Integration of health care delivery. Report of a WHO Study Group.

WHO defines health by use of the term "well-being". Many people have a more limited view, however, seeing health as no more than the absence of illness. This limited view is reflected in the various "vertical" programmes that aim to combat a specific disease or carry out a particular medical intervention. The achievements of vertical programmes have been tremendous in eradicating or reducing disease. But there remains the obvious but very important problem that a programme that deals with one disease has but limited effect when health is influenced by a range of different factors. Health care has to be provided in an integrated manner if it is to have maximum impact in raising health standards. This report by the WHO Study Group on Integration of Health Care Delivery is a frank assessment of ways to achieve a more holistic approach to health promotion and care. This means not just bringing together different elements of the health system but also strengthening health-related activities in other sectors. The report looks at ways countries have tried to do this-some successful and some not so successful. The report proposes a model of an integrated district health care system. It is a model in which different levels of health care and different approaches to health care both coexist and complement each other. A detailed plan of action contains guidelines for health care integration at district, as well as national and international, levels. The report will be useful for policy-makers, planners and all who have responsibility for organizing a health care system that most fully meets the needs of the whole community.