submit report to link facility stock records; stock report Add CHEW
Summary for CHW treatment and
Tracking Register
Link Facility – Facility Supervise CHEWs according to schedule and Existing: CHEW report (+ iCCM
in-Charge/HRIO document using DHMT checklist elements)
Review and compile CHEW data and submit to sub- New: Supervision checklist for CHWs;
county/enter into DHIS stock records; stock report
Provide feedback to CHWs
Sub-county – DMHT Supervise link facilities and CHEWs Existing: SCHMT supervision checklist
- CHS Manage data compilation and entry into DHIS for (+iCCM elements), other?; SCHMT
the sub-county and provide to county training inventory
Rapid data quality assessment(RDQA) New: Any reports
Provide feedback to facilities and community units
County – CHMT CHS Supervise sub-county level CBHIS linked to DHIS;
focal person Review sub-county level data and maintain county
level information and reports
Prepare reports and provide feedback to sub-county
National – Review county level data and CBHIS linked to DHIS
DCAHiCCM M&E Prepare reports and provide feedback to counties/
Secretariat other departments
22
5.4 Data Quality Assurance
Mechanisms to routinely assess and enhance data quality will be implemented at all levels
of the system. CHWs will be trained on how to record data and report on management of
iCCM conditions and how to maintain accurate and up-to-date stock records. The CHWs will
be supervised regularly by CHEWs, who will review records and validate reports to ensure data
quality and completeness and reinforce good practices. Similarly, link facilities will be oriented
on how to review and validate monthly data reported by CHEWs so that errors and problem
areas can be identified and resolved at the lowest levels. At the sub-county and county levels,
staff responsible for monitoring iCCM will be trained to assess data submitted by facilities for
completeness and perform basic quality checks.
In addition to routine data quality checks, efforts will be made to conduct periodic rapid data
quality assessments (RDQA). These RDQAs will help determine the availability, completeness
and quality of the data and assess the use of iCCM data in program management and decision
making.
Monitoring data for iCCM will be entered into the DHIS as part of the overall CHS M&E framework.
Data captured on community units, including that related to iCCM, will be integrated into
the existing DHIS web-based system. Data will be entered into the DHIS at the lowest level
that has the required resources (computers, internet accessand staff for entry). Guidelines on
appropriate information storage and measures to protect information security will be provided
through DHIS.
The CHS database will be updated to incorporate iCCM information requirements by the DCHS.
As part of the database development, it will be possible to include dashboards to display key
indicators that will aid data use and interpretation by all users.
Use of program monitoring data for decision-making will also be encouraged through regular
review meetings at multiple levels to assess the progress of iCCM implementation by identifying
opportunities, challenges and looking for solutions. Experience sharing and dissemination
of success stories, good practices and lessons learnt are addressed in such meetings. Review
meetings will be held at national and county level at least once a year and at sub-county level at
least twice in a year involving relevant stakeholders. The DCAH in conjunction with Community
health services, County Health Management teams and Sub-county Health Management Teams
shall be responsible to organize review meetings at their respective level. In order to make the
review meetings effective and feasible, iCCM review meetings will be conducted by integrating
with other health review meetings. Proceedings of the reviews are expected to be disseminated
to all levels timely.
5.5 Evaluation Plan

Outcome indicators: The main indicators to assess the outcome of the iCCM program in Kenya
are outlined in Table 10, along with the data source and targets. Most of these indicators pertain
to care-seeking and treatment for childhood illness and can be measured through a household
survey with interviews of mothers/caretakers of children who have experienced iCCM conditions
in the previous two weeks. Measuring compliance with referral from a CHW will require a special
study to track those referred and determine whether they receive care at the referral facility.
23
Table 10. Outcome Indicators for iccm and Targets
Indicator Definition Data source & Target

Frequency of By 2017
reporting
Treatment Percentage of sick children who received timely and Household survey; 80%
Coverage appropriate treatment according to specific protocol episodic (baseline, 2-3
(overall) (reported separately by iCCM condition) years later)
 Malaria (ACTs within 24 hours)
 Diarrhoea (ORS and zinc within 24 hours)
 Pneumonia (amoxicillin within 24 hours)
 Malnutrition (RUTF; )
 Newborn illness (injectable antibiotic;)
Treatment Percentage of sick children who received timely and Household survey; 80%
Coverage by appropriate treatment according to specific protocol episodic (baseline, 2-3
CHW* provided by CHWs years later)
 Malaria (ACTs within 24 hours)
 Diarrhoea (ORS and zinc within 24 hours)
First Source Proportion of sick children under five in iCCM target areas Household survey; TBD
of Care taken to iCCM-trained CHWs as first source of care. episodic (baseline, 2-3
years later)
Successful Proportion of sick children recommended for referral who Routine data & Special TBD
Referral were received at the referral facility (based on the CHW study of referrals
referral form-Annex 5)
*Note that in the detailed indicator matrix this indicator is included as a disaggregation of the first indicator
(treatment coverage overall), but has been listed separately here to provide further clarification
Evaluation questions: Table 11 outlines several key evaluation questions for the iCCM program
in Kenya as well as proposed data collection methods. These evaluation questions can be
answered in part through national level surveys such as DHS, MICS, MIS but others will require
special studies. In addition, it is recommended that qualitative methods be included to help
provide context and to illuminate the underlying factors and issues. These special studies will
require additional resources and implementing partners should coordinate through the M&E
sub-group of the iCCM TWG to address them in their evaluation plans as part of any program
funding proposal.
24
Table 11. Evaluation Questions and Data Collection Methods
Evaluation question Data collection methods

 What was the impact of the iCCM program on coverage of  Representative household survey comparing baseline
treatment for iCCM conditions? What was the coverage of to endline - ideally with comparison area
early Post Natal Care home visits for newborn? Equity?  Qualitative interviews with families to assess
perceptions of iCCM services
 What was the use of iCCM services? How did it vary
by iCCM condition and age group (child vs. newborn)
and why?
 What was the demand of iCCM services? Were there
changes in care-seeking for newborn and child illness? How
effective were the behavior change strategies?
 How well did referral work for children and newborns?  Special study tracking referrals made by CHWs to
What was the range of experience? What were the assess referral compliance and outcomes
challenges?  Qualitative interviews with CHWs and families to
understand referral barriers and facilitators
 What was the quality of iCCM services provided by CHWs?  Special study of CHWs with direct observation and
What was the quality of case management services clinical re-examination
provided at link facilities?  Qualitative interviews with families to assess
perceived quality of care
 How was the supply of commodities at various levels (CHW,  Review of routine records and reports on commodity
community unit, link facility)? What was the range of stock- supplies at CHW, community unit, and link facility
outs and the reasons for stock-outs? levels
 Periodic CHW/link facility surveys to assess
availability of supplies and stock-outs
 What are the major factors that are critical to expand or  Qualitative interviews with staff at various levels
scale up iCCM at various levels? (community, facility, sub-county, county, national)
5.6 Implementation Capacity

There is need to assess capacity to implement iCCM M&E. Some considerations to make for
this assessment include: Human resource, Infrastructure hardware and software, Tools and Staff
readiness for M&E and financial support. iCCM focusses on the community level, and as such the
immediate priority will be to strengthen the capacity of CHWs and CHEWs to collect, manage
and use data to improve the delivery of community-based services. In addition, the CHS M&E
framework also outlines the need to strengthen capacity at the national level to:
• Maintain the CHS database
• Analyse and interprete data for evidence based decision making
• Provide supportive supervision to the decentralized levels
25
5.7 Operations/Implementation Research and Special Studies
The research component in the iCCM implementation shall be used to improve access to cost
effective high impact newborn and child health interventions. It will also be used to developing
practical solutions to critical problems in the implementation of these interventions. The
objectives to be addressed within the framework shall include the following:
• Identify common implementation problems, and their main determinants, which prevent
effective access to interventions, and determine which of these problems are susceptible to
research;
• Develop practical solutions to these problems and test whether new implementation
strategies based on these solutions can significantly improve access to interventions
• Introduce these new implementation strategies into the programmes and facilitate their
full-scale implementation, evaluate them, and modify as required.
Twenty-four research questions were identified for iCCM in Kenya during an implementation
research consultative meeting led by WHO and UNICEF in 2011. These were prioritized based
on the following criterion: answerability by research; likeliness to reduce maternal and child
mortality; addresses the main barriers to scaling up; innovativeness and originality; likely
to promote equity; and likeliness of use of the research results by policy makers. Table 12
highlights the list of ten implementation/operations research questions prioritized by iCCM
stakeholders Several of the priority implementation research questions (Rank #1, 3, 9) could be
feasibly embedded within iCCM programs as part of an evaluation. Programs should allocate at
least two years, with about six months for planning and preparation, one full year of run-time
and another six months for assessment and analysis. Other questions are directly related to
indicators in the national iCCM M&E Plan, but would require special studies.
26
Table 12. Priority Implementation Research Questions for iCCM in Kenya
Research Question Rank

How can care seeking for sick newborns be improved? 1
What is the effectiveness of different approaches for scaling up CHW perinatal home visits? 2
How can care seeking for child with cough or difficult breathing, fever and diarrhoea be improved? 3
How can we improve early postnatal care for mothers and newborns? 4
How can care seeking for early antenatal care be improved? 5
Can the use of different technological modalities (mobile phones-based algorithm, computer-based algorithm, 6
treatment charts, etc.) improve health worker performance and increase compliance with standard management
guidelines?
What is the effectiveness of different options (financial and non-financial) to attract, and retain skilled doctors, 7
nurses, technicians and community health workers in rural areas and in hard to reach areas?
What is the effectiveness of different approaches (e.g. health facility boards, village health committees) to enhance 8
community-health facility linkage for improving Maternal Newborn and Child Health service utilization?
Can trained, supervised and well supplied community health workers perform iCCM correctly, including pneumonia 9
management with antibiotics, in hard to reach areas in order to increase coverage with effective interventions, within
the context of the MOH community strategy?
What is the appropriate delivery channel of health service to ensure equity of service for hard to reach populations 10
(urban and rural)?
The M&E subgroup of the iCCM TWG will be responsible for coordination of the overall research
agenda to avoid duplication of efforts. Implementing partner agencies with research capacity
should be encouraged to include these questions in their proposals for research and/or program
funds and to explore how they can address these research questions by embedding them within
already funded programs/studies where feasible or within upcoming studies. As with the M&E
plan, the research agenda and questions should be reviewed and updated annually.
5.8 Dissemination and Use

A wide range of stakeholders, including policy makers, donors, program managers,
implementing partners, facility staff, CHWs, and the target communities, constitute the main
audience for dissemination of iCCM M&E information. Dissemination of iCCM information will
be embedded within the existing CHS program and will include publication and distribution
of quarterly and annual reports, program newsletters, and information sharing through
national and international meetings and workshops. In addition, routine iCCM data captured
through the DHIS will be available online for real-time access and analysis at the desired level of
disaggregation.
Anticipated information products related to iCCM include, but not limited to:
Integrated CHS Reports: DCHS will produce annual consolidated CHS M&E report on the
national core indicators as well as quarterly reports for the routine data and disseminate them
to all the stakeholders.
District report for routine data: District office will produce report with data required for CHS/or
incorporate CHS data in the existing report and submit it to DCHS via County office.
27
Information Products for Non-Routine Data Sources: The report of non-routine data will be
generated by the respective responsible organization/body. Special requests for additional
information products will require documentation for future appraisal of dissemination efforts.
Planning and Review Reports: To ensure all formal Planning and Review meetings contribute
to evidence-based programme planning, budgeting and implementation, comprehensive
meeting reports will be compiled that highlight M&E and research findings reviewed, key
issues addressed and lessons learnt. The respective Technical Coordination Group or M&E sub-
committee will be responsible for documenting and forwarding the proceedings from planning
and review meeting to DCHS.
5.9 Detailed M&E Action Plan and Resources

The Plan of Action found in the National iCCM framework provides an overview of main activities,
timelines and budget for iCCM M&E at national, county and sub-county levels. This M&E Action
plan will be reviewed and updated under the leadership of the iCCM TWG.
5.10 Review of the M&E plan

The M&E plan for iCCM will be updated regularly and reviewed every three years . The M&E
sub-group of the National iCCM TWG will be responsible for bringing MOH and implementing
partners together to share data, update the indicator matrix with available data, revise and
refine indicators and M&E activities and workplan as needed.
28
ANNEX 1: NATIONAL iCCM INDICATORS
No. Indicator Indicator Definition Type of Target Roles and Frequency of Data Disaggregation
Area Indicator responsibilities data collec- sources
tion
Component 1: Policy & Coordination
1 ICCM Policy ICCM is incorporated Yes: National policy guidelines Input Yes (by ICCM TWG Annual MOH policy, National
(Global) into national MNCH pol- have been adopted to allow CHWs 2014) strategy or
icy/guideline(s) to allow to provide treatment in line with guideline
CHWs to give: WHO recommendations, for all
• low osmolarity ORS relevant conditions (diarrhea,
and zinc supplements for pneumonia and malaria in coun-
diarrhea tries with malaria)
• antibiotics for pneu- Partial: National policy guidelines
monia have been adopted to allow CHWs
• ACTs (and RDTs, where to provide treatment in line with
appropriate) for fever/ WHO recommendations, for at
malaria in malaria-en- least one but not all relevant con-
demic countries ditions
No: No national policy guidelines
exist that support CCM in line with
WHO recommendations
2 ICCM coordi- An ICCM stakeholder Yes: MOH-led ICCM stakeholder Input Yes Nat’l: Secretariate Annual TWG meet- County level fo-
nation coordination group, group established and meeting (quarterly (DCAH) ing minutes rums addressing
working group or task as outlined in terms of reference mtgs) iCCM should
force, led by the MOH (TOR), or if no TOR exists, at a min- also be formed/
and including key stake- imum of twice per year integrated into
holders, exists and meets Partial: MOH-led ICCM stakeholder existing county
regularly to coordinate group established but meets less level forums once
ICCM activities. than twice per year (0-1 meetings) roll-out begins
No: MOH-led ICCM stakeholder
group not established
29
30
tion
3 ICCM part- List of ICCM partners, Yes: List/map of all known sites Input Yes (na- National; DCAH- Annual DCAH & County
ner map activities and locations whereI CCM is being implemented, tional & County: CHMT CHMT
available and up to date by whom and for which condition county) partner
(diarrhea, pneumonia, or malaria) mapping
is available and updated within matrix
the last year
Partial: List/map of some or all
known ICCM partners, activities
and locations available but not
updated within the last year
No: List/map of ICCM partners,
activities and locations not avail-
able
Component 2: Costing and Financing
4 Annual ICCM A costed operational Yes: A costed CCM operational plan/ Input Yes (na- Nat’l: DCAH Annual Annual County, sub-coun-
costed oper- plan for CCM exists (or is work plan for all relevant CCM con- tional, County: CHMT workplans ty
ational plan part of a broader health ditions (as specified by country policy county & District: DHMT
(Global) operational plan) and is or implementation status) exists (or is sub-coun-
updated annually. part of a broader health operational ty)
plan) and has been updated within
the past year
Partial; a) A costed CCM operational
plan exists (or is part of a broader
health operational plan), including at
least one but not all relevant CCM
conditions, and has been updated
within the past year; OR b) A costed
CCM work plan exists (or is part of
a broader health operational plan)
including at least one relevant CCM
condition, but is not updated within
the past year No: No costed
plans for CCM are available for any
relevant health condition
tion
5 ICCM gov- Percentage of the total Numerator : Total annual public Input N/A Nat’l: DCAH Annual AWP and County, sub-
ernment annual CCM budget budgeted funding (MOH, county, Cnty: CHMT gap anal- county
financial which comes from Ken- and sub-county budgets) allocated Dist: DHMT ysis tool;
contribution yan government funding to CCM Annual
sources Denominator: Total annual bud- Expenditure
geted funding allocated to CCM Reports
program (public plus international
donors)
Component 3: Human Resources
6 Targeted Proportion of CHW/ Numerator: Number of CHWs/ Output a) 80% DCHS/DCAH/ Annual AWPs County, sub-
CHWs/ CHEWs targeted for CHEWs targeted for iCCM who of estab- DOMC Training county
CHEWs ICCM who are trained in have completed training in iCCM lished reports CHW, CHEWs
trained in ICCM Denominator: Number of CHWs CUs by
ICCM targeted for iCCM 2015
7 Trained Proportion of CHWs Numerator: Number of CHWs Output >80% DCHS/DCAH/ Quarterly/ DHIS County, sub-
CHWs pro- trained in ICCM who are trained in iCCM who have pro- DOMC Annual (CHEW re- county
viding ICCM providing ICCM services vided iCCM services (managing ports) CHW, CHEWs
(Global) malaria, diarrhea, pneumonia, CHW survey
malnutrition and newborn cases
according to protocol) in the last
3 months
Denominator: Number of CHWs
trained in iCCM
31
32
tion
Component 4: Supply Chain Management
8 Medicine Proportion of link facil- Numerator: Number of link facil- Output 80% Collection: Monthly/ Supportive County, sub-
and diag- ities that had no stock ities with all key ICCM medicines CHEWs; facility quarterly/ supervision county
nostic avail- out of recommended and diagnostics in stock (antima- in-charge; phar- episodic (DHMT), Commodity
ability – Link medicine and diagnos- larials, antibiotics, ORS, zinc, RDTs, maceutical direct ob-
facilities tics during the day of timer, RUTF, antibiotic for newborn Compile: servation
assessment visit or last infection) during the last assess- sub-county phar- and surveys
day of reporting period, ment/observation visit or the last macists
(key products defined by day of a reporting period.
country policy) Denominator: Number of link facil-
ities assessed in target areas
9 Medicine Proportion of CU who Numerator: Number of CUs with Output 80% Collection: Monthly/ Supportive County, sub-
and diagnos- had no stock out of rec- all key medicines and diagnostics CHEWs; facility quarterly/ supervision county
tic availabili- ommended medicine and (ACTs, ORS, zinc, RDTs) in stock in-charge; phar- episodic (DHMT), Commodity
ty - CU diagnostics during the during the last assessment/ob- maceutical direct ob-
(Global) day of assessment visit or servation visit or the last day of a Compile: servation
last day of reporting peri- reporting period. sub-county phar- and surveys
od, (key products defined Denominator: Total number of CUs macists
by country policy). assessed
Component 5: Service Delivery and Referral

10 Treatment Percentage of sick Numerator: Number of children Outcome 80% by DCHS/DCAH/ Episodic Household County
coverage children who received under five with a CCM condition 2017 DOMC surveys Point of service
timely and appropriate (diarrhea, suspected pneumonia, Varies at county (DHS, MICS, (community, facili-
treatment according to or malaria in malaria-endemic level MIS, other) ty, etc)
specific protocol areas, acute malnutrition) that CCM condition
received timely and appropriate Sociodemograph-
treatment during the last two we ics
eks
Denominator: Number of children
under five with a CCM condition in
the last two weeks
tion
11 ICCM case Number of ICCM condi- Numerator: Number of cases of Output TBD DCHS/DCAH/ Quarterly/ DHIS (CHW County, sub-coun-
managment tions managed by CHWs sick children under five managed DOMC Annually register ty
rate per 1,000 children under by CHWs in a given time period Varies at county and CHEW Point of service
five in target areas in a (quarterly/annually) in target area level report) (community, facili-
given time period (quar- Denominator: Number of children Household ty, etc)
terly/annually) (reported under five in target areas at a surveys CCM condition
by condition) given time (quarterly /annually)
divided by 1,000
12 RDT use at Proportion of children Numerator: Number of sick chil- Output TBD DCHS/DCAH/ Quarterly/ DHIS (CHW County, sub-coun-
community with fever who are tested dren under five in target areas DOMC Annual/ treatment ty, health facility,
level with RDTs at community who present with fever and who CHEWs Episodic register CU
level (where RDTs are are tested with an RDT at the and CHEW
part of the package) community level (in a given time report)
period) Direct ob-
Denominator: Number of sick servation
children under five in target areas
presenting with fever at the com-
munity level in a given time period
13 First source Proportion of sick chil- Numerator: Number of sick chil- Outcome TBD DCHS/DCAH/ Episodic Household County, sub-coun-
of care dren under five in CCM dren under five in the target area DOMC surveys ty, health facility,
target areas taken to whose caregivers sought care from Varies at county (DHS, MICS, CU
CCM-trained CHWs as CCM-trained CHWs as first source level MIS, other) By CCM condition
first source of care of care for the child By child age (new-
Denominator: Number of sick chil- born, child)
dren under five in the target area
33
34
tion
14 Complete Proportion of CHWs Numerator: Number of CHWs Output TBD CHEWs, facility Quarterly DHIS (CHW County, sub-coun-
and consis- whose registers show whose registers show complete- in-charge supervision ty, health facility,
tent registra- completeness and consis- ness and consistency between checklist/ CU
tion tency between classifica- classification and treatment for CHEW re-
tion and treatment at least four out of five cases report)
viewed CHW survey
Denominator: Number of CHWs
assessed
15 Follow up Number and proportion Numerator: Number of cases fol- Output >80% CHEWs, facility Quarterly; Epi- DHIS (CHW County, sub-
rate of cases followed up lowed up according to protocol in-charge, other sodic supervision county, health
after receiving treatment after receiving treatment from checklist/ facility, CU
from CHW according to CHW in target area CHEW re- Child age (new-
country protocol Denominator: Total number of cas- port), inter- born; child)
es receiving treatment from CHW views with
in target area caregivers
16 Successful Proportion of sick chil- Numerator: Number of sick chil- Outcome TBD CHEWs, facility Quarterly; Epi- CHW Refer- County, sub-
referral dren recommended for dren with danger signs who are in-charge, other sodic ral/counter county, health
referral who are received referred by CHW and who are re- referral facility, CU
at the referral facility ceived at the referral facility forms; CCM condition
Denominator: Total number of sick CHEW re- Child age (new-
children with danger signs recom- ports born; child)
mended for referral by CHW Special
study
17 Newborn Proportion of newborns Numerator: Number of newborns Output 80% CHEWs Quarterly/ DHIS (CHW County, sub-
care who received a home who received a home visit from a Episodic register county, health
visit from a CHW within CHW within 48 hours of delivery and CHEW facility, CU
48 hours of delivery Denominator: Total number of report)
newborns Household
surveys
Component 6: Communication and Social Mobilization

tion
18 Caregiver Proportion of caregivers Numerator: Number of caregivers Output >80% DCHS/DCAH/ Episodic Household County, sub-
knowledge in target areas who of children under five from target DOMC surveys county, health
of CHW know the presence and communities who can describe the Varies at county (MIS, MICS, facility, CU
role of their CHW. location of a CHW in their commu- level other)
nity, and the role and CCM services
provided by that CHW
Denominator: Total number of care-
givers of children under five inter-
viewed from target communities
19 Caregiver Proportion of caregivers Numerator: Number of caregivers Output 80% by DCHS/DCAH/ Episodic Household County, sub-
knowledge who know two or more of children under five interviewed 2017 DOMC surveys county, health
of illness signs of childhood illness who can correctly state 2 or more Varies at county (MIS, MICS, facility, CU
signs that require immediate signs of childhood illness that level other)
(Global) assessment and treat- require immediate assessment and
ment, if appropriate treatment, if appropriate.
Denominator: Number of caregiv-
ers of children under five inter-
viewed
Component 7: Supervision and Quality Assurance

20 Routine Proportion of CHWs/ Numerator: Number of CHWs who Output TBD CHEWs; sub-coun- Quarterly/ DHIS (CHW County, sub-
supervision CHEWs who received at received at least one administra- ty staff Annual supervision county
coverage least one administrative tive supervisory contact in the prior checklist/ CHEWs/CHWs
(Global) supervisory contact in 3 months during which registers CHEW re-
the prior three months and/or reports were reviewed port)
during which registers Denominator: Number of CHWs CHW sur-
and/or reports were re- trained or number of CHWs inter- veys
viewed viewed (if survey used for mea-
surement)
35
36
tion
21 Clinical Proportion of CHWs Numerator: Number of CHWs Output TBD CHEWs; sub-coun- Quarterly/ DHIS (CHW County, sub-
supervision who received at least receiving at least one supervisory ty staff Annual supervision county
coverage one supervisory contact contact in the prior three months checklist/
during the prior three where a sick child visit was ob- CHEW
months where a sick served or scenario was assessed report)
child visit or scenario was and coaching provided CHW
assessed and coaching Denominator: Number of CCM- surveys
was provided trained CHWs, or number of CHWs
interviewed (if survey used for
measurement)
22 Correct case Proportion of CHWs Numerator: Number of CHWs who Output TBD DCHS/DCAH/ Episodic Supportive County, sub-
management who demonstrate correct demonstrate correct management DOMC supervision county, CU
(knowledge) knowledge of manage- of sick child case scenarios Varies at county CHW survey ICCM condition
(Global) ment of sick child case Denominator: Number of CHWs level
scenarios assessed
23 Correct case Proportion of CHWs who Numerator: Number of CHWs who Output TBD DCHS/DCAH/ Episodic CHW survey County, sub-
management demonstrate correct case correctly managed sick child case(s) DOMC with direct county
(observed) management of a sick under direct observation with clinical Varies at county observa- ICCM condition
child under direct obser- re-examination level tion, clinical
vation with clinical re-ex- Denominator: Number of CHWs ob- re-examina-
amination (Note: can also served with clinical re-examination tion
be analyzed with sick child
as unit)
24 Correct clas- Proportion of CHWs who Numerator: Number of CHWs who Output TBD CHEWs Quarterly/Epi- DHIS (CHW County, sub-
sification of correctly classify mal- demonstrate correct use of MUAC sodic supervision county, health
malnutrition nourished children using Denominator: Number of CHWs checklist/ facility, CU
MUAC assessed CHEW re-
port)
IMAM tools
25 Respiratory Proportion of CHWs Numerator: Number of CHWs who Output TBD CHEWs; sub-coun- Quarterly/ DHIS (CHW County, sub-
rate who correctly count correctly count the respiratory rate ty staff Episodic supervision county, health
respiratory rate of live case, supervisor, community checklist/ facility, CU
infant, or video CHEW re-
Denominator: Number of CHWs port)
assessed CHW survey
tion
26 Counselling Proportion of caregivers Numerator: Number of children Output TBD CHEWs Quarterly/ DHIS (CHW County, sub-coun-
quality whose children received provided medicines where care- Other (for surveys) Episodic supervision ty, CU
treatment from a CHW givers were provided proper coun- checklist/ CCM condition
who were provided prop- seling for provision of treatments CHEW re-
er counselling (dose, duration, frequency and port)
follow-up) CHW sur-
Denominator: Number of cases of veys with
children prescribed medicines clinical
re-examina-
tion
Component 8: Monitoring and Evaluation and HMIS
27 National Existence of a compre- Yes: An M & E plan for ICCM has Input Yes (by DCAH/DCHS Annual M&E plans NA
Monitoring hensive, integrated mon- all the critical components (listed 2012) and docu-
and Evalua- itoring and evaluation below) and covers all relevant ments
tion Plan for (M&E) plan for ICCM CCM conditions. Components may
ICCM be country defined but should ide-
(Global) ally include the following:
- Program goals and objectives;
- Indicators to be measured;
- How (tools), how often(frequen-
cy) and where the indicator data(at
what level) will be collected (meth-
odologies);
- Dissemination/use of information
(how often and to what levels);
Partial: M&E plan exists but has
only some of the above critical
components or does not cover all
ICCM conditions
No: Plan has no critical compo-
nents or there is no written M & E
plan that covers ICCM
37
38
tion
28 ICCM utiliza- One or more indicators of Yes: One or more ICCM indicator is Input Yes DCAH/DCHS/ Annual HMIS tools CCM condition
tion indica- community-based treat- included in the national HMIS sys- HMIS and reports
tors included ment for diarrhea, pneu- tem and disaggregated by level
in HMIS monia and/or malaria are No: No recommended ICCM in-
included in the national dicators are included in national
HMIS system HMIS, or are included but not dis-
aggregated by level..
29 County & Proportion of counties/ Numerator: Number of implement- Input 80% DCHS/DCAH Quarterly/ County & County, sub-coun-
sub-county sub-counties reporting ing counties and sub-counties re- Annual sub-county ty
monitoring ICCM data on time and porting complete ICCM monitoring monitoring
completely data on time reports
Denominator: Number of counties
and sub-counties implementing
ICCM
ANNEX 2: CHW PERFORMANCE MATRIX
Indicator Indicator Indicator Definition Roles and Re- Frequency of Data
Area sponsibilities Data Collection Sources
Trained Proportion of Numerator: Number of DCHS/DCAH/ Quarterly/ Routine:
CHWs/CHEWs CHWs/CHEWs CHWs/CHEWs trained DOMC Annual DHIS
providing trained in ICCM in iCCM who have (CHEW
ICCM who are pro- provided iCCM services reports)
viding ICCM (managing malaria,
services (malaria diarrhoea, pneumonia,
and diarrhoea) malnutrition and new-
born cases according to
protocol) in the last 3
months
Denominator: Number
of CHWs/CHEWs trained
in iCCM
Medicine and Proportion of Numerator: Number of Collection: Monthly/quarterly/ Supportive
diagnostic CU who had CUs with all key med- CHEWs; facility episodic supervi-
availability - no stock out of icines and diagnostics in-charge; phar- sion, LMIS,
CHW/CU recommended (ACTs, ORS, zinc) in maceutical direct
medicine and stock during the last Compile: observa-
disgnostics assessment/observation sub-county tion and
during the day of visit or the last day of a pharmacists surveys
assessment visit reporting period.
or last day of Denominator: Total
reporting period, number of CUs assessed
(key products
defined by coun-
try policy).
Complete and Proportion of Numerator: Number of CHEWs, facility Quarterly Supportive
consistent CHWs whose CHWs whose registers in-charge supervi-
registration registers show show completeness sion
completeness and consistency be- CHW sur-
and consistency tween classification and vey
between clas- treatment for at least
sification and four out of five cases
treatment reviewed
Denominator: Number
of CHWs assessed
Follow up rate Number and pro- Numerator: Number of CHEWs, facility Quarterly; Episodic Supportive
portion of cases cases followed up ac- in-charge, other supervi-
followed up after cording to protocol after sion, CHIS,
receiving treat- receiving treatment interviews
ment from CHW from CHW in target with care-
according to area givers
country protocol Denominator: Total
number of cases re-
ceiving treatment from
CHW in target area
39
Indicator Indicator Indicator Definition Roles and Re- Frequency of Data
Area sponsibilities Data Collection Sources
Correct Proportion of Numerator: Number of CHEWs Quarterly/Episodic Supportive
classification CHWs who CHWs who demonstrate Supervi-
of malnutri- correctly classify correct use of MUAC sion, CHIS,
tion malnourished Denominator: Number IMAM
children using of CHWs assessed tools
MUAC
Respiratory Proportion of Numerator: Number of CHEWs; Quarterly/ Supportive

rate CHWs who CHWs who correctly sub-county staff Episodic supervi-
correctly count count the respiratory sion
respiratory rate rate of live case, super- CHW sur-
visor, community infant, vey
or video
Denominator: Number
of CHWs assessed
Counseling Proportion of Numerator: Number of CHEWs Quarterly/ Superviso-
quality caregivers whose children provided med- Other (for sur- Episodic ry reports
children received icines where caregivers veys) CHW sur-
treatment from a were provided proper veys with
CHW who were counseling for provision clinical
provided proper of treatments (dose, re-exam-
counselling duration, frequency and ination
follow-up)
Denominator: Number
of cases of children pre-
scribed medicines
Correct case Proportion of Numerator: Number of DCHS/DCAH/ Episodic Supportive
management CHWs who CHWs who demonstrate DOMC supervi-
(knowledge) – demonstrate cor- correct management of Varies at county sion
(Global) rect knowledge sick child case scenarios level CHW sur-
of management Denominator: Number vey
of sick child case of CHWs assessed
scenarios
40
ANNEX 3A: CHEW MONTHLY SUMMARY
WITH ICCM INDICATORS
COMMUNITY HEALTH EXTENTION WORKER SUMMARY MOH 515
Province:……………………………………………….
DISTRICT:…………………..……………..……..…………………...……………… DIVISION:……………………………….………
LOCATION:………………..…………..……..………………….. SUB LOCATION: ………….……………….……………

Total Villages:………………………………….
NAME OF CU:. ……….…….....………..……..……………………….…..………… NUMBER OF CHWs:………………….…………..…..

Total Reported:……………………………….
ICCM trained CHWs:……………CHWs providing ICCM:……………………………….
CHEW Name: ……………………………………...………….…..……………… Month:…………………...……………………………. Year:……………..….
Indicators Total
Sno.
Number of households
1
Total population Indicator Total
2
Sno
Total women 15-49 years
3
Total children 0- 6 months Number of deaths < 1yrs
4
Total children under one year old 1-5 yrs
5
Total children under five years old Maternal
6
39
Adolencent and youth - Girls (13 - 24 years) Other deaths
7
Adolescent and youth - Boys (13 - 24 years)
8
Total population of the elderly (60+ years) Total deaths
9
Number of Households without staple food
10 Number of household using treated water 40
Number of household with hand washing facilities e.g. leaky Number of school drop out Male
12 tins in use
42
Female
13 Number of households with functional latrines
Total pregnant women
14
Did the community unit experience stock-outs of more than 7 days for any of the following
15 Number of pregnant women reffered for ANC care commodities
16 Number pregnant women referred for ANC # COMMODITY YES NO
Number of newborns visited at home

17 within 48 hours of delivery
a Antimalarials
Number of Mothers with newborns counselled on Exclusive
(child dosages)
Breastfeeding
18 Children <5 years participating in growth monitoring b ORS
children < 5 years with MUAC indicating moderate c Zinc

malnutrition.
children < 5 years with MUAC indicating severe d RDTs
malnutrition.
19 Number of deliveries by skilled delivery

………………………………...………………..………………
Number of newborn referred to a health facility
20
Signature:………………………………
Number of women(15-49yrs) provided with FP commodities
21 by CHWs
Number of children under one year referred for
22 immunization
Number of children 6 to 59 Months referred for Vitamin A
23 supplementation Remarks …………………………………………………………
Number of immunization defaulters traced
24
25 Number of children 2-14 years dewormed

………………………………...………………..………………
26 Number of fever cases seen by CHWs

………………………………...………………..………………
27 Number of Fever cases < 7 days RDT done

Signature:………………………………
Number of Fever cases < 7 days RDT +ve
Number of under 5 Malaria Cases (RDT +ve) treated with

ACT
Number of over 5 years Malaria Cases (RDT +ve) treated
28 with ACT
Number of cases of diarrhea identified in children under five
Number of under 5 children with diarrhoea treated

29
with Zinc and ORS
41
ANNEX 3B: SUPPORT SUPERVISION
CHECKLIST FOR DISTRICT/SUB COUNTY
LEVEL SUPERVISION TO LEVEL 1
(COMMUNITY)
(Source: Division of Community Health Services, MOPHS, 2012)
Name of County/District
Name of Community Health Unit
Total population of the CHU
Total number of CHWs under the CHU
Name (s) of the Community Health Extension Worker
Name of the link facility
Name of the link facility in charge
Phone number of the link facility in charge
Date of Supportive Supervision
Name of Supervisor(s)
SECTION 1: LEADERSHIP & GOVERNANCE (CHEW as respondent)
1-2 Do you have the following plans?
Plans Check and make remarks

Annual Community Work Plans
Quarterly implementation plans
Monthly Action Plans
42
1-3 AWP Targets for Key priority areas
i) Key achievements in high impact intervention areas (CHEW as respondent for the CHU)
Performance indicator Target Achieved Achievement (%) Make remarks

Proportion of pregnant women
completing all four ANC visits within the
catchment area
Proportion of women receiving skilled
care during delivery within the catchment
area
Proportion of children under 6 months
who are exclusively breastfed
Number of ARV defaulters traced and
referred by CHWs
Number of TB defaulters traced and
referred by CHWs
Proportion of households with a
serviceable latrine
Proportion of households with a hand
washing facility
Proportion of households with access to
regular safe water for drinking
Number of child immunization defaulters
traced and referred
Number of children <5yrs with diarrhoea
managed with ORS and zinc
No of new-borns visited within 48 hours
of birth.
Proportion of children beyond one year
receiving 2 doses of Vitamin A
Number of women of reproductive age
who are new family planning users
Proportion of CHWs who provide timely
(by the 5th of the month) monthly reports
to the CHEW.
Proportion of CHWs correctly applying
the Treatment Registers
Proportion of CHWs correctly maintaining
commodities stock and inventory cards.
I) CHU on track in performance of the specific priority areas (Rating):

1-3 AWP Targets for Key priority areas
43
Q1. Are the CHWs and CHEWs reporting on key priority areas (as per MOH513/514/515/516)?
Yes ¨ No ¨
Remarks
1-4 Meetings in the Last Quarter (respondent should be the CHEW on behalf of CHU)
Meetings Number Date of Last Availability of

Meeting or Minutes-write
supervision [Yes/No]
How many supervisory visits have been made in the last

quarter
How many Stakeholder Forums held?
How many CHWs received at least one

supervisory contact?
SECTION 2: CHW MOTIVATION AND TRAINING
2-3: Staff Motivation

What are the motivation strategies put in place for CHWs and CHCs? (List the different types of
motivation strategies and ask the CHEW to mark/tick that apply)
Continuous training beyond basic (specify)

Mentorship
Recognition (Certificates)
Cash incentive (specify amounts)
Non-cash incentive (specify)
Other (specify)
2-4: Staff Training and Update

Q1: Has Training Needs Assessment for CHEWs, CHC and CHWs been done for the FY? Yes/No.
Show report. Yes/No
(CHWs need to be given a logbook for recording trainings)
SECTION 3: HEALTH INFORMATION
Q1. Is the CHU reporting monthly? Yes ¨ No ¨

Is the CHU reporting quarterly? Yes ¨ No ¨
44
Q2. What is the level of accuracy, completeness and timeliness of reports?
(Circle the most appropriate rating e.g. 3 with 1 being the lowest and 5 the highest)
Reporting parameter Level/status (Rating scale) Remarks
1 Accuracy 1 2 3 4 5
2 Completeness 1 2 3 4 5
3 Timeliness 1 2 3 4 5
2-4 Utilization of Information

Q1: (Observe) whether last month’s data was updated in the chalkboard Yes ¨ No ¨
Q2: (Observe) whether the update for key indicators was displayed on MOH 516?
Yes ¨ No ¨
Q3: Was the data displayed discussed by the CHC? Yes ¨ No ¨
Q4: If No, please explain (1, 2, 3)
2-5 Information Resource Corner (CHEW as respondent)

Q1: Has the CHU established an Information Resource Corner/Centre ?
Q2: How many written feedbacks did the DHMT provide to the supervisee?
Q3: What follow up have you done on previous recommendations? Explain in the space below.
45
Q4. What were top three challenges encountered in bridging the previous recommendations?
Challenges:
1.
2.
3.
SECTION 4: SERVICE DELIVERY (CHEW as respondent)
Q1. How many CHWs conducted house visits as per the number assigned?
Q2. How many CHWs filled and returned the MOH513 and MOH514 within the stipulated
requirements? Yes ¨ No ¨
Q3. How many cases of sick children under five were managed by CHW in the last month?
Yes ¨ No ¨
Q4. How many newborns received a home visit from CHWs within 48 hours of delivery?
Yes ¨ No ¨
Q5. Does the CHW have a Job Aid? Yes ¨ No ¨
SECTION 5: FINANCING
Q1. What was the CHC budget? KES

Q2. How much of the budget was funded?
Q3. Does the CHC have with safe custody of finances and financial facilities e.g. bank account?
Yes ¨ No ¨
Comments:
46
SECTION 6: TRANSPORT AND REFERRAL SYSTEM
Q1. Means of transport
S/N Available Means of Transport Number Remarks

1 Ambulance
2 Motor bikes
3 Bicycles
4 Others (donkey carts, etc.)
Q2. Do you use any standard referral form for referring Patients in the community?
Yes ¨ No ¨
Q3. What is the available communication system for referrals?

Phone Yes ¨ No ¨
Other Yes ¨ No ¨
If other (specify)
SECTION 7: SUPPLIES AND COMMODITIES
Q1. Does the CHU have an updated inventory of?

CHW kit contents Yes ¨ No ¨
Data collection tools Yes ¨ No ¨
Q2. Proportion of CHW kits with Expired Drugs in the Quarter
Q3. Proportion of CHW kits with no stock outs of key commodities
Q4. Proportion of CHW with all Basic Equipment
Comments:
47
SECTION 8: FUNCTIONALITY OF COMMUNITY HEALTH UNITS
8.1 Functional Status
Number Remarks
Active CHWs Reported
CHC Members
Dialogue days held in the last quarter
Health action days held last six months
CHC meeting held in the last quarter
CHIS tools available

MOH 513
MOH 514
MOH 515
MOH 516
Comments:
48
ANNEX 4: CHEW SUPERVISION CHECKLIST
KENYA COMMUNITY HEALTH STRATEGY CHW SUPERVISION CHECKLIST
Supervisor Name: Date:
Supervisor Designation: County:
CHW name: SubCounty:
Name and code of community unit : Health facility code:
# Item Yes No NA Comment
A AVAILABILITY OF MEDICINES (Check medicines and ask about availability.)
1 ORS (At least 12 Sachets)
2 Did you have ORS everyday last month? If no, for about how many days were you
without ORS last month?............
3 AL 1X6 (At least 10 blister packs)
7 Did you have AL everyday last month? If no, for about how many days were you without
AL last month?.........
8 Zinc sulfate 20mg (Approximately 60 tablets)
9 Did you have a con nuous supply of AL, ORS and zinc for the last 3 months without any
stock-out of those products?
10 Albendazole 400mg (approximately ( 20 tablets)
11 Paracetamol 500mg (Approximately 36 tablets)
12 Tetracycline Eye ointment 1% (At least 6 tubes)
13 Combined oral contracep ves (at least 25 packs )
14 Povidone Iodine Solu on (At least a bo le in use)
AI CHW HAS ALL KEY ICCM MEDICINES (AL/ORS/ZINC) [yes for 1,3,4&8]
A2 CHW HAD NO STOCK-OUTS OF MORE THAN 7 DAYS FOR KEY iCCM MEDICINES
A3 CHW HAS ALL KEY CHS MEDICINES [yes to all]
B MEDICINE STORAGE AND QUALITY Yes No NA Comment
1 Medicines are stored appropriately (as per guidelines)
2 All medicines are valid (unexpired).
B1 CHW DEMONSTRATES APPROPRIATE DRUG MANAGEMENT
C AVAILABILITY OF SUPPLIES (Observe availability of the following supplies) Yes No NA Comment
1 Appropriate mer (measures seconds) available and func oning
2 Mid upper arm circumference (MUAC) tape
3 RDTs)
4 Digital thermometer
5 Salter scale/Colour coded salter scale
6 Medical dispensing envelopes
7 First aid kit
8 Water quality supplies (Chlorine / flocculant (coagulant and disinfectant); Lavibond
Comparator; DPD tablets)
9 Male condoms
11 Community treatment and tracking register with blank pages (for at least 10 cases)
Sick Child Recording Form
12 CHS Job aids/counselling cards

13 Blank referral Slips (at least 3)
14 Service Log Book (MOH 514)
C1 CHW HAS ALL KEY JOB AIDS (Sick Child Recording Form and CHS Job Aid)
C2 CHW HAS ALL KEY ICCM SUPPLIES (MUAC, TIMER, RDTS)
C3 CHW HAS FULL CHS KIT
49
D. PROVISION OF ICCM SERVICES (Ask to see CHW register and record below) Yes No NA Comment
D1 CHW HAS MANAGED ICCM CASES IN LAST 3 MONTHS IF NO, describe why and
skip to section H
E. CLASSIFICATION-TREATMENT CONSISTENCY (Review the 2 most recent cases of fever, Yes No NA Comment
diarrhea and malnutrition in the Register.)
1 Case 1: correct classification-treatment/referral
E1 CHW REGISTER SHOWS CLASSIFICATION-TREATMENT CONSISTENCY (4/6 OR 6/6 'YES')
F. CASE FOLLOW-UP (Review 2 cases managed in the previous month and tick if follow up Yes No N/A Comment (describe
for each case was completed within 3 days) condition)
1 Case 1: follow up complete
Case 5: follow up complete
F1 CHW COMPLETING FOLLOW-UP FOR ICCM CASES (4/6 OR 6/6 'YES')
G REGISTER AND REPORT COMPLETENESS Yes No NA Comment
1 Treatment Register filled completely (all blanks filled and all boxes appropriately filled or
ticked) for last full sheet
2 Household register updated in the last 6 months
3 Log book updated in the past week
G1 CHW REGISTERS AND REPORTS COMPLETE AND UP TO DATE
H CASE MANAGEMENT AND COUNSELLING (Administer case scenario or simulation) Yes No NA Comment( Give
1 Takes child's identification (name AND age AND sex )?
2 Assesses for all danger signs correctly
2b Identifies danger sign(s) correctly
3 Counts respiratory rate correctly (+/- 2 breaths)
4 Decides to treat or refer child's illness correctly
5 Gives correct treatment
6 Demonstrates how to administer treatment correctly
7 Counsels (correct messages on feeding, increased fluids and when to return)
8 Explains how to administer medicines correctly
9 Asks mother to repeat back how to administer
10 Asks caregiver to return for follow-up visit
11 Refers if child has danger sign or condition he/she cannot treat
12 Facilitates referral (provides referral slip AND first dose)
H1 CHW DEMONSTRATES CORRECT COUNSELING ("Yes" for 6, 7, 8, and 9)
H2 CHW DEMONSTRATES CORRECT CASE MANAGEMENT ("Yes" for 2, 4, 5 and 7)
I ASSESSMENT SKILLS (Refer to instructions) Yes No NA Comment
I1 CHW DEMONSTRATES CORRECT USE OF MUAC TAPES
J KNOWLEDGE OF DANGER SIGNS Yes No NA Comment
1 CHW can state at least 4 newborn danger signs
2 CHW can state at least 4 danger signs in pregnancy
3 CHW can state at least 4 danger signs in child under 5
J1 CHW DEMONSTRATES KNOWLEDGE OF DANGER SIGNS ("Yes" for any 2 cohorts)
L MATERNAL AND NEWBORN CARE HOME VISITS AND COUNSELLING Yes No NA Comment
1 CHW has counselled one or more pregnant women in the last month
2 CHW has conducted home visit within 48 hours to newborn (at least one in past two
months)
L1 CHW CONDUCTING MATERNAL AND NEWBORN ACTIVITIES ("Yes" for 1 & 2)
GENERAL COMMENTS
What were the CHW's most important concerns (and your responses)? Number by priority.
Observations and recommendations? Also record in Supervision Log Book at

Community Unit
PERFORMANCE RATING OF THE CHW
50
CHW Performance Scoring
Indicator No Yes
CHW HAS ALL KEY ICCM MEDICINES (AL/ORS/ZINC) [yes for 1,3,4&8] 0 1
CHW HAD NO STOCK-OUTS OF MORE THAN 7 DAYS FOR KEY iCCM MEDICINES 0 1
CHW HAS ALL KEY CHS MEDICINES [yes to all] 0 1
CHW DEMONSTRATES APPROPRIATE DRUG MANAGEMENT (criteria TBD) 0 1
CHW HAS ALL KEY JOB AIDS (Sick Child Recording Form and CHS Job Aid) 0 1
CHW HAS ALL KEY ICCM SUPPLIES (MUAC, TIMER, RDTS) 0 2
CHW HAS FULL CHS KIT 0 2
CHW HAS MANAGED ICCM CASES IN LAST 3 MONTHS 0 2
CHW REGISTER SHOWS CLASSIFICATION-TREATMENT CONSISTENCY (4/6 OR 6/6 ‘YES’) 0 2
CHW COMPLETING FOLLOW-UP FOR ICCM CASES (4/6 OR 6/6 ‘YES’) 0 2
CHW REGISTERS AND REPORTS COMPLETE AND UP TO DATE 0 1
CHW DEMONSTRATES CORRECT COUNSELING (“Yes” for 6, 7, 8, and 9) 0 2
CHW DEMONSTRATES CORRECT CASE MANAGEMENT (“Yes” for 2, 4, 5 and 7) 0 2
CHW DEMONSTRATES CORRECT USE OF MUAC TAPES 0 1
CHW DEMONSTRATES KNOWLEDGE OF DANGER SIGNS (“Yes” for any 2 cohorts) 0 2
CHW CONDUCTING MATERNAL AND NEWBORN ACTIVITIES (“Yes” for 1 & 2) 0 2
Total 0 25
Excellent performance( full incentives) 18 and above

good performance( 80% incentives) From 14 - 17
Average performance( 50% incentives) from 9 - 13
Poor performance( No incentives) Below 9
51
ANNEX 5: COMMUNITY REFERRAL FORM
REPUBLIC OF KENYA
MINISTRY OF HEALTH - MOH:100
COMMUNITY REFERRAL FORM

SECTION A: Patient /Client Data
Date: Time of referral:
Name of the patient:
Sex: Male Female Age:
Name of Community Health Unit:
Name of Link Health Facility:
Reason(s) for Referral
Main problem(s):
Treatment given:
Comments:
CHW Referring the Patient

Name: Mobile No:
Village/Estate: Sub location:
Location:
Name of the community unit:
Receiving Officer
Date: Time:
Name of the officer:
Profession:
Name of the Health facility:
Action taken:
SECTION B : Referral back to the Community
Name of the officer:
Name of CHW: Mobile No:
Name of the community unit:
Call made by referring officer: Yes: No:
Kindly do the following to the patient:
1.
2.
3.
Official Rubber Stamp & Signature:
52
Child’s name: __________________________________________ Age:___________________
Sick Child Recording Form 3. Refer or treat child If ANY Danger Sign, If NO Danger Sign,
REFER URGENTLY to treat at home and
(tick treatments given and other actions) health facility advise caregiver
(for community-based treatment of child age 2 months up to 5 years)
If any danger sign, If no danger sign,

REFER URGENTLY to health facility: TREAT at home and ADVISE on home care:
Date:_____/_____/20____ CHW’s Name: ______________________________________ Tel: _____________________
ASSIST REFERRAL to health facility: Give ORS. Help caregiver give child ORS solution in front of you
Explain why child needs to go to health until child is no longer thirsty.
Child’s name: First _________________________ Family __________________ Age: _____Years/_____Months. Boy / Girl If Diarrhoea Give caregiver 4 ORS packets to take home. Advise to give as
facility. GIVE FIRST DOSE OF TREATMENT: (less than 14 much as child wants, but at least 1/2 cup ORS solution after each
days AND no loose stool.
Caregiver’s Name: __________________________________ Relationship: Mother / Father / Other: ___________________
blood in stool) Give zinc supplement. Give 1 dose daily for 10 days:
If If child can drink, begin giving Age 2 months up to 6 months—1/2 tablet (total 5 tabs)
Name of Community Unit: ____________________________________ Name of Link Facility: _________________________ Diarrhoea ORS solution right away. Age 6 months up to 5 years—1 tablet (total 10 tabs)
House Hold Number: ___________________________ Caregiver’s Phone Number: ________________________________ Give rectal artesunate
If Fever AND suppository (100 mg) Do a rapid diagnostic test (RDT).
Convulsions or Age 2 months up to 3 If Fever __Positive __Negative
1. Identify problems
Unusually sleepy years—1 suppository (less than 7
If RDT is positive, give oral antimalarial AL (Artemether-
or unconscious or Age 3 years up to 5 years—2 days) in a
SICK but NO Lumefantrine).
ASK and LOOK Any DANGER SIGN Not able to drink suppositories malaria area
Give twice daily for 3 days:
Danger Sign? or feed anything ------------------------------
Vomits everything Age 2 months up to 5 months up to 1/2 tablet (total 3 tabs)
-------------------- antimalarial AL. Age 5 months up to 3 years up to 1 tablet (total 6 tabs)
ASK: What are the child’s problems? If not Age 3 years up to 5 years up to 2 tablets (total 12 tabs)
If Fever AND Age 2 months up to 3
reported, then ask to be sure. danger sign other years—1 tablet Help caregiver give first dose now. Advise to give 2nd dose
YES, sign present Tick NO sign Circle than the 3 above Age 3 years up to 5 after 8 hours, and to give dose twice daily for 2 more days.
years—2 tablets
Fever, give paracetamol
o Cough for 14 days If child can drink, give Age 2yrs up to 3yrs tablet 500mg 1/4
Cough? If yes, for how long? __ days Age 3yrs up to 5yrs tablet 500mg 1/2
or more If Chest indrawing,
(amoxicillin tablet—250 mg) Every six hours for 3 days
or
Diarrhoea (3 or more loose stools in 24 hrs)? o Diarrhoea for 14 o Diarrhoea (less Fast breathing Age 2 months up to 12
months—1 tablet If Fast
Refer.
IF YES, for how long? ____days. days or more than 14 days Age 12 months up to 5 breathing
AND no blood years—2 tablets
IF DIARRHOEA, blood in stool? o Blood in stool If Yellow on
in stool) Counsel caregiver on feeding or refer the child to a
MUAC strap
supplementary feeding programme, if available
o Fever (less and continue feeding.
Fever (reported or now)? o Fever for last 7 days Advise to keep child warm, if child is NOT hot with fever.
than 7 days) in Advise on when to return. Go to nearest health facility
If yes, started ____ days ago. or more Write a referral note.
a malaria area For ALL immediately or if not possible return if child
children treated o Cannot drink or feed
Arrange transportation, and help solve other
Convulsions? o Convulsions at home, advise o Becomes sicker
on home care o Has blood in the stool
FOLLOW UP child on return at least once a week until Advise caregiver on use of a bednet (ITN).
o Not able to drink or child is well. Follow up child in 3 days (schedule appointment in item 6 below).
IF YES, not able to drink or feed anything? feed anything Vitamin A for age given?
Age Vaccine
4. CHECK VACCINES, DEWORMING 6 months
& VITAMIN A STATUS OPV-0
Vomiting? If yes, vomits everything? o Vomits everything Birth BCG
(up to 2wks) 12 months (1 year)
(Tick deworming drug 18 months (1½ years)
or or vitamin A doses 6 weeks DPT—Hib + HepB 1 ROTA 1 Pneumo 1 OPV-1
LOOK: 24 months (2 years)
completed; Circle
10 weeks DPT—Hib + HepB 2 ROTA 2* Pneumo 2 OPV-2 30 months (2 ½ years)
those missed):
36 months (3 years)
Chest indrawing? (FOR ALL CHILDREN) o Chest indrawing Advise caregiver, if needed: 14 weeks DPT—Hib + HepB 3 Pneumo 2 OPV-3 42 months (3 ½ years)
WHEN and WHERE to get the Yellow
9 Months Measles 1 48 months (4 years)
IF COUGH, count breaths in 1 minute: next dose. fever **
54 months (4 ½ years)
not given beyond 32 weeks 18 Months Measles 2
_______breaths per minute (bpm) only in selected districts
60 months (5 years)
Fast breathing: DEWORMING FROM 1 YEAR 5. If any OTHER PROBLEM or condition
o Fast breathing
Age 2 months up to 12 months: 50 bpm or you cannot treat, refer child to health
Give once every six months to all children one year and above:
more If Mebendazole 500mg or Albendazole 200mg for children 1 to 2 years and Date of facility, write referral note.
400mg for children 2years and above. next visit
Age 12 months up to 5 years: 40 bpm or more Describe problem: __________________
Age Drug Dosage ________________________________________________
Unusually sleepy or unconscious? o Unusually sleepy or 12 months (1Year) ________________________________________________
unconscious
18 months (11/2Years) 6. When to return for FOLLOW UP (circle):
24 months (2Years) Monday Tuesday Wednesday Thursday
For child 6 months up to 5 years, MUAC strap Yellow on MUAC Friday Saturday Sunday
o Red on MUAC strap 30 months (21/2Years)
colour: red__ yellow__ green__ strap
7. Note on follow up:
36 months (3Years)
Child is better—continue to treat at home.
Swelling of both feet? o Swelling of both feet 42 months (31/2Years)
Day of next follow up:_________.
48 months (4years) Child is not better—refer URGENTLY to
health facility.
If ANY Danger Sign, If NO Danger Sign, 54 months (41/2Years)
Child has danger sign—refer URGENTLY to
2. Decide: Refer or treat child REFER URGENTLY to treat at home and 60 months (5Years) health facility.
ANNEX 6: SICK CHILD RECORDING FORM
(tick decision) health facility advise caregiver
53
GO TO PAGE 2
54
TOTALS
TOTALS
County:
County:
A
A
Date Name of Patient

Date Name of Patient
B
B
Caregiver Phone No. Caregiver Phone No.

C
C
Male Male
Female Female
D E
D E
Age Age
F
F
Household Number Household Number

G
G
Slept under mosquito net last night (Yes/No) Slept under mosquito net last night (Yes/No)
Child Information
Child Information
If child aged below 6 months is there Exclusive If child aged below 6 months is there Exclusive
H
H
breastfeeding (Yes/No) breastfeeding (Yes/No)

If child is above 6 months is vitamin A status If child is above 6 months is vitamin A status
I
I
upto date (yes/No) upto date (yes/No)

J
J
Duration of illness (days) Duration of illness (days)

Diarrhoea < 14 days and NO Blood in Stool (Yes Diarrhoea < 14 days and NO Blood in Stool (Yes
K
K
or No) or No)
L
L
Fever/Hotness of the body Fever/Hotness of the body

Fever < 7 days RDT done Fever < 7 days RDT done
services
services
Fever < 7 days RDT +ve Fever < 7 days RDT +ve
M N O
M N O
Fast breathing Fast breathing

P
P
MUAC (Yellow or Red) MUAC (Yellow or Red)

Assessed, for treatment or
Assessed, for treatment or
Sub-‐County:
Sub-‐County:
Q
Q
Cough for 14 days or more Cough for 14 days or more
Diarrhoea for 14 days or more Diarrhoea for 14 days or more
Blood in stool Blood in stool
Fever for 7 days or more (RDT+or -‐or not done) Fever for 7 days or more (RDT+or -‐or not done)
Fever for 7 days or more and RDT not done Fever for 7 days or more and RDT not done
CLASSIFICATION
CLASSIFICATION
R S T U V
R S T U V
Convulsions Convulsions
W
W
Not able to drink or feed at all Not able to drink or feed at all
X
X
Vomits everything Vomits everything

Y
Y
Chest in-‐drawing Chest in-‐drawing

Referral
Referral
Unusually sleepy or unconscious Unusually sleepy or unconscious

Link facility:
Link facility:
Red on MUAC Red on MUAC

Swelling of both feet Swelling of both feet
Immunization required (Yes/No) Immunization required (Yes/No)
Z AA AB AC AD
Z AA AB AC AD
Newborn danger signs present (Yes/No) Newborn danger signs present (Yes/No)
Newborn delivered at home (Yes/No) Newborn delivered at home (Yes/No)
ORS(20.5g/ltr0; Sachets-‐write number given ORS(20.5g/ltr0; Sachets-‐write number given
ZINC (20mg)' Tabs-‐write number given ZINC (20mg)' Tabs-‐write number given
Zinc and ORS copacked-‐Tabs-‐write number Zinc and ORS copacked-‐Tabs-‐write number
AE AF AG AH
AE AF AG AH
given given
AMOXYCILLIN (indicate:125mg or 250mg or AMOXYCILLIN (indicate:125mg or 250mg or
AI
AI
375mg//5mls Bottle or Tablet) 375mg//5mls Bottle or Tablet)

ACTs (6s)-‐tick as appropriate ACTs (6s)-‐tick as appropriate
Name of CU:
Name of CU:
ACTs (12s) tick as appropriate ACTs (12s) tick as appropriate
Community Treatment and Tracking Register
Community Treatment and Tracking Register

Albendazole (ABZ); Tabs-‐refer to instruction Albendazole (ABZ); Tabs-‐refer to instruction
page page
Paracetamol Tabs-‐Indicate number given Paracetamol Tabs-‐Indicate number given
AJ AK AL AM AN AO AP
AJ AK AL AM AN AO AP
Tetracycline Eye Ointment (TEO); 1%; tube Tetracycline Eye Ointment (TEO); 1%; tube
Vitamin A (50 or 100 or 200 IU)-‐indicate units Vitamin A (50 or 100 or 200 IU)-‐indicate units
AQ
AQ
given given
Treatment or Services Given
Treatment or Services Given
If Given Vitamin A has been given, have you If Given Vitamin A has been given, have you
AR
AR
recorded in the Mother child booklet recorded in the Mother child booklet
(Yes/No/mother has no booklet) (Yes/No/mother has no booklet)
First Aid Given-‐(Yes/No) First Aid Given-‐(Yes/No)
Counselled Counselled
Treated within 24 hrs of illness onset Treated within 24 hrs of illness onset
Referred Referred
Date of 1st Follow up Date of 1st Follow up
Referral compliance within 24 hours Referral compliance within 24 hours
Referral compliance more than 24hrs Referral compliance more than 24hrs
Adverse (unusual) Drug Reaction (ADR) Adverse (unusual) Drug Reaction (ADR)
Defaulted-‐(refetr to instrution page) Defaulted-‐(refetr to instrution page)
Outcome
Outcome
Recovered from current illness Recovered from current illness
AS AT AU AV AW AX AY AZ BA BB BC
AS AT AU AV AW AX AY AZ BA BB BC
Died Died
Remarks/Comments
Remarks/Comments
Name of CHW/CHEW …………………………………
Name of CHW/CHEW …………………………………
and tracking register
ANNEX 7A: Community treatment
55
9
8
7
6
5
4
3
2
1
20
20
20
19
18
17
16
15
14
13
12
11
10
Serial
TOTALS
County:
REPORTING MONTH
A
___________________________________________
Name of CHW

B
CHW Phone No.

C
Total Males
D
Total Females
E
Total Number of Children (male and Females)

F
Total number of children who slept under

mosquito net last night
G
Total number of child aged below 6 months EBF

Child information
H
Total children above 6 months vitamin A status

upto date
I
Diarrhoea < 14 days and NO Blood in Stool

J
Fever or Hotness of the body

K
Fever < 7 days RDT Done

L
Sub-‐County:
Fever < 7 days RDT +ve

M
Fast breathing
N
Yellow on MUAC

Treatment (TOTALS of YES or TICK)
O
Cough for 14 days or more

P
Diarrhoea for 14 days or more

Q
Blood in stool

R
Fever for 7 days or more (RDT+or -‐or not done)

S
Convulsions
T
Not able to drink or feed at all

Link facility:
Vomits everything
V
Chest in-‐drawing
W
Unusually sleepy or unconscious

X
Referral (TOTALS OF YES or TICK)
Red on MUAC

Y
Swelling of both feet

Z
Immunization required
AA
Newborn danger signs present

AB
ORS(20.5g/ltr0; Sachets
Name of CU:
AC
ZINC (20mg)' Tabs

ASSESSMENT AND CLASSIFICATION
AD
AMOXYCILLIN (125mg/250mg/375mg) tabls/

Bottle
AE
ACTs (6s)
CHEW iCCM Treatment Summary Register
AF
ACTs (12s)
ACTs (18s)
ACTs (24s)
AG AH AI
Albendazole (ABZ); Tabs

AJ
Paracetamol; Tabs
AK
Tetracycline Eye Ointment (TEO); 1%; tube

AL
Combine Oral Contraceptives (COC); pills

Chlorine/floculant
Treatment or Services (TOTALS)
Chlorine tabs
DPD tabs
Male condoms
Female condoms
AM AN AO AP AQ AR
Dispensing envelops
Counselled
AS AT
Treated within 24 hrs of illness onset

Household No.: ……………To …………..
Referred
AU AV
Referral compliance
AW
Referral compliance more than 24hrs

Recovered
Name of CHEW:-‐
Died
AX AY AZ
Outcome Totals
Adverse Drug Reaction (ADR)

BA
Defaulter
BB
Remarks/Comments
0
Summary form
ANNEX 7B: CHEW iCCM Monthly
INVENTORY CONTROL CARD - CHW
56
Product Name: Max months of stock (MMS):
Strength/Presentation: Max quantity (AMC*MMS):
Counting unit Max quantity (AMC*MMS):
Emergency order point (EOP):
Emr. Ord.Qty (AMC*EOP):
Emr. Ord.Qty (AMC*EOP):
Average monthly consumptiom (AMC):
Batch Quantities
no./Serial Beginning Quantity
Date No balance requested Received Issued Losses Adjustments Balance Remarks/Initials
A B C D E F G H I
ANNEX 8: CHW INVENTORY CARD
CHEW Requisition, Issue and Receipt Voucher
Name of CHEW:
Phone no (CHEW): CHEW Requisition, Issue and Receipt Voucher
Name of CHEW: Requisition number:
Phone no (CHEW): Facility MFL code:
Facility name:
Request Receipt
Facility phone number:
Commodity name Unit of Balance
Request Batch Current
Quantity Quantity Quantity Receipt
Commodity name Unit Balance Quantity Quantity Quantity Quantity Batch Current
issueof brought on hand requested received No. Balance
/description
issue brought Quantity on hand requested received No. Balance
Item
Item No.
No. Date
Date forward
forward issued
issued Remarks
Remarks
RECEIPT VOUCHER
Name of Store Manager Date
Health Worker of Link Facility Date
57
Name of CHEW Date
ANNEX 9: CHEW REQUISITION, ISSUE AND
58
CHEW/CHW stock control card
Product name:
Strength:
Formulation
Presentation
Batch
Quantities
Commodity no./Serial Expiry Balance
name No date BF Received DN no. Issued Losses Adjustments Balance Remarks/Initials
A B C D E F G H I J K K= (E+F)-(H+I+J)
NB: Adjustment = Gains or loss after physical stock count

ANNEX 10: STOCK CONTROL CARD
DN =Delivery Note
Supply Worksheet
County: Sub‐County:Link F a ci l i t y : N a m e of CU:
Key: D=Dispensed;
B=Balance (stock on hand); AMOXYCILLIN Tetracycline Eye Combined Oral
QR=Quantity required ORS ZINC (20mg) ACTs (6s) ACTs (12s) RDTs Albendazole (400mg) Paracetamol
QS=Quantity supplied
(125mg/5mls) ointment (TEO)(1%) Contraceptives (COC)
Sachets Tablets Bottles Tablets Tablets Tablets Tablets Tubes Pills

Date Name of CHW D B QR QS D B QR QS D B QR QS D B QR QS D B QR QS D B QR QS D B QR QS D B QR QS D B QR QS D B QR QS
ANNEX 11: CHEW RE-SUPPLY REGISTER
Totals
59
ANNEX 12: COMMUNITY NEWBORN
CHECKLIST
Name of the Baby:
Age in Days:
Name of CU:
Date/month/year:
Name of CHW:
Refer to the link facility IF ANY of the following danger signs
(From number 1-11) are there.
1. Not able to feed since birth, or stopped feeding well. Yes c No c
2. Convulsed or fitted since birth. Yes c No c
3. Fast breathing: Two counts of 60 breaths or more in one minute Yes c No c
(Use a watch)
4. Severe chest in drawing (chest draws in as the baby breathes) Yes c No c
5. High temperature: 37.5°C or more or by touch or mother’s report Yes c No c
6. Very low temperature: 35.4°C or less Yes c No c
(check extremities feet, hand and body)
7. Only moves when stimulated, or does not move even on Yes c No c
stimulation.
8. Yellow sole Yes c No c
9. Bleeding from the umbilical stump Yes c No c
10. Signs of local infection: umbilicus red or draining pus, skin boils, Yes c No c
or eyes draining pus
11. Weight chart using color coded scales if RED or Yellow Yes c No c
(refer < 2.5kgs or those born less than 36 weeks of age)
12. Follow up and check if baby taken to hospital Yes c No c
(if any of the above signs noted)
NB/Postnatal visits to be conducted on day 1, 3 and 7 of life of all newborns and postnatal
register used for cross reference.
Tick as appropriate.
60
ANNEX 13: list of contributors
Name Designation Department/Organization

Dr. Elizabeth Ogaja Senior Deputy Chief Pharmacist MoMs-Department of Pharmacy
Dr. Annah Wamae Head Department of Family Health MOPHS
Dr. Stewart Kabaka Head, DCAH DCAH
Grace Wasike Program Officer DCAH
Charles Matanda Program Officer DCAH
Lydia Karimurio Program Officer DCAH
Dr. Deborah Okumu Program Officer DCAH
Edwina Anyango Program Officer DVI
Stanley Mbuva Program Officer DCAH
Samuel Murage Program Officer DON
Dr. David Soti Head DOMC DOMC
Dr. Andrew Nyandigisi Program Officer, Malaria Case Management focal DOMC
Jacinta Opondo M&E Officer DOMC
Peter Njiru Program Officer DOMC
Julius Kimitei Program Officer DOMC
James Njiru Program Officer DON
Gichohi Mwangi Regional Customer Services Officer KEMSA
Dr. James Mwitari Head DCHS
Jane Koech Program Officer DCHS
Samuel Njoroge Deputy Head DCHS
Ruth Ngechu Program Officer DCHS
Hillary Chebon Program Officer DCHS
Dr. Santau Migiro Deputy Head DHP
Dr. Assumpta Muriithi Child and Adolescent Health Specialist WHO KCO
Dr. Vincent Orinda Consultant UNICEF
Dr. Ketema Bizuneh Chief Health Section UNICEF
Dr. Laban Tsuma Child Survival Technical Advisor USAID MCHIP/W
Dr. Muthoni Kariuki Deputy Director USAID MCHIP/K
Dr. Dan Otieno Child Health Technical Advisor USAID MCHIP/K
61
Name Designation Department/Organization
Dr. Tanya Guenther M & E Advisor USAID MCHIP/W
Dr. Savitha Subramanian M& E Advisor USAID MCHIP/W
Herbert Kere M&E Technical Advisor USAID MCHIP/K
Dr. Mark Kabue Deputy Director, M&E JHPIEGO
Dr. Makeba Shiroya Snr Child Health Technical Advisor USAID MCHIP/K
Edwin Wambari Training Coordinator USAID MCHIP/K
Peter Kaimenyi Newborn Technical Officer USAID MCHIP/K
Mildred Shieshia Regional Logistics Advisor JSI/SC4CCM
Olive Agutu Nutrition Specialist UNICEF
Eunice Ndungu CSD Officer UNICEF
Dr. Peter Okoth Child Health Specialist UNICEF
Dr. Khadija Abdalla MNCH Specialist UNICEF
Jayne Kariuki Communication Specialist UNICEF
Henry Neufville National Supply Officer UNICEF
Dr. Agutu Silas Deputy Head DCAH
Maureen Khambira Consultant UNICEF
Dr. Mohamed Elmi CSD Advisor UNICEF
Judith Raburu CSD Technical Officer UNICEF
Doris Kamawera Program Assistant UNICEF
Dr. Abdullahi Tinorga Chief CSD UNICEF
Dr. Maricianah Onono Research Officer KEMRI
Charles Muruka Program Manager, Health & Nutrition Save the Children (UK)
Pauline Irungu Family Health Advocacy Officer PATH
Bridget Job Johnson Chief, Communication for Development UNICEF
Dr. Onditi Samuel Child Survival Technical Advisor APHIAPlus Zone 1
Stephen Biwott Integrated Child Development Officer World Vision
Enock Marita Program Officer AMREF
Caleb Chemirmir MCH Program Manager KRCS
Elijah Mbiti Senior Program Officer Micronutrient Initiative
62
REFERENCES
Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF,
Cibulskis R, Eisele T, Liu L, Mathers C; Child Health Epidemiology Reference Group of WHO and
UNICEF. (2010). Global, regional, and national causes of child mortality in 2008: a systematic
analysis. Lancet , 1969-87.
CORE GROUP (2010). Community case management essentials-Treating common childhood

illnesses in the community. A guide for program mangers.
Ministry of Health (2005): Reversing the Trends- Second National Health Sector Strategic Plan
of Kenya: NHSSPII. Nairobi.
Ministry of Public Health and Saintation (2010): Child Survival and Development Strategy.
Nairobi: MOPH.
Ministry of Public Health and Saintation (2006): Taking Kenya Essential Package for Health to
the community; A strategy for delivery of level one services in Kenya. Nairobi.
National Coordinating Agency for Population and Development, Ministry of Medical Services,
Ministry of Public Health and Sanitation, Kenya National Bereau of Statistics and ICF Macro.
(2012): Kenya Service Provision Assessment. Nairobi.
National Coordinating Agency for Population and Development, Ministry of Public Health and
Sanitation. (2010). Child Survival Indicator Survey. Division of Child and Adolescent Health,
Nairobi.
Ministry of Public Health and Saintation (2010): Policy Guidelines on control and Management
of Diarrhoeal disease in Children below five years in Kenya. Nairobi
Kenya National Bereau of Statistics (2008/9): Kenya Demographic and Health survey. Nairobi
WHO/UNICEF. (2012). Integrated Community Case Management-(iCCM); An equity- focused

strategy to improve access. Geneva.
63

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MINISTRY OF HEALTH

AUGUST 2013 EDITION

Dr Annah Wamae, OGW

1.1 Background of the M&E Plan 11

1.2 Goals and Objectives of the iCCM M&E Plan 11

2. NATIONAL ICCM FRAMEWORK AND PLAN FOR ACTION 13

4. DATA COLLECTION METHODS 17

4.1 Routine data collection: 17

4.2 Periodic/survey data collection: 18

4.3 Complementary Methods: 19

5. IMPLEMENTATION OF M&E FOR iCCM 20

5.1 Coordination of iCCM M&E Plan 20

5.2 Monitoring of the iCCM program 20

5.3 Data flow 22

5.4 Data quality assurance 23

5.5 Evaluation plan 23

5.6 Implementation Capacity 25

5.7 Operations/Implementation research and special studies 26

5.8 Dissemination and Use 27

5.9 Detailed M&E Action Plan and Resources 28

5.10 Review of the M&E plan 28

ANNEX 2: CHW PERFORMANCE MATRIX 39

ANNEX 3A: CHEW MONTHLY SUMMARY WITH ICCM INDICATORS 41

ANNEXT 3B: SUPPORT SUPERVISION CHECKLIST FOR SUB COUNTY

ANNEX 4: CHEW SUPERVISION CHECKLIST 49

ANNEX 5: CHW REFERRAL FORM 52

ANNEX 6: SICK CHILD RECORDING FORM 53

ANNEX 7A: CHW TREATMENT & TRACKING REGISTER 54

ANNEX 7B: CHEW iCCM Monthly Summary form 55

ANNEX 8: CHW INVENTORY CARD 56

ANNEX 9: CHEW REQUISITION, ISSUE AND RECEIPT VOUCHER 57

ANNEX 10: STOCK CONTROL CARD 58

ANNEX 11: CHEW RE-SUPPLY REGISTER 59

ANNEX 12: COMMUNITY NEWBORN CHECKLIST 60

ANNEX 13: LIST OF CONTRIBUTORS 61

Table 2: Selected Routine Indicators 15

Table 3: List of Periodic Indicators 16

Table 4: List of National Milestone Indicators 16

Table 5: Overview of Tools Used For Routine Data Collection 17

Table 6: Overview of Periodic Data Sources 18

Table 7: Overview of Complementary Data Sources 19

Table 8: Overview of Implementation Strength Indicators, Targets and

Table 9: Overview of Data Flow, Roles and Responsibilities and Forms

Table 10: Outcome Indicators for iCCM and Targets 24

Table 11: Evaluation Questions and Data Collection Methods 25

Table 12: Priority Implementation Research Questions for iCCM in Kenya 27

1.1 Background of the M&E Plan

1.2 Goals and Objectives of the iCCM M&E Plan

Domain iCCM Indicator

Table 2: Selected Routine Indicators

Component iCCM Indicator

Component iCCM indicator

Table 4: List of National Milestone Indicators

Component iCCM indicator

4.1 Routine Data Collection

Table 5: Overview of Tools Used For Routine Data Collection

Tool Information that can be collected

4.2 Periodic/Survey Data Collection

Table 6: Overview of Periodic Data Sources

Periodic Surveys/Tools for Information that can be collected