A diagonal approach to building primary healthcare systems in resource‐limited settings: women‐centred integration of HIV/AIDS, tuberculosis, malaria, MCH and NCD initiatives

Abstract

La nécessité d’une intégration des systèmes des soins de santé primaire pour les femmes offrant des services pour les maladies infectieuses et non transmissibles courantes dans les cadres à ressources limitées, est discutée.

Children’s health priorities and interventions

“…Vertical programmes may also provide a platform to incrementally build on other child health priority interventions. 32 Quality of services Poor quality of care is a critical barrier to children's utilisation of health services and to health outcomes in many low and middle income countries. Provision of high quality services for children requires a competent and motivated health workforce, availability of essential medicines and physical resources, evidence based standards of care, an actionable health information system, and a functional referral system.…”

Prevention of mother-to-child HIV transmission within the continuum of maternal, newborn, and child health services

“…While integrated health systems may streamline service provision, reduce stigma, and broaden coverage, in most settings such models cannot address existing gaps in health infrastructure such as staffing shortages and physical space (22). Integrated health approaches themselves require investment, perhaps leveraged through existing resources for HIV care (23, 24), to realize their full potential.…”

Beyond vertical and horizontal programs: a diagonal approach to building national immunization programs through measles elimination

“…Some countries have attempted to use the resources provided for a vertical program to enhance their platforms for delivering comprehensive preventive and therapeutic care. The term 'diagonal approach' has been used to describe this approach by Sepulveda, Frenk, and others [3][4][5][6]. In Mexico, multiple 'vertical' interventions were integrated into the health system over a period of 25 years and had a clear impact on reducing mortality in children [3,4].…”

“…In Mexico, multiple 'vertical' interventions were integrated into the health system over a period of 25 years and had a clear impact on reducing mortality in children [3,4]. Examples of leveraging the platform provided by vertical programs to deliver other services include targeting HIV control programs in sub-Saharan Africa to integrate breast and cervical cancer prevention services and building up a comprehensive HIV treatment program in Haiti, resulting in a revitalized health-care structure in 2003 [5][6][7][8].…”