CODES - Community and District Empowerment for Scale-up




New approaches are urgently needed to resolve the many difficulties of scaling up lifesaving interventions to prevent deaths due to pneumonia and diarrhea, which together account for more than a third of child mortality. Previous studies have demonstrated that the obstacles are essentially due to four factors: the lack of supportive policies, failure to prioritize those interventions that are most likely to prevent deaths, problems with the essential commodities for vaccination services and treatment of illnesses, and the absence of community-based health promotions activities and care.

CODES aims to develop and evaluate the effect of a focused approach to scaling up high impact intervention to accelerate mortality reduction from pneumonia and diarrhoea. Uganda, which has one of the highest child mortality rates in Africa and a highly decentralized health system, will be the case study for this approach. The CODES project aims to demonstrate that a management strategy based on three pillars will lead to improvements both regarding coverage and quality of key interventions to prevent children from dying of diarrhea and pneumonia. The three pillars of improvements are:

  1. Improved targeting of interventions to match disease burden, and better allocation of resources;
  2. Regular review and improvement of district health team performance, and use of evidence-based management tools and focal funding to overcome management bottlenecks;
  3. Community oversight and inputs.

The method Diagnose-Intervene-Verify-Adjust will be used to identify and respond to health system and demand-side bottlenecks that arise at the district level in order to strengthen the district health system, support capacity development and empower communities. 

The core partners are: U.S. Fund for UNICEF, UNICEF Uganda Office, Karolinska Institutet, Makerere University and Ministry of Health of Uganda.


Bill & Melinda Gates foundation

Contact person


Stefan Peterson

Organizational unit: Global health (IHCAR)

Global HealthPublic Health