Neil, I was thinking along the same lines when I saw your comment on the definition of "integrated care". It is quite complex, especially when we think about integrated service provision at a policy and programmatic level, away from an individual patient. And then there are examples of coupling certain health services with other interventions, such as climate change mitigation/adaptation or education.
I attended a session at the International Conference on Family Planning focused on integrated social and behavior change interventions. It was facilitated by Breakthrough Research, a 5-year USAID-funded partnership between Population Council, Tulane School of Public Health, Institute for Reproductive Health at Georgetown, Population Reference Bureau, Avenir Health, and ideas42 [https://www.popcouncil.org/research/breakthrough-research]. The project focuses on building consensus around SBC research agendas, generating evidence, and using that for policy making and programming. I am sure that HIFA members from these partner organizations could say more.
Many interesting questions came out of this discussion:
-Which services/issues package together well? (sequencing/exposure)
-What should be the methodology of integration? User-driven or standardized?
-Where is the integration happening? Can be on individual, community, district level etc.
-How do we prevent information overload? Which accelerator behaviors should we target that affect others?
-Which outcomes do we measure? Cross-cutting or issue-specific? (And then how can we know which elements are cost-effective?)
-How do you set up systems to identify when there might be unintended consequences?
-When is integration too much? Is time a factor? Are there structural barriers, ie in hospitals?
-How do we keep fidelity to the original vision when we scale?
Amelia Plant, MPH
Maternal & Child Health, UC Berkeley
HIFA profile: Amelia Plant is a consultant in sexual & reproductive health research & practice. Projects have included: managing grants to African-based organizations that distribute contraceptives at the community level; surveying the data that links contraceptive use and fertility decline with economic development; co-authoring an online abortion course; and coding and analyzing qualitative data about LGBTQ experiences. Amelia is a member of both the HIFA project on community-health workers and the HIFA project on family planning.¦nbsp; She is originally from the USA and is currently based in Tunis, Tunisia. She is a member of the HIFA working group on Family Planning