Community and District Empowerment for Scaling-Up (codes) Project

CHDC in collaboration with MUSPH and Karolinska Institute is conducting case studies and synthesized lessons learnt from the CODES intervention. CODES is funded by Bill and Melinda Gates Foundation through UNICEF. CODES is premised on the assumption that proven effective interventions recommended by WHO and UNICEF that are likely to prevent deaths from pneumonia, diarrhea and malaria among young children have not been adequately prioritized and implemented by local governments especially at district and community level partly due to poor management capacity. This is manifested in: lack of sufficient expertise to local data to select and contextualize interventions; district health management systems placing insufficient emphasis on results; lack of capacity for identification of bottlenecks; no financial leeway to initiate and carry out context specific solutions and failure to consistently involve communities as active proponents in helping overcome obstacles to effective coverage, identifying access barriers and helping stimulate better quality of services. CODES combines management, diagnostic and evaluation tools to: analyze bottlenecks hindering the scale up of locally prioritized child survival interventions and provides districts specific solutions to improve coverage; builds capacity among district health management teams to develop and implement context-specific solutions and foster community monitoring and social accountability to continue improving the delivery of services as well as increase community demand. CODES is premised on the hypothesis that implementing interventions that have been prioritized based on district specific epidemiologic profiles and bottleneck analysis, combined with quality improvement interventions to improve management, and appropriate community mobilization will lead to accelerated scale up of key protective, preventive and curative interventions against pneumonia and diarrhea mortality among children under five.