Expert Insight

Integrating vertical programs into primary health care

Is it always best to integrate vertical programs with primary health care (PHC)? When? Which ones — or which parts of ones? And what are the risks?

In a new report, authors from Results for Development, PSI, and Databoom investigated whether, when, and how integrating vertical programs into PHC can result in more efficient and effective health services. They also explored efforts to more fully ingrate family planning services into PHC in Ghana and Malawi.

The paper offers practical guidance for policymakers who need to make decisions about whether and how to integrate specific vertical programs into their country’s 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 uses the PHC Conceptual Framework to characterize the relationship between a vertical program and the broader system and explores the potential opportunities and constraints that come with integration. The Annex includes brief case studies from South Africa and Ethiopia illustrating how the PHC Conceptual Framework can help policymakers understand integration efforts. Two other, more detailed case studies about ongoing integration efforts in Ghana and Malawi are also presented.