Integrating Vertical Programs into Primary Health Care: A Decision-Making Approach for Policymakers

The universal health coverage movement has strengthened advocacy for integration in service delivery and its enabling systems and inputs, particularly following the 2018 Global Conference on Primary Health Care, which marked the 40th anniversary of the Alma Ata Declaration. Many see integration as a way to ensure equitable financing for and access to a range of services, not just those offered by a handful of privileged programs. Countries are also increasingly cognizant of resource constraints and are eager to increase health system efficiency, including through integration.

“Integrating Vertical Programs into Primary Health Care: A Decision-Making Approach for Policymakers” offers practical guidance for policymakers who need to make decisions about whether and how to more fully integrate specific vertical programs into their country’s broader health system, with a focus on PHC. It discusses what the evidence shows about the successes and failures of such efforts, considerations for policymakers when making decisions about integration, and ways to balance potential gains and losses. It also proposes use of a tool called the PHC Conceptual Framework for characterizing the relationship between a vertical program and the broader system and exploring the potential opportunities and constraints that come with integration. The Annex includes brief case studies from South Africa and Ethiopia illustrating how the framework can help to understand integration efforts.

Two other, more detailed case studies about ongoing integration efforts in Ghana and Malawi are also available. You can also read more about this work on the R4D blog.

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