Recap: Integrating Health Services- Where to Next?
By Cristina Bisson, Senior Health Systems Strengthening Specialist
RTI was pleased to welcome a wide range of international health professionals and others to its Washington D.C. office on March 17 for a panel discussion exploring areas of action and measurement on integrated health services. It was a rich and engaging discussion both in-person and online at #IntegrateHealth. If you were unable to attend or wish to review the discussion, you may watch the full recording of the event below, including audience Q&As. Here are a few of our top takeaways from the event.
1. Integrated service delivery is not a ‘new’ topic, but there are important distinctions between past and current conversations. A main difference is that the focus is now where it should be — on the patient. Efforts to integrate health services are increasingly focused on the end user, as opposed to the process of how care is operationalized. Edward Kelley, Director of the Service Delivery and Safety, Health Systems and Innovation Cluster for the World Health Organization (WHO), gave an engaging overview of the people-centered approach to integration. It starts around 7 minutes — and check out the graphic he shows at about 22 minutes!
2. Information technologies must be leveraged to simplify integration, break down its apparent complexities, help us determine which interventions may have the greatest programmatic impact, and most importantly, support the delivery of quality care. Gina Lagomarsino, CEO of Results for Development (R4D), discussed primary health care and the benefits for the patient and the provider, as well as the relevance of data and information and communication technologies. We particularly appreciated Gina’s words:
We’re too focused on pushing data upstream versus downstream, and we should be focused on creating technologies and systems to help health workers treat their patients and for patients to navigate their own health needs.
RTI’s Doris Rouse went on to focus on a presentation about MANDATE, a health information technology platform that provides policy makers with an understanding of the impact of maternal and neonatal health interventions on morbidity and mortality. This all starts around 50 minutes in the video.
3. One of the main challenges of integration is financing — both at the end user and system level. While it’s logical to think that integrated services are more cost-efficient, careful attention must be paid to both the burden placed on the health workforce and the quality of services. At the same time, we know we will never reach goals on universal health coverage if services are not financially accessible to the end user. To confront this challenge, we need to strengthen policy level discussions to ensure that quality of care across the public and private sectors is accessible to all.
4. During the Q&A, Dr. Kelley made the point that in the case of health service integration, talk is useful. Yes, there is lingo and jargon surrounding integrated service delivery, but there is a need for the global health community to continue to advocate for attention to the area. It’s also important to more clearly refine and measure concepts to ensure that integrated service delivery sets out to achieve impact towards more efficient, safe, equitable, and cost effective services.
Many other points came up that deserve to be explored further, including the dynamics around vertical/diagonal/integrated health programming, the integration of non-communicable diseases into health services, public-private partnerships, and governance as a supportive mechanism for integrated service delivery. There was a clear appetite in the room for discussions to be continued.
I look forward to continued dialogue, joint advocacy, and country support for integrated service delivery, coupled with a constant link to metrics that enable us to show the successes, challenges and impact of integrated service delivery.
To learn more about RTI’s work in health systems strengthening, please visit http://www.rti.org/practice-area/global-health