Modeling potential reduction of child mortality after national scale-up of community-based treatment of childhood illnesses in Ethiopia.

BACKGROUND: Since 2010, 28,000 female health extension workers (IEWs) received training and support to provide integrated community based case management (iCCM) of childhood pneumonia, diarrhea, malaria, and se- vere malnutrition in Ethiopia. OBJECTIVE: We conducted a modeling exercise using two scenarios to project the potential reduction of the under five mortality, riate due io the iCCM program in the four agrarian regions of Ethiopia. METHODS. We created three projections: (1) baseline projection without iCCM; (2) a "moderate" projection using 2012 coverage data scaled up to 30% by 2015 and (3) a "best case" scenario scaled up to 80% with 50% of newborns with sepsis receiving effective treatment by 2015. RESULTS. If the 2012 coverage gains (moderate projection) were applied to the four agrarian regions, we project that the iCCM program could have saved over 10,000 additional lives per year among children age 1-59 months. If iCCM coverage reaches the, "best case" scenario, nearly 80,000 additional lives among children 1-59 months of age would be saved between 2012 and 2015. CONCLUSION. High quality iCCM, delivered and used at scale, is an important contributor to the reduction of under five mortality in rural Ethiopia. Continued investments in iCCM are critical to sustaining and improving recent declines in child mortality.