The added value of a mobile application of Community Case Management on under-5 referral, re-consultation and hospitalization rates in two districts in Northern Malawi: the Supporting LIFE study protocol for a pragmatic cluster-randomized controlled trial

Background: There is evidence to suggest frontline community health workers in Malawi are under-referring children with acute illness to higher-level facilities. Integrating a digitized version of paper-based methods of delivering Community Case Management (CCM) could strengthen delivery, increasing urgent referral rates and preventing unnecessary re-consultations and hospital admissions. This trial aims to evaluate the added value of the Supporting LIFE electronic Community Case Management Application (SL eCCM App) compared to paper-based CCM on urgent referral, re-consultation and hospital admission rates, in two districts in Northern Malawi. Methods: This is a pragmatic stepped-wedge cluster randomized trial assessing the added value of the SL eCCM App on urgent referral, re-consultation, and hospitalization rates of children aged ≥2 months to