2. Definition of integration
โข Meriam Webster; the act or process or an instance of integrating the
integration of art and/with technology: such as a: incorporation as equals into
society or an organization of individuals of different groups
โข Integration, in mathematics, is the process of calculating an integral, which is
the continuous analog of a sum
โข Integration in IT a broader context, integration can refer to the connection and
sharing of information between different systems
โข Integration in health programs refers to the process of combining different
types of healthcare services, programs, and systems to improve overall health
outcomes.
โข - Integration refers to the process of bringing together different health-related
services and activities in order to improve the quality and efficiency of care.
This can be done at the level of the individual patient, the community, or the
health system as a whole.
3. Coordination,
collaboration,
integration
โข Coordination refers to the process of ensuring that different
parts of a program are working together in a way that is consistent
with the program's goals. This can involve coordinating activities,
sharing information, and resolving conflicts.
โข Collaboration refers to the process of working together with
others to achieve a common goal. This can involve sharing
resources, expertise, and ideas.
โข Integration refers to the process of combining different parts of a
program into a cohesive whole. This can involve merging different
programs, developing common standards, and creating a shared
vision
5. A programme consists of a cluster of projects that have common features such as thematic focus,
geographic focus, a common M&E framework, indicators,
programme are often complementary to each other with clear synergies between the results generated
Coordinated programme: collaboration to achieve joint goal while maintaining separate structures;
Including coordinating committees, financial coordination of components, staff/facility sharing, use of
similar M&E indicators.
Integrated programme: complete merging of some or all components of different programmes;
Including single management body, joint financing arrangements, multi-disciplinary teams under the
same management, single M&E system.
8. Types of integration
โข Horizontal Integration: This type of integration refers to the
coordination and collaboration between different public health
programs that have a similar focus or target population. For
example, integrating HIV/AIDS prevention and treatment
programs with tuberculosis control programs.
โข Vertical Integration: This type of integration refers to the
coordination and collaboration between different levels of
healthcare services, such as primary care, secondary care, and
tertiary care. Vertical integration aims to ensure continuity of care
and improve health outcomes by providing a seamless service
delivery system.
9. โข Functional Integration: This type of integration refers to the
coordination and collaboration between different functions
within a public health program or organization. For example,
integrating epidemiology, laboratory services, and disease
surveillance within a public health department
โข Organizational Integration: This type of integration refers to
the coordination and collaboration between different
organizations that provide healthcare services or public health
programs
โข System Integration: This type of integration refers to the
coordination and collaboration between different sectors, such
as healthcare, education, and social services, to address social
determinants of health and improve health outcomes
10. D/C between
functional and
horizontal integration
โข the main difference between functional integration and horizontal
integration is that functional integration focuses on integrating
different functions within an organization or program, while
horizontal integration focuses on integrating different programs or
services that have a similar focus or target population
11. CONDUCT A NEEDS
ASSESSMENT: THE
ORGANIZATION
SHOULD START BY
CONDUCTING A NEEDS
ASSESSMENT TO
IDENTIFY THE HEALTH
ISSUE THEY WANT TO
ADDRESS, THE TARGET
POPULATION, AND THE
RESOURCES
AVAILABLE
CONSIDER THE GOALS OF
THE ORGANIZATION:
THE ORGANIZATION
SHOULD CONSIDER ITS
GOALS FOR ADDRESSING
THE HEALTH ISSUE AND
IMPROVING HEALTH
OUTCOMES FOR THE
TARGET POPULATION
ASSESS THE CURRENT
STATE OF
INTEGRATION: THE
ORGANIZATION
SHOULD ASSESS THE
CURRENT STATE OF
INTEGRATION WITHIN
THEIR ORGANIZATION
AND THE BROADER
HEALTHCARE SYSTEM
IDENTIFY POTENTIAL
PARTNERS: THE
ORGANIZATION
SHOULD IDENTIFY
POTENTIAL PARTNERS
THAT THEY COULD
COLLABORATE WITH
TO ACHIEVE THEIR
GOALS
EVALUATE THE BENEFITS
AND CHALLENGES:
ORGANIZATION SHOULD
EVALUATE THE BENEFITS AND
CHALLENGES OF DIFFERENT
TYPES OF INTEGRATION,
CONSIDERING FACTORS SUCH
AS COST, FEASIBILITY, AND
POTENTIAL IMPACT ON
HEALTH OUTCOMES.
DEVELOP AN
INTEGRATION PLAN
ORGANIZATION
SHOULD DEVELOP A
PLAN FOR
INTEGRATING
SERVICES AND
PROGRAMS THAT IS
TAILORED TO THEIR
SPECIFIC NEEDS AND
GOALS
12. โข - to provide more comprehensive and coordinated
healthcare services to individuals and
communities, with the aim of improving health
outcomes and reducing healthcare costs. This
approach recognizes that health is influenced by a
variety of factors beyond just medical care, and
that addressing these factors in a coordinated
manner can lead to better health outcomes
The goal of integration in health programs
13. โข -
The benefits of integrated health programs:
Reduced
duplication of
services:
Improved health
system
strengthening:
Increased equity:
Greater efficiency
and cost-
effectiveness:
Improved health
outcomes:
Increased
patient/community
satisfaction:
Improved quality of
care:
Improved
coordination of
care:
Enhanced
sustainability:
14. โข Integrated health programs require strong leadership,
effective communication, and collaboration among different
stakeholders, along with a willingness to adapt and change
as needed to ensure the success of the program. By
addressing multiple determinants of health simultaneously,
integrated health programs can improve health outcomes
and promote sustainable development
15. Differing priorities: Different health services may have
different priorities, which can make it difficult to integrate
them effectively
Lack of resources: Integration in health can require
significant resources, which can be a challenge for
health systems that are already under-resourced
Cultural barriers: There may be cultural barriers to
integration in health, such as a lack of trust between
different health services or a reluctance to share
information
Fragmentation of funding streams: Often, funding for
different health programs comes from different sources,
which can lead to fragmentation and competition for
resources
16. Lack of coordination and communication: Effective integration
of health programs requires coordination and communication
among different stakeholders, including public health agencies,
government departments, and community organizations
Different programmatic approaches: Different health programs
may use different programmatic approaches, which can make it
difficult to integrate programs effectively
Different planning cycles: Different health programs may have
different planning cycles, which can make it difficult to align
activities and resources
Different monitoring and evaluation systems: Different health
programs may use different monitoring and evaluation systems,
which can make it difficult to measure the impact of integrated
programs
17. Resistance to change: Resistance to change can be a significant challenge to
integrating health programs. Different stakeholders may have different priorities and
resist changes that require them to adapt their roles or responsibilities
18. strategies that can be used
to overcome the
challenges to integration
โข Developing a shared vision: All stakeholders involved
in integration need to have a shared vision of what they
want to achieve
โข Creating a common language: It is important to
develop a common language that all stakeholders can
understand
โข Building trust: Trust between different health services
is essential for successful integration
โข Sharing information: Sharing information between
different health services is essential for providing
patients with the most appropriate care
19. Examples of public health
programs that have
successfully implemented
functional integration:
โข The New York City Department of Health and Mental Hygiene has
integrated its epidemiology, laboratory services, and disease
surveillance functions to improve its ability to detect and respond to
infectious disease outbreaks
โข The Indian Health Service has implemented functional integration by
integrating its primary care and behavioral health services
โข The Centers for Disease Control and Prevention has integrated its
injury prevention and control functions with its chronic disease
prevention and control functions
โข The Oregon Health Authority has implemented functional integration
by integrating its public health and primary care systems
20. Examples of public health
programs that have successfully
implemented horizontal integration:
โข The Integrated Management of Childhood Illness program
is a global initiative that aims to improve the quality of
healthcare for children under 5 years old
โข The Family Planning and HIV Integration program is an
initiative that integrates family planning and HIV/AIDS
prevention and treatment services
โข The Stop TB Partnership is a global initiative that aims to
eliminate tuberculosis as a public health threat
โข The Healthy Start program is a U.S. federal initiative that
aims to improve maternal and infant health outcomes in high-
risk communities
21. The Chronic Care Model is a healthcare delivery model
that aims to improve care for patients with chronic
conditions
The Hospital at Home program is a healthcare delivery
model that provides hospital-level care to patients in
their own homes
The Comprehensive Cancer Control program is a U.S.
federal initiative that aims to reduce the burden of
cancer by implementing strategies to prevent and
control cancer
The Mental Health Integration program is an initiative
that integrates mental health services into primary care
settings
22. Health Extension Program : The Health Extension Program in Ethiopia is
a community-based program that provides basic health services, including
maternal and child health, disease prevention and control, and WASH
Integrated Family Health Program : The Integrated Family Health
Program in Ethiopia is a community-based program that provides a range
of services, including maternal and child health, family planning, nutrition,
and WASH
WASH & NTD : tackling neglected tropical Disease through water
sanitation and hygiene 2019
Community-Based Health Insurance : The Community-Based Health
Insurance program in Ethiopia is a national health insurance program
that provides coverage for a range of health services, including maternal
and child health, disease prevention and control, and WASH
