In South Sudan the DFID Integrated Case Management Programme (ICCM) was initiated in April 2013 to complement the Global Fund home management of malaria for children under 5 years of age. It allows treatment of additional childhood illnesses including pneumonia, diarrhoea and severe acute malnutrition by community based distributors at the household level. This is the second year Annual Review of the three-year programme, which is currently being implemented in 26 counties in 9 of the 10 states of South Sudan.
Year 1 of implementation was fairly stable until fighting broke out in Juba in December 2013 spreading quickly to the rest of the country. Throughout Year 2 the security situation continued to be unstable. All quarterly reports for these periods document incidences of migration of people including Community Based Distributors and restrictions of movements due to insecurity. Furthermore, flooding in the July-September 2014 period hampered prompt delivery of drugs, supportive supervision activities, and timely collection of reports.
Because of the multitude of challenges experienced in the first year of implementation, and as recommended by the first annual review in April 2014, the programme’s logical framework (Log Frame) was revised in October 2014. A new output and a few output indicators were added, some output indicators revised and targets at the outcome level adjusted.
Despite a difficult operating environment, the programme was able to expand geographically as well as scale up the nutrition component in Year 2. There has been considerable progress against all three outputs of the programme from Year 1, catching up well on some key results that lagged behind significantly. The outcomes achieved to date show that the programme is on track to achieve the results expected at the end of the programme. The programme needs to make better efforts to improve monitoring as well as internal coordination, sharing and learning.