There is still remarkably little empirical evidence available about integration of services to guide policy makers, program managers, those providing technical assistance, and those responsible for financing health care. The following questions are critical, but the answers remain largely unknown, or are uncertain in a particular country or program context:
- Which service combinations are feasible?
- Which services are acceptable to clients and providers?
- Which services can effectively increase access to one or both services without compromising the quality or safety of their delivery?
- Does their joint provision lead to a synergistic impact on both the individual client’s health status and that of the population served?
Over time, a number of methodologies for undertaking what are known as health facility assessments (HFAs) of service delivery have been developed and field-tested, but none of these focus specifically on measurement of the integration of services. This handbook presents a methodology that seeks to address this gap.